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The incidence of postoperative deep vein thrombosis in Malaysia

Cunningham IG, Yong NK

Br J Surg, 1974 Jun;61(6):482-3.
PMID: 4835202
Matched MeSH terms: Iodine Radioisotopes
A rare case of minimally invasive follicular thyroid cancer with intraluminal superior vena cava and right atrium metastases

Khoo ACH, Chen SL

World J Nucl Med, 2019 9 14;18(3):301-303.
PMID: 31516376 DOI: 10.4103/wjnm.WJNM_43_18

Follicular thyroid cancers are known to spread hematogenously to the bones and lungs and rarely presenting with massive angioinvasion. We report a case of a middle-aged female who had undergone total thyroidectomy for minimally invasive follicular thyroid cancer with angioinvasion in 2014. She was noted to have a large tumor thrombus extending from the superior vena cava to the right atrium on whole body scan post-Iodine-131 (131I) remnant ablation therapy. We discuss the various imaging modalities, treatment options, and difficulties in managing such massive angioinvasion in patients with well-differentiated thyroid cancers.

Matched MeSH terms: Iodine Radioisotopes
Hyperthyroidism in pregnancy

Zainuddin Z, Shaker AAH

Family Physician, 2005;13(3):2-4.
MyJurnal

Thyroid diseases are common in women, including at the time of pregnancies. Many typical features of hyperthyroidism are common in normal pregnancies and this may delay or mask the diagnosis. Uncontrolled thyrotoxicosis increases the rate of miscarriage, intrauterine growth restriction (IUGR), premature labour and perinatal mortality. Multi-disciplinary efforts are required to achieve optimal control of thyrotoxicosis. Anti-thyroid drugs are safe and should be used with the lowest possible doses. Radioiodine treatment is contraindicated during pregnancy and lactation. Indications of surgery include: compression symptoms, thyroid malignancy, non-compliance to medications or when the patient develop drugs side effects

Matched MeSH terms: Iodine Radioisotopes
Features of post-radioiodine whole body scan in non-invasive Follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP)

Wong TH, Tan TH, Chin SC, Lee BN

Med J Malaysia, 2018 06;73(3):181-182.
PMID: 29962506

Recently, encapsulated follicular variant of papillary thyroid carcinoma has been reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) to emphasize the benign nature of this entity. In our institution, we have assessed 455 patients treated with radioiodine ablation for differentiated thyroid carcinoma and 20 of them were retrospectively found to fulfill the new NIFTP criteria. There was no evidence of metastasis on post radioiodine whole body scans for NIFTP cases and these patients were in remission subsequently. The benign features of these patients' whole body scans and good clinical outcome following treatment further support NIFTP as a low risk thyroid neoplasm.

Matched MeSH terms: Iodine Radioisotopes
Staff and ambient radiation dose resulting from therapeutic nuclear medicine procedures

Alkhorayef M, Sulieman A, Mohamed-Ahmed M, Al-Mohammed HI, Alkhomashi N, Sam AK, et al.

Appl Radiat Isot, 2018 Nov;141:270-274.
PMID: 30145016 DOI: 10.1016/j.apradiso.2018.07.014

With associated cure rates in excess of 90%, targeted 131I radioactive iodine therapy has clearly improved thyroid cancer survival. Thus said, potential radiation risks to staff represent a particular concern, current study seeking to determine the radiation exposure of staff from 131I patients during hospitalization, also estimating accumulated dose and related risk to staff during preparation of the radioactive iodine. In present study made over the three-month period 1st February to 1st May 2017, a total of 69 patient treatments were investigated (comprising a cohort of 46 females and 23 males), this being a patient treatment load typically reflective of the workload at the particular centre for such treatments. The patients were administered sodium iodide 131I, retained in capsules containing activities ranging from 370 to 5550 MBq at the time of calibration, radioiodine activity depends on many factors such as gender, clinical indication, body mass index and age. The staff radiation dose arising from each patient treatment was measured on three consecutive days subsequent to capsule administration. In units of µSv, the mean and dose-rates range at distances from the patients of 5 cm, 1 m and 2 m were 209 ± 73 (165-294), 6.8 ± 2 (5.3-9.5) and 0.9 ± 0.3 (0.7-1.2). The annual dose (also measured in units of µSv), based on annual records of doses, for medical physicists, technologists and nurses were 604, 680 and 1000 µSv respectively. In regard to current practice and workload, staff exposures were all found to be below the annual dose limit for radiation workers.

Matched MeSH terms: Iodine Radioisotopes
Fulltext Papillary Thyroid Carcinoma Presenting with Chronic Cough and Hemoptysis in Primary Care: A Case Report

Abd Hamid MF, Abdul Razak S, Azraai AM, Miptah HN

Am J Case Rep, 2023 Nov 10;24:e941089.
PMID: 37946402 DOI: 10.12659/AJCR.941089

BACKGROUND The article discusses an unusual case of papillary thyroid carcinoma in which chronic cough and hemoptysis were the predominant symptoms. While the more common causes of hemoptysis are pulmonary in origin, extrapulmonary etiologies have been reported, including thyroid carcinoma. The clinical presentation of thyroid malignancy in this case mimics many other common disorders, such as pulmonary tuberculosis, bronchogenic carcinoma, bronchiectasis, and chronic obstructive pulmonary disease. Hence, making it challenging to suspect early when patients present to primary care. CASE REPORT A 54-year-old woman presented with a chronic cough and hemoptysis in our Primary Care Medicine Clinic. While initial assessments in the primary care medicine clinic yielded no remarkable findings, a subsequent high-resolution computed tomography scan of the thorax uncovered a thyroid lesion. Subsequent evaluation in the hospital setting included an ultrasound examination, revealing multiple thyroid nodules, and fine needle aspiration that confirmed papillary thyroid carcinoma. She underwent total thyroidectomy with central and left lateral neck dissection, complicated by left vocal cord palsy. She received 2 cycles of periodic radioactive iodine therapy and injection laryngoplasty postoperatively. There was no evidence of iodin avid disease and recurrence of hemoptysis after surgery. CONCLUSIONS This case report emphasizes the significance of considering papillary thyroid carcinoma when assessing hemoptysis in the primary care setting, as early detection and treatment of it would result in a better outcome.

Matched MeSH terms: Iodine Radioisotopes
Incidental Finding of Endometrioid Adenocarcinoma of the Ovary on 131I Whole-Body Scan

Mohd Rohani MF, Amir Hassan SZ

Clin Nucl Med, 2022 Jan 01;47(1):e20-e22.
PMID: 34028418 DOI: 10.1097/RLU.0000000000003698

A 57-year-old woman was referred for radioactive iodine therapy 12 weeks after completion thyroidectomy and left modified radical neck dissection for pT2N1Mx follicular variant papillary thyroid carcinoma. After 4 weeks of l-thyroxine withdrawal, stimulated serum thyroglobulin level was less than 0.1 ng/mL with positive thyroglobulin antibody. Posttherapy 131I scintigraphy with SPECT/CT of the head and abdominopelvic region showed thyroid residual in the neck, occipital bone metastasis, and heterogenous tracer uptake in a large peritoneal mass, likely arising from the left ovary. Left salpingo-oophorectomy was performed, and histopathologic examination revealed endometrioid carcinoma of left ovary.

Matched MeSH terms: Iodine Radioisotopes
Fulltext Cardiac Iodine-123-Meta-Iodo-Benzylguanidine Uptake in Carotid Sinus Hypersensitivity

Tan MP, Murray A, Hawkins T, Chadwick TJ, Kerr SR, Parry SW

PLoS One, 2015;10(6):e0126241.
PMID: 26057525 DOI: 10.1371/journal.pone.0126241

Carotid sinus syndrome is the association of carotid sinus hypersensitivity with syncope, unexplained falls and drop attacks in generally older people. We evaluated cardiac sympathetic innervation in this disorder in individuals with carotid sinus syndrome, asymptomatic carotid sinus hypersensitivity and controls without carotid sinus hypersensitivity.

Matched MeSH terms: Iodine Radioisotopes/metabolism*
Pre-ablative diagnostic whole-body scan following total thyroidectomy for well-differentiated thyroid cancer: is it necessary?

Teoh CM, Rohaizak M, Chan KY, Jasmi AY, Fuad I

Asian J Surg, 2005 Apr;28(2):90-6.
PMID: 15851360

This study reviewed the incidence of positive pre-ablative diagnostic scan after total thyroidectomy and the efficacy of the current ablative dose. The predictive factors for outcome using a standard ablative dose and postoperative complications of total thyroidectomy were also examined.

Matched MeSH terms: Iodine Radioisotopes/therapeutic use
The quantification of PET-CT radiotracers to determine minimal scan time using quadratic formulation

Said MA, Musarudin M, Zulkaffli NF

Ann Nucl Med, 2020 Dec;34(12):884-891.
PMID: 33141408 DOI: 10.1007/s12149-020-01543-x

OBJECTIVE: 18F is the most extensively used radioisotope in current clinical practices of PET imaging. This selection is based on the several criteria of pure PET radioisotopes with an optimum half-life, and low positron energy that contributes to a smaller positron range. In addition to 18F, other radioisotopes such as 68Ga and 124I are currently gained much attention with the increase in interest in new PET tracers entering the clinical trials. This study aims to determine the minimal scan time per bed position (Tmin) for the 124I and 68Ga based on the quantitative differences in PET imaging of 68Ga and 124I relative to 18F.
METHODS: The European Association of Nuclear Medicine (EANM) procedure guidelines version 2.0 for FDG-PET tumor imaging has adhered for this purpose. A NEMA2012/IEC2008 phantom was filled with tumor to background ratio of 10:1 with the activity concentration of 30 kBq/ml ± 10 and 3 kBq/ml ± 10% for each radioisotope. The phantom was scanned using different acquisition times per bed position (1, 5, 7, 10 and 15 min) to determine the Tmin. The definition of Tmin was performed using an image coefficient of variations (COV) of 15%.
RESULTS: Tmin obtained for 18F, 68Ga and 124I were 3.08, 3.24 and 32.93 min, respectively. Quantitative analyses among 18F, 68Ga and 124I images were performed. Signal-to-noise ratio (SNR), contrast recovery coefficients (CRC), and visibility (VH) are the image quality parameters analysed in this study. Generally, 68Ga and 18F gave better image quality as compared to 124I for all the parameters studied.
CONCLUSION: We have defined Tmin for 18F, 68Ga and 124I SPECT CT imaging based on NEMA2012/IEC2008 phantom imaging. Despite the long scanning time suggested by Tmin, improvement in the image quality is acquired especially for 124I. In clinical practice, the long acquisition time, nevertheless, may cause patient discomfort and motion artifact.

Matched MeSH terms: Iodine Radioisotopes/chemistry
Fulltext Radionuclide therapy of hepatocellular carcinoma

Sundram F

Biomed Imaging Interv J, 2006 Jul;2(3):e40.
PMID: 21614248 MyJurnal DOI: 10.2349/biij.2.3.e40

Hepatocellular carcinoma (HCC) is a malignant tumour of the hepatocyte. It is a common malignancy worldwide and causes almost half a million deaths annually. Asia is a high risk area. Although surgery (hepatectomy or liver transplantation) is the main form of curative treatment, the majority of patients are not eligible for surgery due to extent of tumour and dysfunction of liver. Radiopharmaceuticals used for transarterial treatment of HCC were Yttrium-90 microspheres, Iodine-131 lipiodol, Rhenium-188 lipiodol, and Holmium-166 Chitosan complex. Yittrium-90 microspheres are glass or resin microspheres of mean sphere diameter of 20 to 30 micrometre. The activity administered was about 4 GBq. Reported response rate was about 20%, and median survival was 54 weeks. On inoperable tumours, reported objective response of I-131 lipiodol was 40 to 70%, and median survival was six to nine months. It showed efficacy similar to TACE. In adjuvant treatment following curative resection of HCC, reported three year survival was 86% compared with 46% for the control group. The administered activity in both adjuvant and inoperable HCC was about 2 GBq (55 mCi). Rhenium-188 lipiodol is a new radioconjugate, and using it we treated 70 patients with inoperable HCC. This treatment was a part of a multi-centre trial sponsored by the International Atomic Energy Agency. Partial response was obtained in 17% of cases, while 49% had stable disease at three months, and 34% showed disease progression. In terms of survival, 19% survived one year, 60% for six months, and 90% for three months. The mean activity was about 4.6 GBq (124 mCi). This method was safe and free from adverse effects.

Matched MeSH terms: Iodine Radioisotopes
Effectiveness of Zinc Supplementation on Lithium-Induced Alterations in Thyroid Functions

Pathak R, Pathak A

Biol Trace Elem Res, 2020 Aug 26.
PMID: 32851540 DOI: 10.1007/s12011-020-02356-9

Lithium is an integral drug used in the management of acute mania, unipolar and bipolar depression, and prophylaxis of bipolar disorders. Thyroid abnormalities have been associated with treatment with lithium. Zinc is an essential trace element that plays a role in several biological activities. Therefore, the present study was aimed at investigating the potential role of zinc in the thyroid gland following lithium administration to explore the role of zinc under such conditions. To achieve this goal, male Wistar rats (150-195 g) were divided into four groups: Group 1 animals were fed standard pellet feed and tap water ad lib; Group 2 rats were fed lithium in the form of lithium carbonate through diet at a concentration of 1.1 g/kg body weight; Group 3 animals received zinc treatment in the form of zinc sulfate (ZnSO4·7H2O) at a dose level of 227 mg/L mixed with drinking water of the animals; and Group 4 animals were given lithium and zinc in a similar manner as was given to the animals belonging to groups 2 and 4 respectively. The role of zinc on thyroid functions in lithium-treated rats was studied after 2, 4, and 8 weeks of different treatments. Zinc has been observed to have the capability to nearly normalize the altered 2-h uptake of 131I, biological and effective half-lives of 131I, and circulating T4 levels that were altered after lithium treatment. The present study concludes that zinc may be an effective agent in normalizing the adverse effects caused by lithium on thyroid functions.

Matched MeSH terms: Iodine Radioisotopes
Clinical determinants of fluorodeoxyglucose positron emission tomography/computed tomography in differentiated thyroid cancer patients with elevated thyroglobulin and negative (131)iodine whole body scans after (131)iodine therapy

Shamim SE, Nang LB, Shuaib IL, Muhamad NA

Malays J Med Sci, 2014 May;21(3):38-46.
PMID: 25246834

A cross-sectional prospective study has been conducted on differentiated thyroid cancer (DTC) patients using negative (131)Iodine ((131)I) whole body scans and elevated thyroglobulin (Tg) levels. The main objective of this research was to determine the prevalence of the conversion of differentiated to dedifferentiated thyroid cancer patients during follow up at the Hospital Kuala Lumpur. It has been demonstrated that fluorodeoxyglucose (FDG) uptake is inversely proportional to the iodine concentration and to differentiation of the cells.

Matched MeSH terms: Iodine Radioisotopes
Serum thyrotropin levels of natives in Sarawak, Borneo Island

Ogihara T, Yamamoto T, Fukuchi M, Oki K

J Clin Endocrinol Metab, 1972 Nov;35(5):711-5.
PMID: 5071341
Matched MeSH terms: Iodine Radioisotopes