Displaying publications 1 - 20 of 28 in total

  1. Mumtaz M, Lim SL, Khaw CH, Mohd Khir AS
    Malays J Med Sci, 2009 Jan;16(1):25-33.
    PMID: 22589645
    Graves' disease is a common cause of hyperthyroidism. Treatment options for Graves' disease include antithyroid medication, surgery or radioactive iodine (I-31) or RAI. This review will focus on the approach to RAI therapy; discussing dose selection, patient preparation, and consideration before and after administering RAI, examining aspects of pre-treatment with antithyroid medication as well as discussing possible adverse events including hypothyroidism and possible worsening of thyroid-associated opthalmopathy. Follow-up is lifelong with the aim of ensuring the patient remains euthyroid or on replacement therapy if there is evidence of hypothyroidism. While there are controversies in treatment of thyrotoxicosis with RAI, with appropriate patient selection and regular follow-up, radioiodine is a safe and effective modality in achieving high cure rates.
    Matched MeSH terms: Iodine Radioisotopes*
  2. Ng AH, Alqahtani MS, Jambi LK, Bugby SL, Lees JE, Perkins AC
    Br J Radiol, 2019 Jun;92(1098):20190020.
    PMID: 30864832 DOI: 10.1259/bjr.20190020
    OBJECTIVE: To examine the imaging capability of a novel small field of view hybrid gamma camera (HGC) using 125I seeds prior to surgical use.

    METHODS: The imaging performance of the camera system was assessed quantitatively and qualitatively at different source depths, source to collimator distances (SCD), activity levels, acquisition times and source separations, utilising bespoke phantoms.

    RESULTS: The system sensitivity and spatial resolution of the HGC for 125I were 0.41 cps/MBq (at SCD 48 mm) and 1.53 ± 0.23 mm (at SCD 10 mm) respectively. The camera was able to detect the 125I seed at a SCD of 63 mm (with no scattering material in place) in images recorded within a 1-min acquisition time. The detection of the seeds beneath scattering material (simulating deep-seated tumours) was limited to depths of less than 20 mm beneath the skin surface with a SCD of 63 mm and seed activity of 2.43 MBq. Subjective assessments of the hybrid images acquired showed the capability of the HGC for localising the 125I seeds.

    CONCLUSION: This preliminary ex vivo study demonstrates that the HGC is capable of detecting 125I seeds and could be a useful tool in radioactive seed localisation with the added benefit of providing hybrid optical γ images for guiding breast conserving surgery.

    ADVANCES IN KNOWLEDGE: The SFOV HGC could provide high resolution fused optical-gamma images of 125I radioactive seeds indicating the potential use in intraoperative surgical procedure such as RSL.

    Matched MeSH terms: Iodine Radioisotopes/analysis*
  3. Zanial AZ, Hamzah F
    Thyroid disorders could be broadly categorised into benign and malignant diseases. Approaches for the
    management of benign and malignant thyroid disorders have been well documented including the treatment
    using radioactive iodine (RAI). RAI has long been used to treat hyperthyroidism and well differentiated
    thyroid cancer. Nevertheless, there are various factors that may influence the outcome of RAI treatment
    including matters related to patient preparations. Thus, healthcare personnel play an important role in
    assisting patients to make the necessary preparations. This article aims to give nurses and clinicians of
    various specialities an insight into the overview of RAI treatment for thyroid disorders particularly in
    Malaysia and further discusses the issues related to preparations of patients.
    Matched MeSH terms: Iodine Radioisotopes
  4. Sulaiman BT, Clarke SE
    Med J Malaysia, 1996 Mar;51(1):131-3.
    PMID: 10967992
    A total of 10 volunteers were monitored for radiation doses, whose spouses were given radio-iodine (131I) orally. Nine of the spouses were given radio-iodine for Graves' disease and one for thyroid carcinoma. It was found that the highest radiation dose received by the volunteer was only 13.5% of the annual dose limit for individual members of the public. Hence, patients treated with radio-iodine do not pose a significant radiation hazard to the public.
    Matched MeSH terms: Iodine Radioisotopes/therapeutic use*
  5. Wong HH, Pang NTP
    BMJ Case Rep, 2021 Oct 14;14(10).
    PMID: 34649855 DOI: 10.1136/bcr-2021-242333
    A woman in her 30s with underlying Graves' disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient's own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible.
    Matched MeSH terms: Iodine Radioisotopes
  6. Zaini A, Ngan A, Paramsothy M, Khoo BH, Ch'ng SL
    Med J Malaysia, 1983 Dec;38(4):331-3.
    PMID: 6599994
    Matched MeSH terms: Iodine Radioisotopes/adverse effects*; Iodine Radioisotopes/therapeutic use
  7. Khalid BA, Ng ML
    Ann Acad Med Singap, 1991 Mar;20(2):273-6.
    PMID: 1883189
    Thyroid eye disease is autoimmune in nature and associated with Graves' Disease. Autoantibodies to the 64 kDa antigen in thyroid membranes cross-react to the 64 kDa proteins in human eye muscle membranes. Antibody dependent cell mediated cytotoxicity against eye muscle cells are also found in patients with thyroid eye disease. The purpose of this paper is to review the treatment available and to share the authors' experience using cyclosporin A. In the majority of cases, thyroid eye disease is mild, manifest only as bilateral or unilateral proptosis, with/without grittiness of the eyes. This is usually treated conservatively with eye drops. If proptosis is more severe and there is incomplete closure of eyelids, epiphora and conjunctival injection, then lateral tarrsorrhaphy is usually effective, combined with use of eye pads and eye drops. The problem of diplopia can be treated conservatively with special lenses, or with surgical correction of tethered muscles. However when proptosis is severe, with raised intraocular pressure, severe chemosis and danger of blindness, then the choice of therapy is controversial: rapid decompression by surgical means or use of high doses of prednisolone. Most prefer prednisolone therapy initially, surgical decompression if it fails. Various other methods have been tried, aimed at the immunological nature of the disease, namely plasmapheresis, radiotherapy and immunosuppressive drugs such as cyclosporin, with variable success. Our experience with cyclosporin had been mixed and inconclusive.
    Matched MeSH terms: Iodine Radioisotopes/administration & dosage; Iodine Radioisotopes/therapeutic use
  8. Dharmalingam SK, Narasimha K
    Med J Malaya, 1972 Sep;27(1):73-6.
    PMID: 4264829
    Matched MeSH terms: Iodine Radioisotopes
  9. Cheen Hoe AK, Fong LY, Halim FNA, Fatt QK, Hamzah F
    World J Nucl Med, 2018 7 24;17(3):182-187.
    PMID: 30034283 DOI: 10.4103/wjnm.WJNM_59_17
    Radioiodine (131I) therapy is the mainstay of treatment for patients who had undergone total thyroidectomy for well differentiated thyroid carcinoma. Increased fluid intake has always been encouraged to minimize the risk of non-target organ exposure to I-131radiation. This study aimed to determine the minimum amount of fluids needed for patients to have the fastest time to achieve permissible level for release after high dose I-131therapy.

    METHODOLOGY: All the patients who were treated with high dose I-131from 18th January 2016 till 31st December 2016 in Hospital Pulau Pinang, Malaysia were recruited. The data from 126 patients on thyroxine hormone withdrawal (THW) group and 18 patients on recombinant human thyroid stimulating hormone (rhTSH) group were analysed. There is no change in patient management in terms of preparation, dose or post therapy whole-body scan. Fluid intake of patients were monitored strictly and whole-body retention of I-131are measured using ionizing chamber meter immediately after ingestion of I-131then at 1 hour, 24 hours, 48 hours, 72 hours and 96 hours.

    RESULTS: The median time to achieve permissible release limit (50 μSV/hr at 1 meter) was 21.6 hours and 22.1 hours post-ingestion of I-131in the THW and rhTSH group respectively. The minimum amount of fluid needed to reach permissible release limit in the fastest time was 2,103 ml and 2,148ml for the THW and TSH respectively.

    CONCLUSION: Clinicians would be able to evidently advise their patient on the amount of fluid to consume and utilize their isolation wards faster to treat more patients.

    Matched MeSH terms: Iodine Radioisotopes
  10. Mohd Shaiful Nizam Mamat Nasir, Bathma Dhevi Susibalan, Muhammad Nasri Abu Bakar, Suhaimi Yusof, Arfahiza Selimin, Kahairi Abdullah, et al.
    Primary thyroid lymphoma is a relatively uncommon pathology of the thyroid gland that mainly occurs in elderly females. We describe a rare case of B-cell thyroid lymphoma in a young healthy male. It is an important diagnosis to be considered in patients presenting with a rapidly enlarging neck mass as its management is different from other differentiated thyroid carcinoma which require total thyroidectomy plus adjuvant radioactive iodine ablation. Our report emphasizes the need for clinical awareness leading to early detection, followed by early multidisciplinary management.
    Matched MeSH terms: Iodine Radioisotopes
  11. Aliyu AS, Evangeliou N, Mousseau TA, Wu J, Ramli AT
    Environ Int, 2015 Dec;85:213-28.
    PMID: 26425805 DOI: 10.1016/j.envint.2015.09.020
    Since 2011, the scientific community has worked to identify the exact transport and deposition patterns of radionuclides released from the accident at the Fukushima Daiichi Nuclear Power Plant (FDNPP) in Japan. Nevertheless, there still remain many unknowns concerning the health and environmental impacts of these radionuclides. The present paper reviews the current understanding of the FDNPP accident with respect to interactions of the released radionuclides with the environment and impacts on human and non-human biota. Here, we scrutinize existing literature and combine and interpret observations and modeling assessments derived after Fukushima. Finally, we discuss the behavior and applications of radionuclides that might be used as tracers of environmental processes. This review focuses on (137)Cs and (131)I releases derived from Fukushima. Published estimates suggest total release amounts of 12-36.7PBq of (137)Cs and 150-160PBq of (131)I. Maximum estimated human mortality due to the Fukushima nuclear accident is 10,000 (due to all causes) and the maximum estimates for lifetime cancer mortality and morbidity are 1500 and 1800, respectively. Studies of plants and animals in the forests of Fukushima have recorded a range of physiological, developmental, morphological, and behavioral consequences of exposure to radioactivity. Some of the effects observed in the exposed populations include the following: hematological aberrations in Fukushima monkeys; genetic, developmental and morphological aberrations in a butterfly; declines in abundances of birds, butterflies and cicadas; aberrant growth forms in trees; and morphological abnormalities in aphids. These findings are discussed from the perspective of conservation biology.
    Matched MeSH terms: Iodine Radioisotopes/analysis
  12. Zaini A, Khir A, Doi SA, Chan SP, Paramsothy M, Khoo BH
    J Int Med Res, 1992 Jun;20(3):279-88.
    PMID: 1397673
    To evaluate the effects of simple compensated fixed-dose iodine-131 therapy for thyrotoxicosis, the long-term results for 74 patients treated with a fixed dose of iodine-131 ranging from 5 to 12 mCi (185 to 444 MBq) were evaluated in the first 2 years of a trial. The dose selected was loosely based on the gross size of the thyroid gland. Routine antithyroid drug therapy was given for a minimum of 3 months after iodine-131 therapy. The mean (+/- SD) duration of follow-up was 74.5 +/- 42 months. The results indicated that roughly 25% of patients treated in this way will become hypothyroid after 5 years and that 85% are cured (need no further therapy during the follow-up period) using a single dose of iodine-131. Of those cured using a single iodine-131 dose, 81% were no longer receiving drugs after 6 months and 85% after 1 year. Such a regimen seems currently to be among the best available where prolonged periods of medication-free euthyroidism after therapy are sought.
    Matched MeSH terms: Iodine Radioisotopes/therapeutic use*
  13. Sundram F
    Biomed Imaging Interv J, 2006 Oct;2(4):e56.
    PMID: 21614336 MyJurnal DOI: 10.2349/biij.2.4.e56
    The incidence of thyroid cancer is low, but when it occurs, it is mainly of the papillary histopathological type. Although PET/CT has a limited role in the diagnosis, it plays a significant role in the overall post-surgery management of a patient with thyroid cancer. This follow-up role is important, especially in patients with elevated serum thyroglobulin, but negative radioiodine whole body scans. There is increasing evidence that PET/CT should be a part of routine care in the Tg positive Radioiodine scan negative patient.
    Matched MeSH terms: Iodine Radioisotopes
  14. Wong TH, Amir Hassan SZ
    Med J Malaysia, 2015 Dec;70(6):356-7.
    PMID: 26988209
    This is a case of follicular thyroid carcinoma with extensive lung, bone and brain metastases. Multi-modality treatments including total thyroidectomy, modified radical neck dissection, cranial radiotherapy and Iodine-131 (RAI) therapy were instituted. Post RAI therapy planar whole body scan showed RAI avid metastases in the skull, cervical spine, bilateral lungs and abdomen. With the use of SPECTCT imaging, rare adrenal metastasis and additional rib metastasis were identified. Besides, management strategy was altered due to detection of non-RAI avid brain and lung metastatic lesions.
    Matched MeSH terms: Iodine Radioisotopes
  15. Zainuddin Z, Shaker AAH
    Family Physician, 2005;13(3):2-4.
    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
  16. 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
  17. 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
  18. Cunningham IG, Yong NK
    Br J Surg, 1974 Jun;61(6):482-3.
    PMID: 4835202
    Matched MeSH terms: Iodine Radioisotopes
  19. 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
  20. 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*
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