[THYROID HEMIAGENESIS: A CASE REPORT].

INTRODUCTION: Thyroid hemiagenesis is a rare congenital anomaly characterized by the absence of one thyroid lobe and the isthmus. This case report presents a 4-year-old girl with a history of prematurity. Incidentally, during a routine ultrasound evaluation of the neck, thyroid hemiagenesis was detected along with the presence of normal lymph nodes. The right thyroid lobe was absent, while the left thyroid lobe was preserved. No previous neck or thyroid surgeries were reported. DISCUSSION: This provides an overview of thyroid hemiagenesis, including its prevalence, predominant involvement of the left lobe, possible genetic and environmental factors, and associations with thyroid and extrathyroidal pathologies. Imaging modalities, such as ultrasound and scintigraphy, play a crucial role in diagnosing thyroid hemiagenesis and identifying additional thyroid gland abnormalities. Long-term follow-up and careful monitoring are recommended to assess thyroid function and identify potential structural abnormalities. The optimal therapeutic approach for thyroid hemiagenesis remains controversial, and further studies are needed to determine the clinical significance and long-term outcomes of this rare condition.

Thyroid US-guided FNA techniques: A prospective,randomized controlled study.

BACKGROUND: Thyroid nodules are common in the general population. Ultrasonography is the most efficient diagnostic approach to evaluate thyroid nodules. The US FNAC procedure can be performed using either the short axis (perpendicular), or a long axis (parallel) approach to visualize the needle as it is advanced toward the desired nodule. The main aim of this study was to compare the percentage of non-diagnostic results between the long and short axis approach. METHODS: A prospective study that included a randomized controlled trial and was divided into two arms-the short axis and the long axis-was conducted. A total of 245 thyroid nodules were collected through the fine needle aspiration cytology, performed with ultrasound, from march 2021 to march 2022. The patient's demographic information were collected and also nodules characteristics. RESULTS: Of 245 nodules sampled, 122 were sampled with the long axis method, while 123 with the short axis method. There is not significantly less non diagnostic approach with either method compared to the other (11.5 % vs 16.3 % respectively). DISCUSSION: Previous studies came to the conclusion that the long axis method yields fewer non diagnostic samples. This study evaluated the two FNA approaches which were proceeded by the same physician who is expert in both techniques. CONCLUSION: The US FNAC performed in the long axis approach will not produce more conclusive results and less non diagnostic results (Bethesda category 1) than the short axis approach one.

Real-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection method.

BACKGROUND: Postoperative hypoparathyroidism caused by parathyroid injury is a problem faced by thyroid surgeons. The current technologies for parathyroid imaging all have some defects. METHODS: Patients with differentiated thyroid carcinoma (DTC) who underwent unilateral thyroidectomy plus ipsilateral central lymph node dissection were recruited. We dissected the main trunk of the superior thyroid artery entering the thyroid gland and placed the venous indwelling tube into the artery. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated. RESULTS: A total of 132 patients enrolled in this single-arm clinical trial, 105 of them completed retrograde catheterization via the superior artery. The sensitivity was 69.23 and 83.33% respectively. The specificity was 72.91 and 64.89%. The accuracy was 72.91 and 64.89%. The PPV was 85.71 and 81.08%. The NPV was 22.58 and 45.45%. There were no patients with allergic reactions to the methylene blue, or methylene blue toxicity. CONCLUSIONS: Retrograde injection of methylene blue via the superior thyroid artery is an effective and safe method to visualize parathyroid glands. This method can accurately locate the target organ by ultraselecting the blood vessel and injecting the contrast agent while avoiding background contamination and reducing the amount of contrast agent. TRIAL REGISTRATION: Clinical trial registration numbers and date of registration: ChiCTR2300077263、02/11/2023.

Autofluorescence-guided hemithyroidectomy in a low-volume thyroid institution with no experience in parathyroid surgery: randomized clinical trial.

BACKGROUND: Recent studies suggest that low-volume surgeons with no experience in parathyroid surgery are at increased risk of causing parathyroid gland damage during thyroid surgery. The aim of this RCT was to evaluate the impact of using autofluorescence in hemithyroidectomy on parathyroid gland identification and preservation in a low-volume institution with no experience in parathyroid surgery. METHODS: Patients referred for hemithyroidectomy were randomized 1 : 1 to either autofluorescence-guided hemithyroidectomy (the near-infrared autofluorescence group) or conventional hemithyroidectomy (the control group). The primary outcome was parathyroid gland identification rate. Secondary outcomes were the rate of parathyroid gland autotransplantation and the rate of inadvertent parathyroid gland excision. RESULTS: A total of 170 patients were randomized to either autofluorescence-guided hemithyroidectomy (84 patients) or conventional hemithyroidectomy (86 patients). In the near-infrared autofluorescence group, 81.0% of parathyroid glands were identified, compared with 57.0% in the control group (P < 0.001). Autofluorescence enabled parathyroid gland visualization before the naked eye in 46.3% of cases. Surgeons had lower confidence in the parathyroid gland identification process in the control group than in the near-infrared autofluorescence group (59.1% versus 87.5% respectively; P < 0.001). In the near-infrared autofluorescence group, the parathyroid gland autotransplantation rate was initially high, but declined over time. There was no difference in the rate of inadvertent parathyroid gland excision. CONCLUSION: Autofluorescence guidance significantly improved the parathyroid gland identification rate in hemithyroidectomy in a low-volume institution with no experience in parathyroid surgery and provided an increase in surgical confidence. The pattern of parathyroid gland autotransplantation in autofluorescence-guided surgery indicates the presence of a learning curve. REGISTRATION NUMBER: NCT05044351 (http://www.clinicaltrials.gov).

Damage to the parathyroid glands is common during thyroid surgery. The main reason for that is that they can be difficult to see during surgery. The aim of this study was to see if the use of a new near-infrared camera during thyroid surgery could make it easier to see the parathyroid glands. Patients, where removal of part of their thyroid gland was planned, were randomly assigned to one of two groups. In the first group, the near-infrared camera was used, whereas it was not used in the other group. When the near-infrared camera was used, more parathyroid glands were found and the surgeons felt more secure in their handling of parathyroid glands.

Giant cell tumor of soft tissue involving thyroid gland: a case report and review of the literature.

BACKGROUND: Giant cell tumor of soft tissue is a low malignant uncommon neoplasm, with histologic features and immunophenotype similar to its bone counterpart. Primary giant cell tumor of soft tissue in the thyroid gland is considered an exceedingly rare entity. CASE PRESENTATION: We describe a case of primary thyroid giant cell tumor of soft tissue in a 69-year-old Chinese female patient. Neck ultrasonography showed a 19 mm × 12 mm × 5 mm nodule with heterogeneous echo and clear boundary located within the left thyroid. Histopathological examination revealed that the neoplasm was composed of two morphological components, mononuclear cells admixed with multinucleated osteoclast-like giant cells. Immunohistochemically, the tumor cells were positive for CD68 and vimentin, but were negative for epithelial membrane antigen, cytokeratin, and additional muscle markers. She underwent left unilateral thyroidectomy, and total thyroidectomy was performed for local recurrence 3 months later. The patient remained well without recurrence or metastasis following up for 12 months. CONCLUSION: The significance of this case lies in its rarity, the challenge of preoperative clinical diagnosis, and the differential diagnosis with other malignancies.

Evaluation of the thyroid gland vascularity during pregnancy using 2-dimensional color Superb Microvascular Imaging vascularization index technique.

PURPOSE: We aimed to investigate maternal thyroid parenchymal vascularity with 2-dimensional color superb microvascular imaging vascularization index (2D-cSMIVI) levels and thyroid gland volume in the first, second and third trimesters. METHODS: This longitudinal prospective study was carried out with participants selected from 30 healthy asymptomatic pregnant women. Ultrasonography (US) for the thyroid gland was performed in each trimester. The vascularization index (VI) values obtained by manually drawing the contours of the thyroid parenchyma in the longutidinal plane, using the free region of interest (ROI) with 2DcSMIVI mode. VI values obtained in each trimester, thyroid hormone levels (TSH, T3, T4) and thyroid volumes were compared. RESULTS: We have detected that thyroid gland vascularity increased significantly as pregnancy progresses. The mean VI values of thyroid gland in third trimester were significantly higher than first and second trimester (p < 0.001), and the mean VI values of the thyroid gland in the second trimester were significantly higher than first trimester (p < 0.001). During pregnancy, we detected the increase in VI values, TSH levels and thyroid gland volumes. CONCLUSION: Maternal thyroid gland gray scale findings, parenchymal vascularization, thyroid volumes should be evaluated routinely for the healthy fetal development. 2D-cSMIVI method allows us to evaluate vascularization with quantitative numerical values objectively. We have detected that the VI values and volume of the thyroid gland increases as pregnancy progresses. In the complex situation of pregnancy process, the thyroid gland can be evaluated quantitatively with SMI method effectively.

Three-dimensional visualization of thyroid ultrasound images based on multi-scale features fusion and hierarchical attention.

BACKGROUND: Ultrasound three-dimensional visualization, a cutting-edge technology in medical imaging, enhances diagnostic accuracy by providing a more comprehensive and readable portrayal of anatomical structures compared to traditional two-dimensional ultrasound. Crucial to this visualization is the segmentation of multiple targets. However, challenges like noise interference, inaccurate boundaries, and difficulties in segmenting small structures exist in the multi-target segmentation of ultrasound images. This study, using neck ultrasound images, concentrates on researching multi-target segmentation methods for the thyroid and surrounding tissues. METHOD: We improved the Unet++ to propose PA-Unet++ to enhance the multi-target segmentation accuracy of the thyroid and its surrounding tissues by addressing ultrasound noise interference. This involves integrating multi-scale feature information using a pyramid pooling module to facilitate segmentation of structures of various sizes. Additionally, an attention gate mechanism is applied to each decoding layer to progressively highlight target tissues and suppress the impact of background pixels. RESULTS: Video data obtained from 2D ultrasound thyroid serial scans served as the dataset for this paper.4600 images containing 23,000 annotated regions were divided into training and test sets at a ratio of 9:1, the results showed that: compared with the results of U-net++, the Dice of our model increased from 78.78% to 81.88% (+ 3.10%), the mIOU increased from 73.44% to 80.35% (+ 6.91%), and the PA index increased from 92.95% to 94.79% (+ 1.84%). CONCLUSIONS: Accurate segmentation is fundamental for various clinical applications, including disease diagnosis, treatment planning, and monitoring. This study will have a positive impact on the improvement of 3D visualization capabilities and clinical decision-making and research in the context of ultrasound image.

Synchronous Triplanar Reconstruction Integrated with Color Doppler Mapping for Precise and Rapid Localization of Thyroid Lesions.

This paper proposes a novel thyroid examination technique based on five-dimensional (5D) synchronous reconstruction of ultrasound data. The raw temporal sequences are reconstructed into 3D volumetric data reflecting anatomical structure. Triplanar visualization from three orthogonal planes is realized to provide a systematic inspection of the entire gland. Color Doppler imaging is integrated into each triplanar slice to map vascularity changes. This multi-modal fusion enables synchronous display of structural, functional, and blood flow information in the reconstructed 5D space. Compared to conventional scanning, this technique offers the benefits of flexible offline diagnosis, reduced dependency on scanning, enhanced intuitive interpretation, and comprehensive multi-aspect evaluation. By minimizing oversight errors, it could improve diagnostic accuracy, especially for novice practitioners. The proposed 5D fusion method allows rapid and precise localization of lesions for early detection. Future work will explore integration with biochemical markers to further improve diagnostic precision. The technique has considerable clinical value for advancing thyroid examination.

Ultrasound characteristics of normal parathyroid glands and analysis of the factors affecting their display.

BACKGROUND: Parathyroid glands are important endocrine glands, and the identification of normal parathyroid glands is crucial for their protection. The aim of this study is to explore the sonographic characteristics of normal parathyroid glands and analyze the factors affecting their display. METHODS: Seven hundred three subjects who underwent physical examination at our hospital were included. The number, location, size, morphology, echogenicity and blood flow distribution of parathyroid glands were recorded. The ultrasound characteristics and display rate were also summarized. Meanwhile, shear wave elastography was performed in 50 cases to provide the stiffness measurements, and 26 cases received contrast-enhanced ultrasonography for the assessment of microcirculatory perfusion. Furthermore, we analyzed the factors affecting parathyroid display, including basic information of the subjects and ultrasound features of the thyroid. RESULTS: ① A total of 1038 parathyroid glands were detected, among which, 79.29% were hyperechoic, 20.71% were isoechoic, 88.15% were oval-shaped, and 86.71% had blood flow of grade 0-I. ② 81.79% of the subjects had at least one parathyroid gland detected. ③ The Emean, Emax, PI and AUC of the parathyroid glands were significantly lower than those of the adjacent thyroid tissue (P < 0.05). ④ The display of normal parathyroid glands was related to BMI, thyroid echogenicity and thyroid volume of the subjects (P < 0.05). CONCLUSIONS: Normal parathyroid glands tend to appear as oval-shaped hyperechoic nodules with blood flow of grade 0-I. BMI, thyroid echogenicity and thyroid volume are independent factors affecting the display of parathyroid glands.

Radiation doses in extraoral bitewing radiography compared with intraoral bitewing and panoramic radiography.

OBJECTIVES: We compared the effective dose (E) and thyroid equivalent dose of 2 extraoral bitewing (EOBW) units and compared E with their respective panoramic (PAN) modes and with intraoral bitewing radiography (IOBW). STUDY DESIGN: Child and adult anthropomorphic phantoms with dosimeters were used to evaluate Orthophos SL, Rayscan α+, and 1 intraoral unit using rectangular and circular collimation. Extraoral bitewing thyroid equivalent dose was assessed without and with thyroid shielding. RESULTS: Child and adult E values of EOBW were lower with Orthophos (3.6 and 8.6 µSv) than with Rayscan (28.1 and 30.2 µSv). For IOBW, E was lower with rectangular vs circular collimation for child (7.0 vs 11.8 µSv) and adult (4.6 vs 14.2 µSv). E values of EOBW were lower than PAN for Orthophos. The IOBW E was lower than Rayscan EOBW for child (≤11.8 vs 28.1 µSv) and adult (≤14.2 vs 30.2 µSv). Adult E for rectangular IOBW (4.6 µSv) was lower than EOBW with Orthophos (8.6 µSv) and Rayscan (30.2 µSv). Thyroid shielding reduced EOBW thyroid equivalent dose with Rayscan in the adult from 190.7 to 89.0 µSv. CONCLUSION: Orthophos provides significantly lower EOBW E than Rayscan, thus EOBW recommendations must be unit specific. For children, Orthophos EOBW could be an alternative to IOBW, for which rectangular collimation is recommended. Thyroid shielding reduced adult Rayscan equivalent dose but added imaging artifacts.

Preoperative point-of-care neck ultrasound: beyond the airway.

PURPOSE: A preoperative point-of-care neck ultrasound, carried out during preoperative airway evaluation by extending the scans to the regions close to the larynx and trachea, can allow for the rapid identification of unknown pathologies or abnormalities in a cost-effective and non-invasive manner. This prospective, observational study examines a series of ultrasound findings in structures close to the airway, made through preoperative point-of-care neck ultrasound in a cohort of 230 patients. METHODS: We conducted a prospective observational study, enrolling 230 adult patients selected for elective abdominal surgery. The primary goal was to verify the predictive role of airway ultrasound in identifying difficult airways, while the secondary goal was to evaluate structures close to the airway such as jugular veins, carotid arteries, thyroid gland and soft tissues. RESULTS: Overall, preoperative point-of-care neck ultrasound proved to be an effective and reliable method of obtaining details about local or systemic pathologies, which could affect perioperative care. For example, the exam consistently revealed the presence of carotid plaques or venous congestion, which could be used to best determine the patient's cardiovascular risk or to instigate further investigations. It also allowed for more accurate central venous catheter placement planning and better airway management and it warned about possible thyroid or neoplastic pathologies that would have otherwise remained unknown. In some cases, information from preoperative point-of-care neck ultrasound has even led to modifications in perioperative therapy. CONCLUSION: Preoperative point-of-care neck ultrasound is fast, inexpensive, and non-invasive, and it can be easily performed by a properly trained professional during the preoperative airway ultrasound evaluation. It can be considered as a new preoperative assessment tool.

[Standardized acquisition and documentation of cine loops on conventional thyroid ultrasound]. / Standardisierte Akquisition und Dokumentation von Videosequenzen bei der konventionellen Schilddrüsensonografie.

Ultrasound is the basic imaging method for the assessment of the thyroid gland. Due to the high prevalence of structural disease, the examination procedure is used very frequently in Germany, in many cases in the context of follow-up. The assessment of thyroid pathologies and their dynamics is subjected to relevant inter- and intraobserver variability. Findings that were not identified during live ultrasound cannot be assessed retrospectively. Applying an SOP for the acquisition and documentation of standardized video sequences of ultrasound images (so-called cine loops), allows for a secondary retrospective evaluation of the thyroid gland, taking into account previously acquired images analogous to other cross-sectional imaging methods such as CT or MRI. The cine loops can be acquired by non-physician personnel, stored to the local PACS and used for educational and research purposes.

Considerations on the morphology of the thyroid ima artery.

PURPOSE AND BACKGROUND: Detailed knowledge of the thyroid ima artery is essential for surgeons consequently we conducted an analysis investigating the arterial vasculature of the thyroid gland in 290 cases by dissection of formalin-fixed cadavers and by studying computed tomography angiographies. METHODS: Our study was conducted on 82 cases obtained from the dissection of formalin-fixed cadavers while 208 cases were computed tomography angiographies. The following aspects were observed: the frequency of the thyroid ima artery, its origin, course, and diameter. All were studied, comparing right to left and according to sex. RESULTS: Following the study of thyroid gland vasculature on a number of 290 cases, the thyroid ima artery was discovered in 16 cases (5.52% of cases), from which 3.45% of cases were in male subjects, and 2.07% of cases in female subjects. Of these, 4.14% of the total cases were left thyroid ima artery, and 1.38% of cases were on the right, found only in female subjects. In 5.17% of the total cases, the thyroid ima artery originated from the aortic arch, of which 3.45% were in the male sex and 1.72% were in the female sex. In one case only (0.35%) in the female sex did the thyroid ima artery originate from the brachiocephalic trunk. In 2.76% of cases, the thyroid ima artery existed with a left-sided inferior thyroid artery originating from the subclavian artery, either directly or from a thyrocervical trunk. CONCLUSIONS: The thyroid ima artery has proven to be one of the highly variable arteries in terms of its presence and origin and the knowledge surrounding it is useful for surgical interventions.

Compact portable higher harmonic generation microscopy for the real time assessment of unprocessed thyroid tissue.

During thyroid surgery fast and reliable intra-operative pathological feedback has the potential to avoid a two-stage procedure and significantly reduce health care costs in patients undergoing a diagnostic hemithyroidectomy (HT). We explored higher harmonic generation (HHG) microscopy, which combines second harmonic generation (SHG), third harmonic generation (THG), and multiphoton excited autofluorescence (MPEF) for this purpose. With a compact, portable HHG microscope, images of freshly excised healthy tissue, benign nodules (follicular adenoma) and malignant tissue (papillary carcinoma, follicular carcinoma and spindle cell carcinoma) were recorded. The images were generated on unprocessed tissue within minutes and show relevant morphological thyroid structures in good accordance with the histology images. The thyroid follicle architecture, cells, cell nuclei (THG), collagen organization (SHG) and the distribution of thyroglobulin and/or thyroid hormones T3 or T4 (MPEF) could be visualized. We conclude that SHG/THG/MPEF imaging is a promising tool for clinical intraoperative assessment of thyroid tissue.

[Normal values for adult thyroid volume on ultrasound - where do they come from and how should they be evaluated?] / Sonographische Normwerte für das Schilddrüsenvolumen Erwachsener ­ woher kommen sie und wie sind sie zu bewerten?

The upper limit for the thyroid volume is 18 ml for women and 25 ml for men. These reference values are used and taught in many clinics and practices across several disciplines. The thyroid volume is a relevant factor for the treatment course. But where do the standard values for thyroid volumes come from, what kind of studies have been carried out to establish them? Should these upper limits be used as an universal standard in clinical routine, and which factors can influence the physiological organ size? The following article is dedicated to a critical review of the commonly used reference values for the thyroid volume of adults.

Multiplexed sensitivity-encoding versus single-shot echo-planar imaging: a comparative study for diffusion-weighted imaging of the thyroid lesions.

PURPOSE: To compare multiplexed sensitivity-encoding diffusion-weighted magnetic resonance imaging (MUSE-DWI) and conventional DWI (cDWI) techniques in thyroid MRI. MATERIALS AND METHODS: Nineteen patients who underwent thyroid MRI using both MUSE-DWI and cDWI at a 3.0 T MRI system were enrolled. Qualitative parameters (image quality, thyroid contour, and lesion conspicuity) and quantitative parameters (signal-to-noise ratio (SNR), lesion-to-thyroid contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC)) were compared between the two sequences. In addition, ADC values derived from MUSE-DWI and cDWI were separately compared between benign and malignant lesions. RESULTS: MUSE-DWI outperformed cDWI in terms of image quality, thyroid contour, and lesion conspicuity. Significantly, higher signal-to-noise ratio (SNR) in both the thyroid and its lesion were found in MUSE-DWI than those in cDWI (both P < 0.05). The lesion-to-thyroid contrast-to-noise ratio (CNR) values were also significantly higher in MUSE-DWI than those in cDWI (P < 0.05). The apparent diffusion coefficient (ADC) of the thyroid in MUSE-DWI was significantly lower than that in cDWI (P < 0.05). The ADC of the lesion in MUSE-DWI was also significantly lower than that in cDWI (P < 0.05). In addition, ADC values derived from MUSE-DWI and cDWI were significantly higher in benign lesions than malignant lesions (P < 0.05). CONCLUSION: Compared with cDWI, MUSE-DWI can improve the image quality, thyroid contour sharpness, lesion conspicuity, SNR in both the thyroid and its lesions, and enhancing the CNR between lesions and thyroid.

One children's hospital planning and development process to adhere to the FDA recommendation that babies and young children undergo thyroid function testing after receiving an injection of iodine-containing contrast media for medical imaging.

The United States (US) Food and Drug Administration (FDA) has issued multiple statements and guidelines since 2015 on the topic of thyroid function testing in babies and children through 3 years old after receiving iodinated contrast media for medical imaging exams. In April 2023, the FDA adjusted this recommendation to target babies and young children younger than 4 years of age who have a history of prematurity, very low birth weight, or underlying conditions which affect thyroid gland function, largely in response to solid arguments from expert statements from the American College of Radiology (ACR) which is endorsed by the Society for Pediatric Radiology (SPR), Pediatric Endocrinology Society (PES), and the Society for Cardiovascular Angiography & Intervention (SCAI). Herein we describe our approach and development of a clinical care guideline along with the steps necessary for implementation of the plan including alterations in ordering exams requiring iodinated contrast media, automatic triggering of lab orders, reporting, and follow-up, to address the 2022 FDA guidance statement to monitor thyroid function in children after receiving iodinated contrast media. The newly implemented clinical care guideline at Ann and Robert H. Lurie Children's Hospital of Chicago remains applicable following the 2023 updated recommendation from the FDA. We will track patients less than 3 months of age who undergo thyroid function testing following computed tomography (CT), interventional radiology, and cardiac catheterization exams for which an iodinated contrast media is administered as a clinical care quality initiative.

Influence of short-lived radioiodines other than 131I on screening direct thyroid measurements with TCS-172 NAI(TL) survey meters.

In a nuclear emergency, one of the actions taken for the sake of public is to monitor thyroid exposure to radioiodines. Japan's Nuclear Regulation Authority recently published a report on such monitoring and proposed direct thyroid measurements with conventional NaI(Tl) survey meters (e.g. Hitachi model TCS-172) as a primary screening method. A previous study proposed screening levels (SLs) used in these simplified measurements as the net reading values of the TCS-172 device. Age-specific SLs were derived from a thyroid equivalent dose of 100 mSv due to the inhalation intake of 131I. This study addressed the possible influence of short-lived iodine isotopes other than 131I on the simplified measurements. In preparation for such measurements, the responses of the device for 132I as an ingrowth component from 132Te, 133I, 134I and 135I in the thyroid were evaluated by numerical simulations using age-specific stylized phantoms in addition to those obtained for 131I in the previous study. The radioactivity ratios of the relevant isotopes were taken from the inventory data of the Fukushima Daiichi Nuclear Power Plant. The results were used to predict the net readings of the device when 132Te-132I and 133I as well as 131I were inhaled at 24 or 72 h after the shutdown of a nuclear power plant. In these cases, the signals from 132Te-132I and 133I become undetectable a couple of days after intake, which could lead to underestimations of the thyroid dose. To estimate the thyroid dose accurately from the simplified measurements, it is necessary to identify the exact time of intake after the shutdown and the actual physiochemical property of 132Te that affects the thyroid uptake of 132I.