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1.
Rev. salud pública Parag ; 10(1): [P59-P65], mar. 2020.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1087931

RESUMO

nuclear permiten visualizar la estructura y función de un órgano, tejido, hueso o sistema dentro del cuerpo, entre ellos la glándula tiroidea, la cual puede presentar un nódulo tiroideo y este es importante diagnosticar por su potencial malignidad. Objetivo: Determinar las características funcionales de los nódulos tiroideos en 183 pacientes que asistieron al Servicio de Medicina Nuclear del Instituto de Investigaciones en Ciencias de la Salud - UNA durante el período de noviembre del 2016 - noviembre del 2019. Metodología: Fue utilizada la gammacámara SPECT doble cabezal, siguiendo protocolo estandarizado, con administración de pertecnetato de sodio. Resultados: Se observó que la gran mayoría de los pacientes corresponden al sexo femenino 89%, así como que el 64% provienen de la capital y del departamento central; las patologías detectadas corresponden a bocio en 82%, 15% a nódulos (hipercaptantes, hipocaptantes y autónomos) y casos particulares de tiroiditis, tiroides ectópica y adenoma tóxico. La medicina nuclear está directamente involucrada tanto en el diagnóstico como en el tratamiento de la enfermedad tiroidea, por lo que se requiere una comprensión de la fisiopatología y el manejo de los trastornos de la tiroides, de manera a que las políticas de salud pública sean implementadas para el fortalecimiento de la lucha contra estas enfermedades. Conclusión: El trabajo de investigación realizado comprobó que un mayoritario porcentaje de participantes de sexo femenino (89%), con enfermedades tiroideas asistieron al IICS/UNA, y que la frecuencia de bocio entre la totalidad de pacientes que participaron de este estudio fué de 151/183 (82%), los pacientes provenían en su mayoría de hospitales de referencia del departamento Central y coinciden con la localización geográfica de los domicilios de los pacientes, quienes provenían principalmente del mismo departamento Central 118/183 (64%), no obstante también participaron del trabajo de investigación pacientes provenientes de otros departamentos del país. Palabras claves: Diagnóstico, medicina nuclear, tiroides, tecnología nuclear en salud, SPECT


Introduction: The images obtained by nuclear medicine allow to visualize the structure and function of an organ, tissue, bone or system inside the body, including the thyroid gland, which can present a thyroid nodule and this is important to diagnose for its potential malignancy. Objective: To determine the functional characteristics of the thyroid nodules were determined in 183 patients, who attended the Nuclear Medicine Service at the Instituto de Investigaciones en Ciencias de la Salud during the period of November 2016 - November 2019. Methodology: It was used the dual head SPECT gamma camera following a standardized protocol with administration of sodium pertechnetate. Result: It was observed that most of the patients corresponded to the female sex 89 %, as well as that 64% came from the capital and the central department. The pathologies detected corresponded to goiter in 82%, 15% to nodules (hypercaptant, hypocaptant and autonoms) and particular cases of thyroiditis, ectopic thyroid and toxic adenoma. Nuclear medicine is directly involved both in the diagnosis and in the treatment of thyroid disease, therefore it requires an understanding of the pathophysiology and management of thyroid disorders in order that public health policies are implemented for strengthening the fight against these diseases. Conclusion: The research carried out showed that a majority percentage of female participants (89%), with thyroid diseases attended IICS / UNA, and the frequency of goiter among all patients who participated in this study was 151/183 ( 82%), the patients mostly they came the reference hospitals in the Central department and coincide with the geographic location of the patients' homes, who tested mainly from the same Central department 118/183 (64%), also participate in the research work patients from other departments of the country. Keywords: Diagnosis, nuclear medicine, thyroid, health technology, SPECT.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Paraguai , Doenças da Glândula Tireoide , Medicina Nuclear
2.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(1): 80-85, 2020 Feb 28.
Artigo em Chinês | MEDLINE | ID: mdl-32131944

RESUMO

Objective To investigate the value of contrast-enhanced ultrasound(CEUS)quantitative parameters in the diagnosis of thyroid benign and malignant nodules. Methods The CEUS features of 85 histopathologically confirmed thyroid nodules were quantitatively analyzed using five parameters including rising time(RT),time to peak(TTP),area under the curve(AUC),maximum intensity(Imax),and mean transit time(mTT).The dynamic vascular pattern(DVP)curves were also drawn. Results The Imax(Z=-7.08,P=0.01)and AUC(Z=-2.03,P=0.04)of thyroid malignant nodules were significantly smaller than those of thyroid tissue,and the Imax(Z=-1.35,P=0.02)and AUC(Z=-0.21,P=0.02)of thyroid benign nodules were significantly larger than those of thyroid tissue.There were significant differences between thyroid benign and malignant nodules in Imax(Z=-4.16,P=0.00),AUC(Z=-3.01,P=0.01),and DVP curve types(P=0.00).RT(Z=-0.28,P=0.62),TTP(Z=-0.10,P=0.89),and mTT(Z=-0.79,P=0.05)were not significantly different between thyroid benign and malignant nodules. Conclusion The quantitative parameters of CEUS,especially Imax and AUC parameters,are valuable in the diagnosis of benign and malignant thyroid nodules.


Assuntos
Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia , Meios de Contraste , Diagnóstico Diferencial , Humanos , Glândula Tireoide/diagnóstico por imagem
3.
AJR Am J Roentgenol ; 214(4): 885-892, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31967504

RESUMO

OBJECTIVE. The purpose of this study was to explore whether a quantitative framework can be used to sonographically differentiate benign and malignant thyroid nodules at a level comparable to that of experts. MATERIALS AND METHODS. A dataset of ultrasound images of 92 biopsy-confirmed nodules was collected retrospectively. The nodules were delineated and annotated by two expert radiologists using the standardized Thyroid Imaging Reporting and Data System lexicon of the American College of Radiology. In the framework studied, quantitative features of echogenicity, texture, edge sharpness, and margin curvature properties of thyroid nodules were analyzed in a regularized logistic regression model to predict malignancy of a nodule. The framework was validated by leave-one-out cross-validation technique, and ROC AUC, sensitivity, and specificity were used to compare with those obtained with six expert annotation-based classifiers. RESULTS. The AUC of the proposed method was 0.828 (95% CI, 0.715-0.942), which was greater than or comparable to that of the expert classifiers, for which the AUC values ranged from 0.299 to 0.829 (p = 0.99). Use of the proposed framework could have avoided biopsy of 20 of 46 benign nodules in a curative strategy (at sensitivity of 1, statistically significantly higher than three expert classifiers) or helped identify 10 of 46 malignancies in a conservative strategy (at specificity of 1, statistically significantly higher than five expert classifiers). CONCLUSION. When the proposed quantitative framework was used, thyroid nodule malignancy was predicted at the level of expert classifiers. Such a framework may ultimately prove useful as the basis for a fully automated system of thyroid nodule triage.


Assuntos
Diagnóstico por Computador/métodos , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Triagem , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia
4.
Clin Nucl Med ; 45(3): e134-e140, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31977485

RESUMO

PURPOSE: The aim of this retrospective study was to determine, by dynamic acquisition, the optimal scan time of F-DOPA PET/CT in patients with recurrent medullary thyroid carcinoma (MTC). METHODS: Twenty-one patients with suspected recurrent MTC underwent dynamic F-DOPA PET/CT (lasting 45 minutes) followed by whole-body scan. Three different time intervals of dynamic acquisition were evaluated: ultra-early phase (2-5 minutes), early phase (5-10 minutes), and late phase (40-45 minutes). The number and SUVmax of all detected lesions among the 3 dynamic acquisition phases were compared on qualitative and semiquantitative analyses. Time-activity curves, SUVmax washout rate between ultra-early or early phase and late phase, and signal-to-noise ratio (SNR) between lesion and background activity were also calculated. RESULTS: At dynamic acquisition, 15 of 21 patients were classified as PET-positive and 6 of 21 as PET-negative, with overall 21 detected lesions. Ultra-early and early imaging provided a better lesion visualization than late phase in more than 70% of cases, as also reflected by SNR (mean SNR reduction between 2 and 45 minutes, -45% ± 19%). Time-activity curves showed a rapid tracer accumulation in MTC lesions, with an average maximum uptake at 2 minutes after injection. Mean lesion SUVmax was 2-fold higher in ultra-early frames compared with last frames (mean washout rate, -44% ± 33%). Finally, compared with whole-body imaging in the same field of view, dynamic acquisition identified 1 additional positive patient and 3 additional lesions in 2 patients. CONCLUSIONS: Our study, showing a very fast F-DOPA uptake in MTC lesions, suggests the utility to obtain early PET/CT images, already at 2 to 5 minutes after tracer injection, when maximum lesion tracer uptake is reached.


Assuntos
Carcinoma Neuroendócrino/diagnóstico por imagem , Di-Hidroxifenilalanina/análogos & derivados , Processamento de Imagem Assistida por Computador , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Fatores de Tempo , Imagem Corporal Total
5.
Orv Hetil ; 161(2): 75-79, 2020 Jan.
Artigo em Húngaro | MEDLINE | ID: mdl-31902232

RESUMO

The authors present the case of a multiplex endocrine neoplasia type 2A (MEN2A). The 55-year-old woman underwent detailed examinations for abdominal complaints. Bilateral adrenal masses and thyroid nodular goiter were found. Based on metanephrine excretion and MIBG imaging, bilateral phaeochromocytomas were diagnosed. The thyroid nodules were confirmed by thyroidectomy as bilateral medullary thyroid carcinoma. Asymptomatic primary hyperparathyroidism was also detected. Laparoscopic adrenalectomy and parathyroid adenoma removal were performed. Based on family history and the characteristic clinical presentation, MEN2A syndrome was confirmed by genetic testing. During genetic screening of first-degree relatives, the patient's 25-year-old daughter was shown to be a gene carrier. Preventive thyroidectomy was performed and histology proved multifocal medullary thyroid cancer. In addition to the importance of genetic testing, the authors emphasize the guideline-based, but individualized approach to patients with suspected MEN2A syndrome. Orv Hetil. 2020; 161(2): 75-79.


Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia , Neoplasia Endócrina Múltipla Tipo 2a/diagnóstico , Feocromocitoma , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/cirurgia , 3-Iodobenzilguanidina , Neoplasias das Glândulas Suprarrenais/patologia , Adulto , Feminino , Bócio Nodular , Humanos , Metanefrina , Pessoa de Meia-Idade , Neoplasia Endócrina Múltipla Tipo 2a/genética , Neoplasias das Paratireoides , Proteínas Ribossômicas , Neoplasias da Glândula Tireoide/genética , Nódulo da Glândula Tireoide/patologia , Tireoidectomia
7.
Clin Nucl Med ; 45(3): 223-224, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31876816

RESUMO

We report the case of a 74-year-old man with suspected recurrent prostate carcinoma who underwent F-PSMA-1007 PET/CT for restaging the disease. PET/CT imaging presented an incidentaloma with intense F-PSMA-1007 uptake in the right thyroid lobe. Biopsy and genomic sequencing test confirmed the diagnosis of Hürthle cell thyroid adenoma. Therefore, it is important to raise awareness of this benign lesion in the differential diagnosis of incidental thyroid nodules with high F-PSMA-1007 activity.


Assuntos
Adenoma Oxífilo/diagnóstico por imagem , Adenoma Oxífilo/metabolismo , Radioisótopos de Flúor , Niacinamida/análogos & derivados , Oligopeptídeos/metabolismo , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/metabolismo , Adenoma Oxífilo/complicações , Idoso , Transporte Biológico , Humanos , Masculino , Estadiamento de Neoplasias , Niacinamida/metabolismo , Neoplasias da Próstata/complicações , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Neoplasias da Glândula Tireoide/complicações
8.
Clin Nucl Med ; 45(1): 76-77, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31524685

RESUMO

Papillary carcinoma of thyroid (PTC) is the most common neoplasm of the thyroid gland that usually invades lymphatics rather than blood vessels. Hematogenous metastasis of PTC is rare, and distant metastasis to the liver is even rarer. Selective internal radiation therapy with Y microspheres is a well-recognized technique in the treatment of liver metastases. Herein, we present a case of PTC with radioactive iodine-negative hepatic metastasis detected by F-FDG PET/CT and treated with selective internal radiation therapy.


Assuntos
Neoplasias Hepáticas/radioterapia , Compostos Radiofarmacêuticos/uso terapêutico , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/radioterapia , Radioisótopos de Ítrio/uso terapêutico , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/radioterapia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia
9.
BMC Urol ; 19(1): 136, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881880

RESUMO

BACKGROUND: Metachronous renal cell carcinoma after radical nephrectomy is extremely rare. Renal cell carcinoma commonly metastasizes to distant organs. However, metastasis to the urinary bladder is very uncommon. CASE PRESENTATION: Herein, we report a case of metachronous renal cell carcinoma with metastasis to the urinary bladder, left acetabulum, left rib, lungs, thyroid, right renal vein and inferior vena cava. The patient had undergone a left-sided radical nephrectomy 28 years ago. The pathological diagnosis of a fragment of the bladder tumor was consistent with Fuhrman grade 2 clear cell renal cell carcinoma. CONCLUSIONS: Although metachronous renal cell carcinoma after radical nephrectomy is rare, active surveillance should be still considered. Renal cell carcinoma has shown to unusually metastasize to the urinary bladder, a rarely reported organ of metastasis. Treatment options, such as immunotherapy, are available to patients with such metastasis and long-term survivorship can be achieved.


Assuntos
Carcinoma de Células Renais/secundário , Neoplasias Renais/patologia , Segunda Neoplasia Primária/secundário , Nefrectomia/métodos , Neoplasias da Bexiga Urinária/secundário , Acetábulo/diagnóstico por imagem , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/cirurgia , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Imagem por Ressonância Magnética , Masculino , Segunda Neoplasia Primária/diagnóstico por imagem , Costelas/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/secundário , Fatores de Tempo , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/cirurgia
11.
Chirurgia (Bucur) ; 114(5): 586-593, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31670634

RESUMO

Background: All patients undergoing thyroid operations should be subjected to preoperative neck ultrasound (US) followed by fine needle aspiration cytology (FNAC) of suspicious lesions. In Western countries, thyroid surgeons routinely perform neck ultrasound. The role of prophylactic central neck dissection (PCND) remains a topic of debate. For treatment of papillary thyroid carcinoma (PTC), in 2014 we introduced two new adjuncts: PCND based on criteria of the European Society of Endocrine Surgeons (ESES) consensus group and surgeon-performed US (S-US). Methods: In order to better understand the role of these two adjuncts in our shift of strategy we aimed to evaluate the outcomes of our patients in two successive 5-year time periods based on a retrospective analysis of our prospectively maintained database (total of 286 patients were included in this study). Results: The two groups were similar regarding epidemiological and clinical data. FNAC was done in only 21.66% of all PTC cases. PTC diagnosis was done in the majority of suspicious cases by FS. S-US guided the selective lateral node dissections (LND), leading to more lymph node metastases detections and it also surpassed endocrinologist performed US (E-US) in terms of PPV. PCND rate of complications was significantly higher due only to transient hypoparathyroidism. Conclusions: Preoperative surgeon-performed ultrasonography is a useful tool in the arsenal of PTC treatment. The systematic preoperative FNAC diagnosis and intraoperative frozen sections in uncertain cases are mandatory. PCND is a safe method of treatment and staging in PTC.


Assuntos
Esvaziamento Cervical/métodos , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Humanos , Excisão de Linfonodo/métodos , Estadiamento de Neoplasias , Estudos Retrospectivos , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia , Resultado do Tratamento , Ultrassonografia
12.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(5): 663-666, 2019 Oct 30.
Artigo em Chinês | MEDLINE | ID: mdl-31699197

RESUMO

Objective To compare the predictive value of different ratio measurement in predicting the risk of malignant thyroid nodules and to determine the best value of ratio in diagnosing thyroid nodules.Methods The clinical data of 342 thyroid nodules diagnosed by ultrasonography and confirmed by histology in our hospital from January 2018 to August 2018 were analyzed.The ratio of nodules in different sections,including longitudinal plane ratio(A/TL)and transverse plane ratio(A/TC),was obtained through the maximum head-foot diameter(TL),the maximum left-right diameter(TC),and the anterior-posterior diameter(A)of transverse section measured by ultrasonography.The correlation of histological diagnosis of benign or malignant nodule with longitudinal ratio and transverse ratio were analyzed.Results The A/TC and A/TL of malignant nodules were 1.00(0.83,1.17)and 0.81(0.65,1.00),respectively,which were significantly higher than those of benign nodules [0.81(0.67,0.93)(Z=-6.567,P=0.000)and 0.63(0.52,0.75)(Z=-7.239,P=0.000)].The area under the ROC curve of A/TC and A/TL was 0.734 and 0.712,respectively,showing no significant difference(area difference:0.0210,standard error:0.0213,95% CI:-0.0207-0.0627,Z=0.987,P=0.3235).The threshold values of A/TC and A/TL for predicting malignant nodules were 0.784 161 5 and 0.985 714 5,respectively.Conclusions Both A/TL and A/TC has similar diagnostic value in predicting the risk of malignant nodules.The best cutoff value of the above two ratios are 0.78 and 0.99 respectively.


Assuntos
Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Curva ROC , Medição de Risco , Sensibilidade e Especificidade , Ultrassonografia
13.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(5): 690-695, 2019 Oct 30.
Artigo em Chinês | MEDLINE | ID: mdl-31699202

RESUMO

Despite its low incidence,medullary thyroid carcinoma(MTC)is featured by its fast progression and poor prognosis.Early diagnosis and treatment is therefore particularly important.As a convenient and non-invasive diagnostic tool,ultrasound plays a key role in the diagnosis and follow-up of MTC.In recent years,the application of conventional ultrasound,ultrasonic elastography,and ultrasound-guided fine needle aspiration biopsy has dramatically improved the diagnostic accuracy of MTC.


Assuntos
Neoplasias da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia , Biópsia por Agulha Fina , Técnicas de Imagem por Elasticidade , Humanos
14.
Cancer Imaging ; 19(1): 73, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31727170

RESUMO

BACKGROUND: A high proportion of patients with advanced stages of medullary thyroid carcinoma (MTC) present with liver metastasis metastases. The aim of our study was to investigate the added diagnostic value of complementary gadoxetic acid-enhanced MRI to 18F-DOPA-PET/CT for liver staging in MTC. METHODS: Thirty-six patients (14 female, median age 55 years) with histologically confirmed MTC undergoing gadoxetic acid-enhanced liver MRI within 1 month of matching contrast-enhanced 18F-DOPA-PET/CT between 2010 and 2016 were selected for this IRB-approved retrospective study. 18F-DOPA-PET/CT and multiparametric MRI data sets were read consecutively and liver lesions were categorised on a 5-point Likert scale (1-definitely benign; 2-probably benign; 3-intermediate risk for metastasis; 4-probably metastasis; 5-definitely metastasis). It was noted if gadoxetic acid-enhanced MRI detected additional, 18F-DOPA-PET/CT-occult metastases (category 5) or if gadoxetic acid-enhanced MRI allowed for a definite classification (categories 1 and 5) of lesions for which 18F-DOPA-PET/CT remained inconclusive (categories 2-4). Follow-up PET/CT and MRI examinations were used as a reference standard. RESULTS: A total of 207 liver lesions (18F-DOPA-PET/CT 149, MRI 207; 152 metastases, 37 benign cysts, 18 hemangiomas) were analysed. Fifty-eight additional lesions were detected by MRI, of which 54 were metastases (median diameter 0.5 cm [interquartile range 0.4-0.7 cm]) occult on 18F-DOPA-PET/CT. MRI allowed for a definite lesion classification (categories 1 and 5) in 92% (190/207) whereas 18F-DOPA-PET/CT allowed for a definite lesion classification in 76% (113/149). MRI lead to a change in lesion categorisation in 14% (21/149). CONCLUSION: Gadoxetic acid-enhanced MRI allows for a more precise liver staging in MTC patients compared to 18F-DOPA-PET/CT alone, particularly for 18F-DOPA-negative metastases and lesions < 1 cm.


Assuntos
Carcinoma Neuroendócrino/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Imagem Multimodal/métodos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Adulto , Idoso , Carcinoma Neuroendócrino/patologia , Di-Hidroxifenilalanina/análogos & derivados , Feminino , Gadolínio DTPA , Humanos , Neoplasias Hepáticas/secundário , Imagem por Ressonância Magnética/normas , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/normas , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/normas , Compostos Radiofarmacêuticos , Neoplasias da Glândula Tireoide/patologia
15.
Int J Nanomedicine ; 14: 7365-7373, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31686812

RESUMO

Background: Molecular imaging has generated a great demand to develop targeted contrast agents for MR imaging. Materials and methods: In this study, we synthesized Src homology 2-containing phosphotyrosine phosphatase 2 (SHP2)-targeted and polylactic-co-glycolic acid--based nanoparticles (NPs), which encapsulated perfluoropentane and being chelated with gadolinium (Gd3+) as an efficient molecular probe for targeting MR imaging on thyroid carcinoma. Results: These NPs displayed practical properties and favorable biocompatibility in vitro. Furthermore, they showed abilities to specifically target thyroid cancer and enhance MRI as a contrast agent in both in vitro and in vivo experiments. Conclusion: This novel MR molecular imaging based on this SHP2-targeted contrast agent provides a useful and non-invasive method for the early detection of thyroid carcinoma.


Assuntos
Imagem por Ressonância Magnética , Imagem Molecular , Nanopartículas/química , Proteína Tirosina Fosfatase não Receptora Tipo 11/metabolismo , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Animais , Apoptose , Linhagem Celular Tumoral , Meios de Contraste , Fluorcarbonetos , Gadolínio/química , Humanos , Camundongos
16.
J Comput Assist Tomogr ; 43(6): 970-975, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31738199

RESUMO

OBJECTIVE: The objective of this study was to determine the value of dual-energy computed tomography (DECT) for the diagnosis of cervical lymph node metastasis in papillary thyroid cancer. METHODS: The normalized iodine concentration (NIC) and the slope of the spectral Hounsfield unit curve (λHU) in the arterial and venous phases were measured using iodine-overlay images and spectral curves. Quantitative DECT data and qualitative conventional CT data were analyzed by radiologists. RESULTS: The best qualitative parameter for lymph node metastasis detection was obvious node enhancement, and the best quantitative parameter for detection was arterial-phase NIC, which showed high sensitivity, specificity, and accuracy values at an optimal threshold of 25.8%. The best combination of qualitative and quantitative parameters consisted of obvious enhancement and arterial-phase NIC; this combination showed a sensitivity of 90.8% and a specificity of 80.5%. CONCLUSIONS: The DECT quantitative parameters NIC and λHU can be an additional tool to diagnose cervical lymph node metastasis.


Assuntos
Linfonodos/patologia , Câncer Papilífero da Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Linfonodos/diagnóstico por imagem , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Pescoço , Variações Dependentes do Observador , Interpretação de Imagem Radiográfica Assistida por Computador , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
17.
Medicine (Baltimore) ; 98(45): e17876, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702656

RESUMO

Radioiodine refractory (RAIR) is the major cause of thyroid cancer-related death. In order to avoid needless Radioiodine (RAI) therapy, recognizing the RAIR cases in time is important for the patients to obtain more time for the effective therapy.Evaluate the ultrasound features of cervical metastatic lymph node in patients with RAIR differentiated thyroid cancer (DTC).Seventeen adult patients with histologically confirmed locally advanced or metastatic RAIR-DTC were prospectively enrolled. The ultrasound (US) characteristics of cervical lesions in patients with the RAIR-DTC were compared with cervical lymph node metastasis from 59 non RAIR-DTC cases.Among the 17 patients, cervical lymph node metastasis was found in 15 patients (88.3%). The cervical lesions of RAIR-DTC (mean size, 2.0 cm) were larger than that in non RAIR-DTC group (mean size, 1.30 cm). More multiple lesions and more lesions with visible flow were found in the RAIR Group, while fewer hyperechogenic punctuations were found in RAIR group (P < .05). The distant metastasis rates showed that RAIR-DTC led to a poorer prognosis than those of patients in the non RAIR Group (P < .01).Ultrasound can help distinguish metastasized cervical lymph nodes of RAIR-DTC patients from non RAIR-DTC patients. For RAIR-DTC patients, a long-term US evaluation should be performed.


Assuntos
Metástase Linfática/patologia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Radioisótopos do Iodo/efeitos adversos , Metástase Linfática/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/dietoterapia , Câncer Papilífero da Tireoide/terapia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/terapia , Ultrassonografia Doppler em Cores
18.
Medicine (Baltimore) ; 98(44): e17657, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689776

RESUMO

New sonographic patterns have been recommended by the 2015 American Thyroid Association (ATA) to stratify nodules in terms of malignancy risk and help guide biopsy decision. This study aimed to compare the ultrasound part of the ATA guidelines and the Thyroid Imaging Reporting and Data System (TIRADS-Na).In 2013 to 2016, 708 thyroid nodules in 505 patients were confirmed by postoperative histopathology. Hypoechogenicity, solidity, microcalcification, irregular margin, and a taller-than-wide shape were considered features suggesting malignancy. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were obtained for the TIRADS and ATA guidelines.Of the 708 nodules, 341(48.2%) and 367(51.8%) were benign and malignant, respectively. Based on the ultrasound 2015 ATA guidelines, 62 nodules had nonspecific pattern (both malignant and benign features); malignancy rates of nodules with very low, low, intermediate, and high suspicion, and nonspecific pattern were 0, 17.7%, 57.9%, 90.0%, and 69.4%, respectively (P < .001). Malignancy rates of categories 2/3/4/5 nodules by TIRADS were 0, 8.1%, 67.0%, and 90.1%, respectively (P < .001). Based on pathological results, the AUC, sensitivity, specificity, NPV, and PPV were 0.926, 96.7%, 81.5%, 84.9%, and 95.9% for TIRADS, and 0.920, 93.5%, 82.4%, 85.1%, and 92.1% for ATA patterns, respectively. The TIRADS was generally more efficient than the 2015 ATA guidelines, especially for nodules >2 cm in diameter or those with nonspecific pattern.The TIRADS show a relative superiority over the ultrasound 2015 ATA guidelines, especially for nodules with >2 cm diameter or nonspecific pattern.


Assuntos
Índice de Gravidade de Doença , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sistemas de Dados , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia , Estados Unidos , Adulto Jovem
19.
Medicine (Baltimore) ; 98(38): e17033, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567939

RESUMO

RATIONALE: Compared with most malignant tumors, papillary thyroid carcinoma (PTC) is usually associated with favorable survival and low recurrence rate. The prognostic factors of PTC include age, sex, tumor size, enlarged lymph nodes, and extrathyroidal extension. Among the extrathyroidal extension, upper aerodigestive tract (ADT) invasion by PTC is a marker of more aggressive tumor behavior, defining a subpopulation of patients at a greater risk of recurrence and death. PATIENT CONCERNS: A 61-year-old woman had a cervical mass that was slowly growing for three years. Additionally, she had haemoptysis of 1-year duration. During the month prior to her visit, she had difficulty breathing. DIAGNOSIS: Neck ultrasonography (US) and thyroid computed tomography (CT) images both showed a well-defined calcified mass on the left lobe of the thyroid gland. Additionally, the thyroid CT revealed that part of the mass protruded into the lumen which resulted in the thickening on the left side of the trachea. Accordingly, her diagnoses were as follows: firstly, a solid mass on the left lobe of the thyroid gland with tracheal compression; and finally, the space-occupying airway lesion. INTERVENTIONS: She underwent a bronchoscopic examination, which revealed a mass blocking most of the upper endoluminal trachea. Thus, the mass was resected at the upper tracheal segment, followed by electrotome and argon plasma coagulation treatment. She was then transferred to the Thyroid Surgery Department. Thyroid surgeons took the surgical type of bilateral subtotal thyroidectomy + exploration of bilateral recurrent laryngeal nerve + dissection of the lymph node in neck central area + circumferential sleeve resection + end-to-end anastomosis + tracheotomy in the patient. OUTCOMES: After surgery, she recovered well without any local recurrence or distant metastasis. LESSONS: When patients with PTC have haemoptysis, hoarseness, dyspnea, or any other symptoms, and the imaging examinations reveal a space-occupying lesion in the thyroid and airway, clinicians should focus on PTC with tracheal invasion, a bronchoscopic examination must be immediately performed because the subsequent surgical management depends on the degree of tracheal invasion.


Assuntos
Câncer Papilífero da Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Traqueia/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Hemoptise/etiologia , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica , Câncer Papilífero da Tireoide/complicações , Câncer Papilífero da Tireoide/secundário , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tomografia Computadorizada por Raios X , Neoplasias da Traqueia/complicações , Neoplasias da Traqueia/secundário , Neoplasias da Traqueia/cirurgia , Ultrassonografia
20.
J Radiol Case Rep ; 13(4): 1-9, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31565176

RESUMO

Thyroid lesions have a comprehensive differential diagnosis which include benign and malignant entities, such as metastases. However, metastases only account for a small percentage of thyroid lesions with renal cell carcinoma as the most common. Metastases to the thyroid pose a diagnostic dilemma as symptoms may not manifest for up to decades after removal of the renal cell carcinoma. Due to the nonspecific appearance on computed tomography and ultrasound, distinguishing metastases from primary thyroid malignancies is of the utmost importance for timely patient management. Our case demonstrates the importance of considering RCC metastases to the thyroid even years after nephrectomy to mitigate potential delays in diagnosis. We present the case of a 66-year-old male with a past medical history of renal cell carcinoma status post nephrectomy 11 years prior who demonstrated incidental thyroid abnormalities on positron emission tomography/computed tomography and ultrasound later confirmed as a metastasis of renal cell carcinoma.


Assuntos
Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/secundário , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Nefrectomia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/secundário , Idoso , Carcinoma de Células Renais/patologia , Diagnóstico Diferencial , Humanos , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/patologia , Neoplasias da Glândula Tireoide/patologia , Fatores de Tempo , Ultrassonografia
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