The aim is to evaluate the usefulness of technetium pertechnetate (99mTc) thyroid uptake (TcTU) obtained from thyroid scintigraphy using quantitative Single Photon Emission Computed Tomography / Computed Tomography (SPECT/CT) in determining personalised dose of 131I radioactive iodine (RAI) therapy for hyperthyroidism. A study of 131 participants with hyperthyroidism referred for RAI therapy was performed. 66 participants were enrolled into the prospective (calculated dose) group whereas 65 participants were from retrospective control (fixed dose) group. Quantitative thyroid SPECT/CT was performed for the prospective group prior to receiving RAI. TcTU and thyroid gland volume obtained from the Quantitative thyroid SPECT/CT were incorporated into modified Marinelli formula for RAI dose. Outcome of RAI was determined at the end of 6 months follow-up. Descriptive analysis of demographics and regression analyses of variables were performed. Mean calculated RAI dose was 17.74 mCi (SD 6.27) with mean dose for successful RAI at 6 months was 16.42 mCi (SD 5.87). Success rate was 80.3 % in the calculated group, versus 60.0 % in the fixed dose group (p-value 0.013). Regression analysis showed thyroid gland volume as an independent factor in determining successful outcome (adjusted OR = 0.963 CI: 0.942, 0.985) with volume of <77.2 ml more likely to produce successful outcome; sensitivity and specificity of 69 % and 83 % respectively. Quantitative SPECT/CT is useful in determining personalised dose of 131I RAI therapy. It significantly improves treatment outcome for hyperthyroidism as compared to the conventional fixed dose method.
Hyperthyroidism

Cancer-induced bone pain is currently facing inadequate pain management due to unwanted side effects and relative ineffectiveness. The search for alternative therapy to alleviate pain and target a few mechanism pathways might improve survival in metastatic patients. Vitamin E which has been promoted as anti-inflammatory, anti-cancer, and anti-metastatic were chosen in this study to potentiate its capability in a cancer-induced bone pain rat model. Rats were randomly grouped into five groups, and a breast cancer cell line was induced into the left femur of four groups: Negative Control (NC), Alpha Tocopherol (ATF), Tocotrienol Rich Fraction (TRF) and Zoledronic Acid (ZA), whereas Sham group as healthy subjects induced with supplementary media. Pain assessment tests were carried out at four days intervals. The animals were sacrificed after 21 days following SPECT/CT imaging. Bone specimens were analyzed for ELISA and gene expression studies. The results showed that the animal model was successfully validated via the presence of abnormal uptake of the skeletal system. Pain assessment tests demonstrated that vitamin E, specifically TRF significantly alleviate pain compared to the NC group. Biomarker activity illustrated that the TRF supplement group was able to regulate the bone turnover activity comparable to the ZA treatment group. Gene expression studies signify the role of TRF supplement comparable to the ZA group in the ability to regulate osteoclastogenesis, osteoclast activation, and regulating the secretion of metastatic cancer cytokine. This finding addressed the beneficial potency of TRF compared to ATF as a therapeutic option in the management of cancer-induced bone pain.