This is a case report of a 51-year-old female diagnosed with papillary microcarcinoma of the thyroid gland after undergoing total thyroidectomy. A 99mTc pertechnetate thyroid scan was done before radioiodine ablation therapy. It showed cervical neck lymph nodes taking up the radiotracer. Another scan after ablation therapy showed the same nodes taking up the therapeutic iodine131. The paper discusses using 99mTc pertechnetate to detect thyroid cancer metastases.
Human ; Female ; Middle Aged ; THYROID NEOPLASMS ; NEOPLASMS ; NEOPLASMS BY SITE ; ENDOCRINE GLAND NEOPLASMS

A study was conducted to validate the Inoue protocol in determining the glomerular filtration rate (GFR) of Filipinos. Dynamic posterior planar kidney images of 402 consecutive Filipino patients referred for in vitro GFR determination were reprocessed using the Inoue protocol. Regression and Bland-Altman analyses were done on surface area normalized glomerular filtration rates (GFRSAnorm) generated using the Inoue linear regression model of the sample, Gates' method, and original regression formula published by Inoue, using respective two-point plasma concentration (in vitro) GFRSAnorm values as reference standards. GFRSAnorm results from the three camera-based techniques had strong correlation with those obtained using the in vitro method (i.e. r values of 0.9349, 0.8922 and 0.9349, respectively). However, agreement analysis showed lack of both bias and precision in the results of the Inoue linear regression model of the sample, and presence of bias and lack of precision in the results of both the Gates' method and the original linear regression model published by Inoue when compared to their corresponding in vitro GFRSAnorm results (standard error of 0.6209, 0.8379 and 0.9473, respectively). Thus, the linear regression model of the Inoue protocol is superior to the Gates' method for camera-based GFR estimation, and is population-specific, but is not robust enough to be a replacement for the in vitro technique.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Bias (epidemiology) ; Glomerular Filtration Rate ; In Vitro Techniques ; Kidney ; Linear Models ; Radioisotope Renography

The use of high- or low-dose radio-iodine therapy (RAIT) for initial thyroid remnant ablation in post-thyroidectomised patients diagnosed with differentiated thyroid cancer (DTC) with no distant metastases has long been a subject of much debate. Meta-analyses and systematic reviews have been previously made using both randomised control trials (RCTs) and observational studies without due regard to differences in study design. Hence, amore focused meta-analysis of available RCTs alone was conducted to determine the presence of a compelling difference between the initial remnant ablation success rates of high- and low-dose RAIT in post-thyroidectomised DTC patient without distant demtastases. An extensive search of PubMed and Cochrane Central register of RCTs (up to August 2013) was performed by two reviewers, which was completed by hand search of referencesfrom releveangt articles and review papers published from 1996 to 2012. The two reviewers independtly selected eligible studies, with disagreement resolved by consensus. The inclusion criteria were as follows: (a) randomised controlled trials, (b) post-thyroidectomised adult subjects diagnosed with well differentiated thyroid cancer and no evidence of distant metastases, and (c) subject randomisation into 30-50 mCi or 100 mCi 131I treatment groups. Studies were exluded if (a) the full text of the study is not available, (b) the study is in another language other than English, and (c) if the data on relative risk was not available or could not be derived from the study. Of eight published RCTs on radio-iodine therapy as of August 2013, only 5 were eligible for this meta-analysis; namely those by JOhansen et al. (1991), Bal et al. (1996), Zaman et al. (2006), Maenpaa et al. (2008) and Caglar et al. (2012). The same two reviewers independenty extracted data from the full text of the selected five studies. Two-by-two tables comparing frequencies of successful and failed remnant ablation using low-dose (30-60 mCi) and high-dise (100 mCi) RAIT were derived from the published results of the included studies, and the weighted and pooled relative risks for successful remnant ablation were computed via the Mantel-Haenszel method using a fixed effects model (cx = 5%). Subgroup analyses were performed based on different definitions of a successful remnant ablation. The pooled relative risk (-0.03) was statistically insignificant (p=0.54) and had poor precision (95% confidence interval of {-0.12,0.06}) even when adjustments to the varied definitions of a successful ablation were performed. Thus, using available RCTs that compare high- and low-dose RAIT for remnant ablation of DTC, there is an apparent trend favoring higher success rates using high-dose RAIT. However, the lack of well designed RCTs precludes recommending high-dose initial RAI ablation, and encourages the present practice of individualized.
Meta-Analysis ; Thyroid Neoplasms ; Iodine Radioisotopes