Objective: To investigate the effect of low-dose X-ray ionizing radiation on thyroid function of radiation workers. Methods: From January to December 2021, a total of 1039 medical workers in some tertiary hospitals in Wuhan were selected as the survey subjects, of which 518 radiation workers were selected as the exposure group, and 521 non-radiation workers were selected as the control group. The general conditions of the two groups were collected, and 5 indicators of thyroid function were measured, including total thyroxine (TT(4)) , total triiodothyronine (TT(3)) , free triiodothyronine (FT(3)) , thyroid stimulating hormone (TSH) , and free thyroxine (FT(4)) . The annual cumulative dose of ionizing radiation exposure in the exposure group was collected. Pearson χ(2) test and independent sample t test were used to compare the general conditions, 5 indicators of thyroid function and abnormal rate between the two groups. Linear regression model was used to analyze the correlation between the annual cumulative dose and 5 indicators of thyroid function in the exposure group. Binary logistic regression was used to analyze the influencing factors of thyroid dysfunction in the exposure group. Results: The TT(4) levels of the workers in the control group and the exposure group were (7.95±1.07) μg/dl and (8.26±1.41) μg/dl, respectively, and the FT(4) levels were (16.33±2.19) pmol/L and (17.15±2.42) pmol/L, respectively, the rate of thyroid dysfunction was 4.80% (25/521) and 8.49% (44/518) , and the above differences were statistically significant (P<0.05) . Linear regression analysis showed that the annual cumulative dose of the exposure group was significantly correlated with TT(4), TT(3), FT(4), and TSH (P<0.05) . For every 1 mSv increase in the annual cumulative dose, TT(4) increased by 1.661 μg/dl, FT(4) increased by 1.422 pmol/L, TT(3) decreased by 0.113 ng/ml, and TSH decreased by 0.731 μIU/ml. Binary logistic regression analysis showed that the older the radiation workers, the higher the risk of thyroid dysfunction (OR=1.080, 95% CI: 1.016-1.148, P=0.013) ; the greater the annual cumulative dose, the higher the risk of thyroid dysfunction (OR=6.400, 95%CI: 1.796-22.811, P=0.004) . Conclusion: The annual cumulative dose of low-dose X-ray ionizing radiation is positively correlated with thyroid function TT(4) and FT(4) of radiation workers, and negatively correlated with TT(3) and TSH; the greater the age and annual cumulative dose, the higher the risk of thyroid dysfunction.
Humans ; Triiodothyronine ; Thyroxine ; Thyroid Gland/radiation effects* ; X-Rays ; Thyrotropin ; Radiation, Ionizing

To identify the effect of post-operative irradiation to the thyroid gland in patients with breast carcinoma. Seventy seven patients with partial or total mastectomized breast carcinoma who received routine irradiation therapy (Hockey stick method: supraclavicular, internal mammary lymph nodes, and chest wall irradiation with 5, 040 rads, divided into 30 treatments) were reviewed in terms of their ipsilateral thyroid gland response. All patients had the bilateral thyroid sizes measured annually by ultrasonography before and after radiation therapy. In the one-year follow-up group (n=77), 32 patients (41.5%) demonstrated decreased ipsilateral thyroid gland size after Hockey Stick irradiation therapy (p=0.428), in the two-year follow-up group (n=37), 26 patients (70.3%) demonstrated decreased gland size after Hockey Stick irradiation (p=0.001), and in the three-year follow-up group (n=21), 15 patients (71.4%) showed a decreased thyroid gland size (p=0.005). Most the patients with breast carcinoma (32/77 at the one-year follow-up, 26/37 at the two-year follow-up, and 15/21 at the three-year follow-up) after post-operative Hockey Stick irradiation therapy showed reduced ipsilateral thyroid gland size. Routine en face treatment of the supraclavicular lymph nodes, using the Hockey Stick method, should be reconsidered.
Breast Neoplasms/*radiotherapy ; Female ; Follow-Up Studies ; Human ; Lymph Nodes/*radiation effects ; Radiotherapy/adverse effects ; Thyroid Gland/pathology/*radiation effects

OBJECTIVE: The purpose of this study is to estimate a patient's organ dose (effective dose) during performance of dual X-ray absorptiometry by using the correlations derived from the surface dose and the depth doses in an anthropomorphic phantom. MATERIALS AND METHODS: An anthropomorphic phantom was designed and TLDs (Thermoluminescent Dosimeters) were placed at the surface and these were also inserted at different depths of the thyroid and uterus of the anthropomorphic phantom. The absorbed doses were measured on the phantom for the spine and femur scan modes. The correlation coefficients and regression functions between the absorbed surface dose and the depth dose were determined. The derived correlation was then applied for 40 women patients to estimate the depth doses to the thyroid and uterus. RESULTS: There was a correlation between the surface dose and depth dose of the thyroid and uterus in both scan modes. For the women's dosimetry, the average surface doses of the thyroid and uterus were 1.88 (micro)Gy and 1.81 (micro)Gy, respectively. Also, the scan center dose in the women was 5.70 (micro)Gy. There was correlation between the thyroid and uterus surface doses, and the scan center dose. CONCLUSION: We concluded that the effective dose to the patient's critical organs during dual X-ray absorptiometry can be estimated by the correlation derived from phantom dosimetry.
*Absorptiometry, Photon ; Female ; Femur/radiography ; Humans ; Linear Models ; Middle Aged ; *Models, Anatomic ; *Phantoms, Imaging ; *Radiation Dosage ; Spine/radiography ; Thyroid Gland/*radiation effects ; Uterus/*radiation effects

BACKGROUND/AIMS: ERCP using fluoroscopy should be practiced with an adequate radiation protection. However, the awareness of gastrointestinal endoscopists to radiation protection was considered insufficient. In Korea, a country with a rapid increase the number of ERCP procedures, there is no data about radiation protection practices for gastrointestinal endoscopists. The purpose of this study was to investigate current clinical practices and the awareness on radiation protection in ERCP performing physicians in Korea. METHODS: An anonymous questionnaire regarding radiation protection practices was mailed to 100 members of Korean Pancreatobiliary Association who was porforming ERCP. The questionnaire included ERCP volume of each endoscopist, use of protection devices such as apron, thyroid shield, lead glasses and any mobile shield for scattered radiation, and whether they monitored their own radiation exposure dosage. RESULTS: All respondents wore lead aprons during ERCP. While 52.5% of endoscopists answered that they always wear thyroid guards, 26.9% rarely or never wore it. Only 14% wore lead glasses during the procedure and 69% never wore it. The preparation rates of mobile shields or lead curtains were only 14% and 24%, respectively. Only 10% of endoscopists attached an X-ray badge and 66.7% never used it. Moreover, 75% of endoscopists responded that they did not monitor their own exposure dose to radiation during ERCP. CONCLUSIONS: The lack of radiation protection of ERCP endoscopists in Korea was seemed serious. Awareness of radiation hazard should be more concerned and educated in parallel with the preparation of radiation protection equipments.
*Cholangiopancreatography, Endoscopic Retrograde ; Eye Protective Devices ; Female ; Hospitals ; Humans ; Male ; Occupational Exposure/*prevention & control ; Questionnaires ; Radiation Monitoring ; Radiation Protection/*methods ; Thyroid Gland/radiation effects

OBJECTIVETo explore the value of color doppler ultrasound examination of thyroid in occupational health care of radiation-exposed physicians.

METHODSOne hundred and thirty-four radiation-exposed physicians (observation group) and sixty-eight non-radiation-exposed physicians (control group) received color doppler ultrasound examination of thyroid using ALOKA SSD-4000 color doppler ultrasonic diagnostic apparatus, and the results were compared between the two groups.

RESULTSThe anteroposterior diameters of the left lobe, right lobe, and isthmus of the thyroid in the observation group were significantly larger than those in the control group (P < 0.01). Compared with the control group, the observation group had significantly larger internal diameters and peak blood flow velocities during systole of the right superior thyroid artery (P < 0.05, P < 0.05). There were no significant differences in detection rates of thyroid nodules and lymph nodes between the observation group and the control group (18.7% vs 13.2%, P > 0.05; 6.7% vs 1.5%, P > 0.05). The radiation-exposed physicians were exposed to low-dose ionizing radiation with a dose between 0.14 and 1.67 mSv/a.

CONCLUSIONThe color doppler ultrasound examination of the thyroid can detect early changes in the thyroid of radiation-exposed physicians exposed to long-term and low-dose ionizing radiation.

Humans ; Lymph Nodes ; Occupational Exposure ; analysis ; Occupational Health ; Physicians ; Radiation Exposure ; analysis ; Radiation, Ionizing ; Thyroid Gland ; diagnostic imaging ; radiation effects ; Ultrasonography, Doppler, Color

BACKGROUND: The Korea Radiation Effect & Epidemiology Cohort METHODS: Using the KREEC-R raw data, we calculated age standardized rates (ASRs) of female thyroid cancer and re-analyzed the results of survey on the use of medical services. We also marked the administrative districts of residents who received the Radiation Health Research Institute (RHRI) health examinations and those in which thyroid cancer case occurred as per the Chonnam National University Research Institute of Medical Sciences (RIMS) final report on maps where the locations of NPPs and 5 km-radii around them were also indicated. And we compared the incidence rates of Radiation-induced cancer measured between the first period when RHRI health examinations were not yet implemented, and the second period when the RHRI health examinations were implemented. RESULTS: The ASR for the far-distance group, which comprised residents living in areas outside the 30 km radius of the NPPs, increased rapidly after 2000; however, that of the exposed group, which comprised residents living within a 5 km radius of the NPPs, started to increase rapidly even before 1995. The frequencies of the use of medical services were significantly higher in the intermediate proximate group, which comprised residents living within a 5–30 km radius of the NPPs, than in the exposed group in women. In case of female thyroid cancer, the second period ASR was higher than the first period ASR, but in case of female liver cancer and female stomach cancer no significant difference were observed between the periods. On map, many administrative districts of residents who received RHRI health examinations and most administrative districts in which thyroid cancer case occurred on RIMS final report were outside 5 km-radii around NPPs. CONCLUSIONS: We could not find any evidence supporting the assertion that detection bias influenced the increased risks of female thyroid cancer observed in the exposed group of the KREEC-R study, as opposed to the control group.
Academies and Institutes ; Bias (Epidemiology) ; Cohort Studies ; Epidemiology ; Female ; Humans ; Incidence ; Jeollanam-do ; Korea ; Liver Neoplasms ; Neoplasms, Radiation-Induced ; Nuclear Power Plants ; Radiation Effects ; Radius ; Stomach Neoplasms ; Thyroid Gland ; Thyroid Neoplasms

Radioiodine activity required for remnant thyroid ablation is of great concern, to avoid unnecessary exposure to radiation and minimize adverse effects. We investigated clinical outcomes of remnant thyroid ablation with a low radioiodine activity in Korean patients with low to intermediate-risk thyroid cancer. For remnant thyroid ablation, 176 patients received radioiodine of 1.1 GBq, under a standard thyroid hormone withdrawal and a low iodine diet protocol. Serum levels of thyroid stimulating hormone stimulated thyroglobulin (off-Tg) and thyroglobulin-antibody (Tg-Ab), and a post-therapy whole body scan (RxWBS) were evaluated. Completion of remnant ablation was considered when there was no visible uptake on RxWBS and undetectable off-Tg (<1.0 ng/mL). Various factors including age, off-Tg, and histopathology were analyzed to predict ablation success rates. Of 176 patients, 68.8% (n = 121) who achieved successful remnant ablation were classified into Group A, and the remaining 55 were classified into Group B. Group A presented with significantly lower off-Tg at the first radioiodine administration (pre-ablative Tg) than those of Group B (1.2 +/- 2.3 ng/mL vs. 6.2 +/- 15.2 ng/mL, P = 0.027). Pre-ablative Tg was the only significant factor related with ablation success rates. Diagnostic performances of pre-ablative Tg < 10.0 ng/mL were sensitivity of 99.1%, specificity of 14.0%, positive predictive value of 71.1%, and negative predictive value of 87.5%, respectively. Single administration of low radioiodine activity could be sufficient for remnant thyroid ablation in patients with low to intermediate-risk thyroid cancer. Pre-ablative Tg with cutoff value of 10.0 ng/mL is a promising factor to predict successful remnant ablation.
Adolescent ; Adult ; Aged ; Female ; Humans ; Iodine Radioisotopes/*therapeutic use ; Male ; Middle Aged ; Republic of Korea ; Thyroglobulin/blood/immunology ; Thyroid Gland/*pathology/*radiation effects ; Thyroid Neoplasms/*radiotherapy ; Thyrotropin/blood ; Treatment Outcome ; Young Adult

OBJECTIVE: To determine the effect of radiotherapy on the thyroid of patients with nasopharyngeal cancer. METHODS: Thyroid dynamic imaging was performed on 51 patients with nasopharyngeal cancer who had the metastasis of the jugular lymph node before and after the radiotherapy. The peak time of the thyroid artery perfusion and the constant K were obtained. The levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) in the blood serum were measured at the same time. RESULTS: The peak time of the left and right thyroid artery perfusion before the radiotherapy was (14.5+/-2.1)s and (15.1+/-1.9)s, respectively, while that after the radiotherapy was (19.3+/-3.2)s and (20.2+/-3.5)s, respectively. There was significant difference between the pre- and post-radiotherapy (P<0.001). The constant K of the left and right thyroid before the radiotherapy was significantly higher than that after the radiotherapy (0.0265+/-0.0074 vs. 0.0173+/-0.0062; 0.0249+/-0.0065 vs. 0.0167+/-0.0053, P<0.001, respectively). The level of FT3 and FT4 was significantly higher than that after the radiotherapy, but the TSH level had no obvious change[(4.76+/-0.95) pmol/L vs. (3.85+/-0.71) pmol/L,P<0.001; (18.63+/-3.84) pmol/L vs. (15.69+/-3.27) pmol/L,P<0.001; (1.17+/-0.52) mU/L vs. (1.22+/-0.76)mU/L ,P>0.05, respectively]. CONCLUSION The peak time of the thyroid artery perfusion and the constant K which reflect blood stream status after the radiotherapy are all damaged in patients with nasopharyngeal cancer. The level of FT3 and FT4 in the blood serum is dropped but the TSH level has no obvious change.
Adult ; Aged ; Female ; Humans ; Hypothyroidism ; blood ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; physiopathology ; radiotherapy ; Thyroid Function Tests ; Thyroid Gland ; radiation effects ; Thyrotropin ; blood ; Thyroxine ; blood ; Triiodothyronine ; blood ; Young Adult

OBJECTIVETo evaluate the effect of 90Y-DOTATOC and 131I-MIBG in treatment of metastatic medullary thyroid carcinoma (MTC).

METHODSTwelve histologically confirmed patients with metastatic MTC were included. All patients underwent both 111In-DTPA-octreotide imaging and 131I/ 123I-meta-iodobenzylguanidine (MIBG) imaging. According to the results of the combined imaging, positive patients were selected to be treated with 90Y-DOTA-D-Phe1-Tyr3-octreotide (90Y-DOTATOC) or 131I-MIBG, respectively. The therapeutic procedures of targeted internal radiation were performed with 3.33 GBq 90Y-DOTATOC at 6-week intervals, or 11.1 GBq 131I-MIBG with a minimum interval of three months.

RESULTSThe imaging procedure was positive in all 12 patients: 111In-DTPA-octreotide imaging in eight patients, 131I/ 123I-MIBG imaging in six patients. According to the results of combined imaging, we identified four patients to be treated with 90Y-DOTATOC, and five patients with 131 I-MIBG. After three to five sessions of treatment, three patients with partial remission and six with stable disease were observed. The effective rate was 3/9 (33.3%) and the overall tumor response rate was 9/9 (100%). No relevant toxicity was observed.

CONCLUSIONThe combined imaging technique can be used to identify patients for effective radionuclide treatment. The treatment with 90Y-DOTATOC or 131I-MIBG is well tolerated and may improve the fate of patients with metastatic MTC.

3-Iodobenzylguanidine ; therapeutic use ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Medullary ; metabolism ; radiotherapy ; secondary ; Female ; Follow-Up Studies ; Humans ; Indium Radioisotopes ; Male ; Middle Aged ; Octreotide ; analogs & derivatives ; therapeutic use ; Pentetic Acid ; analogs & derivatives ; Positron-Emission Tomography ; Remission Induction ; Thyroid Gland ; diagnostic imaging ; pathology ; radiation effects ; Thyroid Hormones ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology ; radiotherapy ; Treatment Outcome ; Yttrium Radioisotopes ; therapeutic use