Search

Objective: The aim of this study was to compare the B mode ultrasonography findings of thyroid gland and peak systolic velocity of inferior thyroid artery by color Doppler application, in patients with diffuse toxic goiter at the time of diagnosis and 6-8 months after radioiodine 131-I therapy.Patients and Methods: This was a prospective observational study conducted in National Institute of Nuclear Medicine & Allied Sciences (NINMAS) between June 2015 and October 2016. Forty consecutive diagnosed diffuse toxic goiter patients were selected at the time of diagnosis prior to radioiodine therapy. An ultrasonography evaluation of thyroid gland (measurement of anterior posterior diameter for convenience) and measurement of peak systolic velocity of inferior thyroid artery in both sides of thyroid gland were performed before and after 131-I therapy (6-8 months). The examination was performed in thyroid division of NINMAS by advanced ultrasound machine with a linear transducer (5-12 MHz). The patients were divided into two groups. Group A-diffuse toxic goiter prior to radioiodine therapy and group B- same patients 6-8 months after radioiodine therapy.Results: A reduction in the anterior –posterior diameter of the thyroid gland was observed from pre to post treatment evaluation, performed at 6 and or 8 months after radioiodine therapy. Color Doppler showed increased parenchymal vascularity at the time of diagnosis which gradually declined after radioiodine therapy. Thyroid blood flow, as assessed by PSV of ITA, was significantly higher in Group A than in Group B respectively (70.5 ± 15.5 cm/ sec versus 22.2 ± 12.9 cm/sec). PSV was measured in 10 healthy euthyroid adults & their PSV ranged 13-20 cm/Sec. Parenchymal vascularity of the thyroid gland was higher in hyperthyroid patients than in euthyroid patients.Conclusion: Assessment of thyroid gland by B-mode ultrasound and blood flow by color Doppler study (CDS) is an effective marker in the initial diagnosis of diffuse toxic goiter.Bangladesh J. Nuclear Med. 20(1): 41-44, January 2017

Objective: This interventional study has undertaken to assess the gonadal function of differentiated thyroid cancer (DTC) patients within reproductive age group following single dose of radioactive iodine (131I) therapy/ablation.Patients and Methods: A total of 69 patients (25 male and 44 female) of DTC were included in this study, those were referred for 131I ablation after total thyroidectomy. Following RAI, these patients were followed-up three times at three months interval. The usual I-131 dose was 75 or 100 m Ci for ablation of thyroid residues and 150 mCi for treatment of nodal metastasis. All the patients were interviewed about menstrual (female only) and reproductive history and investigated of the level of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone of male patients and FSH, LH, estradiol (E2) of female patients before administration of 131I and three, six and nine months after therapy.Result: In this study all of the 25 (100.0%) male patients showed high FSH level after three months of therapy. The mean± SD FSH level of male patients was found significantly (p-0.001) higher (15.59±7.53 IU/L) after three months of therapy than the pretherapy (4.85±2.57 IU/L) level. The mean± SD of FSH level was significantly declining in six months and nine months of follow up. The mean± SD of LH hormone level of these patients was found 6.1±3.67 IU/L in pretherapy which was significantly increased to 7.67±4.33 IU/L after three months. The mean LH level was 7.20±3.98 IU/L at six months follow up and 7.3±3.5IU/L after nine months. The differences of LH level between 3 months to 6 months and 6 months to 9 months are not statistically significant. No significant change was observed in testosterone level throughout the study period. In female, five patients developed irregular menstruation (changed duration of cycle or lighter amount), three patients developed amenorrhea associated with hot flashes within six months of 131I administration. Biochemical study of the patients with amenorrhoea showed markedly elevated serum FSH, LH level and declined E2 level. The FSH, LH levels of the two patients with amenorrhea became normal within study period and one patient had persistent amenorrhea at 9 months. E2 level raised slowly.Conclusion: A single dose of radio-iodine (131I) therapy causes impairment of gonadal function of male patients within reproductive age group. In case of female patients the effect is insignificant. The effect is usually reversible and gonadal function of the patients restores within the study period.Bangladesh J. Nuclear Med. 19(2): 92-97, July 2016

Asymmetrical uptake of 99m Tc MDP (methylene diphosphonate) in skeletal scintigraphy in extremity may lead to confusion in the diagnosis of metastasis or complex regional pain syndrome. After the exclusion of possible contamination in this report a case was presented with asymmetrical uptake of MDP in the upper extremity from accidental intra-arterial injection.Bangladesh J. Nuclear Med. 19(2): 152-154, July 2016