Acta medica Austriaca
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Acta medica Austriaca · Jan 1999
Comparative StudyComparison of different tracers in the follow up of differentiated thyroid carcinoma.
In the follow up of differentiated thyroid carcinoma (DTC) several scintigraphic methods are used in addition to the serum thyroglobulin and ultrasonography of the neck. Iodine-131 whole body scintigraphy (WBS), which is performed since many years, is able to detect iodine positive recurrence, lymph node metastases and distant metastases in a very specific way. ⋯ Therefore non specific radionuclides like TI-201 or tracers such as Tc-99m Sestamibi or Tc-99m Tetrofosmin and new metabolic tracers like F-18 FDG were introduced in the diagnostic work up to detect iodine negative metastases as well. This study describes the comparison of different tracers in 35 patients with elevated thyroglobulin and suspicion of metastatic disease or already known metastases from DTC.
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Guidelines for the management of thyroid nodules supposed to be malignant during pregnancy have not yet been established. We recommend performance of fine needle biopsy in thyroid nodules having developed during pregnancy, and in preexisting thyroid nodules suspicious of being malignant, respectively. ⋯ In threatening cases, i.e. in case of rapid growth of the nodule(s) or suspected high malignancy, surgery can be done at any time. Nevertheless, pregnancy itself neither seems to promote growth of thyroid cancer nor to have any impact on the dignity of cancer.
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Acta medica Austriaca · Jan 1996
Comparative StudyThe use of non-specific tracers in the follow up of differentiated thyroid cancer: results with Tc-99m tetrofosmin whole body scintigraphy.
Since many years TI-201, as non-specific tumor-searching radionuclide, plays a certain although somewhat controversial role in the follow-up of differentiated thyroid carcinoma (DTC). Recently some Tc-99m labeled myocardial perfusion agents were introduced, that might be more important for nuclear oncology in the future. Aim of this study was to evaluate prospectively the reliability of the new non-specific tumor searching tracer tetrofosmin (Myoview) in the post operative follow-up of differentiated thyroid carcinoma during TSH suppressive thyroid hormone treatment and to compare the results in patients with metastasizing DTC to Tc-99m sestamibi (Cardiolite) and TI-201. ⋯ Four cases with radioiodine negative disseminated lung metastases showed diffuse pulmonary tetrofosmin uptake. This prospective study shows that Tc-99m tetrofosmin is a new promising tracer to detect malignant recurrence and distant metastases in the follow up of DTC without the necessity of thyroid hormone withdrawl, especially in patients with elevated Tg level and no iodine uptake. Tc-99m tetrofosmin shows slight advantages concerning T/Bg Ratio, background clearance, detection rate and dosimetry compared with TI-201 and Tc-99m sestamibi.
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Diagnosing of alveolitis is a puzzle of many pieces, based on clinical experience and keeping in mind the criteria of extrinsic allergic alveolitis. They are antigen-exposure, typical delayed postexpositional symptoms (cough, chills, fever, dyspnea, tiredness), and serological tests of precipitating antibodies. ⋯ Differential diagnosis are toxic lung disorders, drug adverse effects, sarcoidosis, silicosis, autoimmune alveolitis, idiopathic fibrosing alveolitis. The most frequent failure in diagnosis are common viral cold, bronchopneumonia, sarcoidosis, chronic bronchitis, and miliar tuberculosis.
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The efficiency of first aid resuscitation is affirmed by many publications. In a questionnaire of the division of Cardiology of the Department of Internal Medicine, Graz and the Styrian Heart Patient Society distributed during the course of the Graz spring fair 1993 the population was approached as to first aid in cardiac arrest. 550 subjects responded to answer this circular for assessment dividing the population statistically in 4 different age groups showing differences among male and female and country and city dwellers. It has been shown that general first aid resuscitation has been known sufficiently, whereas special cardiorespiratory procedures (such as artificial respiration or cardiac massage) were unknown to most.