Clinical evaluation of thyroid imaging with 201T1-chloride.

Clinical value and limitation of thyroid imaging with 201T1Cl were studied. The positive rate of 201T1 was 82% in 22 malignant thyroid lesions and 46% in 37 benign lesions. A 201T1 positive image was obtained when a lesion was parenchymatous and a 201T1 negative one when it was cystic, filled with colloid or hyaline and had massive necrosis or bleeding. Thus 201T1Cl localized in a parenchymatous lesion and did not in a nonparenchymatous one regardless of a malignant or benign disease. An increasing positive lesion in contrast with the surrounding thyroid tissue implies that it may be malignant and a decreasing one benign as a results of review of serial scintiphotos. Scintigraphic methods with 131I and 201T1 are complementary each other and a 201T1 negative image itself has a high diagnostic value but it seems to be better to attach much value to the finding of imaging with 131I when a 201T1 positive image is obtained.     

Thallium-201 radioactive implant induced X-ray emission scanning of stable iodine distribution in thyroid--phantom experiment

A new method has been developed for imaging the thyroid gland by the use of 201Tl radioactive implant induced X-ray emission (RIXE). The thyroid phantom was made from two cylindrical tubes embedded in plastic neck phantom. Each tube consisted of stable iodine and 201Tl radioactive source in 10 ml water solution. Some photopeaks in the energy range from 20 to 200 ke V were scanned along a horizontal axis by the collimated Ge detector with high energy resolution. The distribution on the horizontal axis was obtained for the generated I K alpha-ray and some primary 201Tl radiations. The 201Tl RIXE scanning can provide information about the distribution of iodine with 201Tl as well as 201Tl distribution in the thyroid gland. The effectiveness of the 201Tl RIXE technique as a thyroid scanning method is discussed.     

Thallium-201 chloride dynamic analysis using thallium-201 chloride and sodium iodide-131 thyroid subtraction scintigraphy

The mechanism of 201Tl chloride accumulation is unclear in thyroid gland and thyroid tumor. This report examines 108 patients that received thyroid scintigraphy examinations with both 201Tl chloride and sodium 131I. The patients were diagnosed clinically and histologically whenever possible. The ROI were obtained by subtraction imaging with both isotopes and by subtraction positive and negative areas of imaging. Dynamic curves were obtained for 201Tl chloride per square unit of each ROI. The dynamic curve in the radioiodide-accumulated area was examined. The data indicate that the clearance rate of 201Tl chloride (T15) was correlated with the sodium 131I uptake rate at 24 h (r = 0.70).     

高频超声联合PSV、RI、Adler血流分级在甲状腺良恶性结节中的诊断价值

本研究探讨高频超声联合彩色多普勒超声参数在诊断甲状腺良恶性结节中的价值。选取40例甲状腺癌患者作为观察组,42例甲状腺良性结节患者作为对照组,比较两组、不同N和T分期患者高频超声联合彩色多普勒超声参数,并对数据进行统计分析。两组结节形态、边界、回声、钙化超声征象比较,差异具有统计学意义(P<0.05)。观察组A/T_C、A/T_L、TI-RADS分级评分、PSV、RI、Adler血流分级评分高于对照组(P<0.05)。各参数联合诊断恶性甲状腺结节的AUC为0.902,诊断N1分期的AUC为0.879,诊断Ⅲ+Ⅳ分期的AUC为0.915,均大于任一单一参数(P<0.05)。可见采用高频超声、彩色多普勒超声联合观测甲状腺结节征象与A/T_C、A/T_L、TI-RADS分级、PSV、RI、Adler分级,可诊断结节性质,并能评估恶性结节患者术前肿瘤分期,为临床治疗、决策提供量化参考。     

高频超声联合彩色多普勒超声对甲状腺良/恶性结节的诊断价值

本文探讨了高频超声联合彩色多普勒超声对甲状腺结节良/恶性的诊断价值.选择疑似甲状腺结节患者82例作为研究对象,本研究比较了高频超声和彩色多普勒超声与术后病理结果的差异;绘制了ROC曲线,分析了高频超声联合彩色多普勒超声对甲状腺结节良/恶性的诊断效能.结果发现,病理学检查与高频超声联合彩色多普勒超声检查相比较,差异不具有...     

孤立性肺结节的CT形态学特征结合GSI模式的诊断学研究

本研究探讨CT联合能谱成像(GSI)模式诊断孤立性肺结节的临床价值。选取经肺穿刺活检或手术病理学证实的肺孤立性结节患者110例(110个肺结节),对患者的CT平扫、GSI平扫资料进行分析。根据病理学结果分为良性组(炎性结节、非典型腺瘤样增生)41例、恶性组(肺癌小结节)69例,对比两组患者的肺小结节形态学特征综合评分、动静脉期的能谱曲线斜率、40 keV CT值、标准化碘浓度(NIC)的差异。结果显示,恶性组患者的毛刺征和棘突征、分叶征、血管集束征、胸膜凹陷征、支气管征、病灶内钙化、病灶强化值及孤立性肺结节形态学特征总分均高于良性组(P<0.05);恶性组患者的动脉期、静脉期的能谱曲线斜率、40 keV CT值、NIC均低于良性组(P<0.05)。肺部孤立性恶性结节的形态学特征与肺部良性结节差异显著,恶性结节的能谱曲线斜率、40 keV CT值、NIC值与良性结节差异明显。因此,综合分析结节的形态学特征及GSI参数对其良恶性诊断具有重要意义。     

Molecular Pathological Diagnosis of Thyroid Tumors Using Spatially Resolved Metabolomics

The pathological diagnosis of benign and malignant follicular thyroid tumors remains a major challenge using the current histopathological technique. To improve diagnosis accuracy, spatially resolved metabolomics analysis based on air flow-assisted desorption electrospray ionization mass spectrometry imaging (AFADESI-MSI) technique was used to establish a molecular diagnostic strategy for discriminating four pathological types of thyroid tumor. Without any specific labels, numerous metabolite features with their spatial distribution information can be acquired by AFADESI-MSI. The underlying metabolic heterogeneity can be visualized in line with the cellular heterogeneity in native tumor tissue. Through micro-regional feature extraction and in situ metabolomics analysis, three sets of metabolic biomarkers for the visual discrimination of benign follicular adenoma and differentiated thyroid carcinomas were discovered. Additionally, the automated prediction of tumor foci was supported by a diagnostic model based on the metabolic profile of 65 thyroid nodules. The model prediction accuracy was 83.3% when a test set of 12 independent samples was used. This diagnostic strategy presents a new way of performing in situ pathological examinations using small molecular biomarkers and provides a model diagnosis for clinically indeterminate thyroid tumor cases.     

CT、MRI对良恶性甲状腺结节的鉴别价值

本文探讨了计算机断层扫描（CT）、磁共振成像（MRI）对良恶性甲状腺结节的鉴别价值。方法：选取2015年3月至2018年3月本院收治的甲状腺结节患者150例，依据病理结果分为恶性48例、良性102例，所有患者均给予CT、MRI检查，分析CT、MRI对良恶性甲状腺结节的鉴别价值。结果发现，MRI总病灶、形态不规则、边界不清/毛糙、信号/密度不均检出率明显高于CT，MRI钙化灶检出率明显低于CT，差异有统计学意义（P<0.05），CT、MRI淋巴结转移检出率比较，差异无统计学意义（P>0.05）；在鉴别良恶性甲状腺结节的敏感度、特异度、准确度中，CT为79.17%、74.51%、76.00%，MRI为83.33%、80.39%、81.33%，CT联合MRI为95.83%、96.08%、96.00%，CT联合MRI明显高于CT、MRI，差异有统计学意义（P<0.05）。说明CT、MRI可作为鉴别良恶性甲状腺结节的重要方法，CT对钙化灶有较高的分辨能力，MRI对软组织及小病灶有较高的分辨能力，CT联合MRI可有效提高其鉴别价值。     

Distribution of 201Tl in the blood

Thallium-201 distribution in the blood was investigated both in vivo and in vitro. Thallium-201 was distributed into the erythrocytes and plasma with the ratio of 1.4 +/- 0.3 to 1.0, immediately after its administration. The uptake of 201Tl into the erythrocytes in vitro were affected by the incubation temperature and the presence of ouabain and KCl; indicating that the 201Tl was uptaken into cells partly through their membranes Na, K-ATPase. Erythrocytes could retain 201Tl in it, whereas 201Tl was present as free ion in the plasma. Thallium-201 was flew out of erythrocytes into the plasma, keeping the ratio of 201Tl in erythrocytes/plasma to be 1.9 +/- 0.2/1.0.     

Sequential changes of the cardiomyopathy in Duchenne muscular dystrophy by 201Tl myocardial SPECT

201Tl myocardial SPECT was performed to evaluate cardiomyopathy in Duchenne type of progressive muscular dystrophy (DMD). Follow up SPECT images of the same patients were also obtained about 1 year after the first scan. Cases subjected to study were 10 DMD. At the first study the hypoperfusion area of the left ventricular muscle was observed in 6 cases (60%) out of 10. At the second study the hypoperfusion areas became wider and lower in 4 out of 6 cases (66.7%). The new hypoperfusion area which was not demonstrated at the first study was observed at the second study in one case of these cases. These results suggested that the positive rate of cardiomyopathy in DMD by 201Tl myocardial SPECT was high, and 201Tl myocardial SPECT is a useful examination to detect the change of myocardial damage in DMD.     

Gamma-ray spectra of 201Tl-radiopharmaceuticals with a scintillation camera--crosstalk of contaminating nuclides of 200Tl and/or 202Tl onto 201Tl-photopeaks

In cardiac imaging with 201Tl, the collimator for low energy high resolution is generally used, and also the energy window, which is set on the spectral display of a pulse height analyzer of a scintillation camera, is chosen 70 +/- 12.5 keV. The purpose of this study is to discuss those conditions in 201Tl imaging with the scintillation camera. Two types of collimators for HR (high resolution) and ME (medium energy) were used in this experiment, and we measured the pulse height spectra of 201TlCl radiopharmaceuticals in air and in a cuboid phantom, connecting a multi-channel pulse height analyzer to the scintillation camera. As a result of measuring of the pulse height spectra, two different energies of gamma rays which are not supposed to emit from 201Tl nuclide were observed, and we also identified the presence of a small amount of 202Tl (with 439 keV) and/or 200Tl (with 368 keV) from their half-life measurements. Thus, the use of the HR-collimator with 201Tl imaging is not suitable, because the shielding effects of its septa is poor to 439 keV gamma-rays, and the scattered radiation produced by the Compton interaction contributes to the principal photopeak on the pulse height spectrum. Here, we recommend the use ME-collimator instead of the HR-one, and of the window width of 76 +/- 25 keV for increasing the count rate.     

SMI技术测定血流分布模式、消融灶体积与甲状腺结节良恶性诊断及患者疗效预测的关系研究

分析SMI（微血管成像技术）测定血流分布模式、消融灶体积与甲状腺结节良恶性诊断及患者疗效预测的关系。将我院2017年1月～2019年2月期间收治的60例甲状腺结节患者依照患者术后病理检测结果分为良性组及恶性组;采用微波消融术对患者进行治疗,并在治疗前后采用SMI及CEUS（超声造影）对患者病情进行评估。结果显示,采用SMI对患者进行评估的敏感度、特异度、准确度及AUC,均明显高于CEUS,且差异存统计学意义（P<0.05）;采用SMI扫描检查的病灶未完全消融率、参与微血管率均明显高于CEUS检查,且差异存统计学意义（P<0.05）,采用SMI扫描检查的消融灶体积、消融灶长及消融灶宽均明显高于CEUS扫描检查,且差异存统计学意义（P<0.05）。证明采用SMI技术对甲状腺结节良恶性进行诊断具有较高的应用价值,并可有效用于评估临床疗效。     

Autoantibodies to thyroglobulin in health and disease

Thyroglobulin (Tg)—a heavily glycosylated, iodinated protein—isa major autoantigen in autoimmune thyroiditis. Tg also induces thyroiditis by immunization of experimental animals. Humans with chronic lymphocytic thyroiditis characteristically produce autoantibodies to thyroglobu lin, but similar autoantibodies are also found in some clinically normal, euthyroid individuals. A comparison of the fine specificity of autoantibodies in humans and in experimentally immunized mice was carried out, based on their ability to inhibit a panel of monoclonal antibodies (MAbs). Patients with autoimmune thyroid disease, as well as normal individuals, produced autoantibodies mainly to the conserved, cross-reactive determinants of thyroglobulin. Patients developed additional autoantibodies to species-restricted epitopes. The determinants recognized by patients with Graves' disease differed in some respects from epitopes recognized by thyroiditis patients or patients with differentiated thyroid carcinoma. Similarly, mice that are genetically susceptible to thyroiditis produced autoantibodies that reacted with the mouse-specific antigenic determinants. Using an autoantibody that reacts with one of the epitopes associated with thyroiditis, a reactive 15-k Da fragment of human Tg—localized at the carboxy end of the molecule—was isolated and sequenced. Iodine plays an important role in the precise specificity of the disease-associated epitope, since T cells from patients with thyroiditis react with iodinated but not noniodinated human thyroglobulin. Addition of iodine to Tg generates new or cryptic epitopes. Use of a selected MAb as a surrogate for the T-cell receptor suggests that a specific iodine-containing epitope is sometimes involved in recognition. Finally, thyroglobulin-reactive autoantibodies exhibit proteolytic activity on thyroglobulin.     

LEAFS determination and concentration of metals in Great Lakes ecosystem

A Laser-Excited Atomic Fluorescence Spectrometric (LEAFS) method for Tl determination has been extended to investigate the direct determination (without preconcentration nor acid digestion) of total Pb, for which the method validation was successfully achieved by using a standard reference material as well as many spike recoveries of digested and undigested unfiltered water samples. The method was applied to study total and dissolved Pb in many water columns collected from different stations in Lake Ontario. Dissolved Pb was found to be about twice as much as dissolved Tl, and total Pb about seven times higher than total Tl. Seventy five percent of Pb is in particulate form versus 11% for Tl. Also, a simple cold dissolution procedure using HNO(3) and HF (not a hot acid digestion) is proposed to "liquefy" sediments in a form suitable for LEAFS analysis and was used to analyze a sediment core, where pore water samples were also collected. The interaction dynamics of Tl within the natural environment of a water/pore water/sediment system from Lake Erie was assessed. The calculations of fluxes suggest a strong similarity between Tl and Cd geochemical transport. The paper also presents for the first time a genuine sediment pore water profile of Tl concentration, which ranged from sub- to 40 ng/l and which was directly determined by LEAFS.     

Quality control of201TlCl solution obtained at IPEN-CNEN/SP

The radiopharmaceutical²⁰¹TlCl(thallium-201 chloride) is used in nuclear medicine for myocardial visualization. The solution of²⁰¹TlCl was prepared using²⁰¹Tl obtained by irradiating a natural mercury target with protons from the CV-28 cyclotron installed at IPEN-CNEN/SP. This solution was subjected to different quality control processes required for its use in medicine. Some of these controls concerned the determination of the radionuclidic impurities:²⁰⁰Tl,²⁰²Tl and²⁰³Hg; the chemical identification of²⁰¹Tl⁺; the hydrazine concentration, mercury contamination and the presence of phosphate. Furthermore. the biological distribution in Wistar rats and tests for sterility, pyrogenicity and toxicity were carried out. It was verified that the solution obtained was in the form of thallous chloride. This radiopharmaceutical gave good heart images in animals but due to the high levels of²⁰⁰Tl and²⁰²Tl its use in humans is not possible unless enriched²⁰²Hg is used as target in the irradiation.     

Determination of rhenium in manganese nodules by inductively coupled plasma mass spectrometry

Understanding of rhenium behavior in seawater gives an idea of the possible behavior of ⁹⁹Tc, which is an important radionuclide in long-term dose assessment for humans. In this study, Re determinations in manganese nodules, which have high Mn content, were carried out. Since Mn, Tc and Re are the member of group 7A in the periodic table, accumulation of Tc and Re in the nodules was also expected. After alkaline fusions and chemical separations, Re concentrations in manganese nodules were measured by ICP-MS. Total chemical recovery of the method for Re was 95% and the detection limit was 4.5 ng/kg. Re concentrations in the manganese nodules were very low, <4.5–49 ng/kg. The results indicated that the nodules had been mineralized under oxic conditions. This type of nodule could not be an important geochemical reservoir of Re and ⁹⁹Tc in the sea.     

桥本氏甲状腺炎合并甲状腺乳头状微小癌患者的超声特点与临床参数的相关性分析

本文探讨了桥本氏甲状腺炎合并甲状腺乳头状微小癌患者的超声特点与临床参数的相关性。选择2010年1月~2018年12月我院收治的桥本氏甲状腺炎合并甲状腺乳头状微小癌患者75例作为研究组,单纯桥本甲状腺炎患者696例作为对照组,分析了两组患者的临床病理特征、二维超声图像特征及内部血流图像特征。结果显示,两组平均年龄、肿块直径、病灶数量、甲状腺结构、形态、晕圈比较无统计学差异(P>0.05);研究组的性别构成、病灶钙化情况、内部回声情况、内部血流情况与对照组有统计学差异(P<0.05)。多因素Logistic回归分析显示,女性、微钙化、边缘回声不清晰、内部极低回声、内部无血流是桥本氏甲状腺炎合并甲状腺乳头状微小癌的危险因素(P<0.05)。说明超声能够对桥本氏甲状腺炎合并甲状腺乳头状微小癌进行有效诊断。     

A case of parathyroid carcinoma visualized by 67Ga citrate and 201Tl chloride scintigraphy

Both 67Ga citrate and 201Tl chloride accumulated in a parathyroid tumor of a 62 year-old woman with primary hyperparathyroidism. Histological studies disclosed that the tumor was a parathyroid carcinoma. The use of both tumor scanning agents, 67Ga citrate and 201Tl chloride to visualize parathyroid carcinoma in a patient with primary hyperparathyroidism has not been reported as far as we could determine.     

LEAFS determination and concentration of metals in Great Lakes ecosystem

A Laser-Excited Atomic Fluorescence Spectrometric (LEAFS) method for Tl determination has been extended to investigate the direct determination (without preconcentration nor acid digestion) of total Pb, for which the method validation was successfully achieved by using a standard reference material as well as many spike recoveries of digested and undigested unfiltered water samples. The method was applied to study total and dissolved Pb in many water columns collected from different stations in Lake Ontario. Dissolved Pb was found to be about twice as much as dissolved Tl, and total Pb about seven times higher than total Tl. Seventy five percent of Pb is in particulate form versus 11% for Tl. Also, a simple cold dissolution procedure using HNO₃ and HF (not a hot acid digestion) is proposed to liquefy sediments in a form suitable for LEAFS analysis and was used to analyze a sediment core, where pore water samples were also collected. The interaction dynamics of Tl within the natural environment of a water/pore water/sediment system from Lake Erie was assessed. The calculations of fluxes suggest a strong similarity between Tl and Cd geochemical transport. The paper also presents for the first time a genuine sediment pore water profile of Tl concentration, which ranged from sub- to 40 ng/l and which was directly determined by LEAFS.     

Does application of cement kiln exhausts affect root nodule biochemistry and soil N2-fixing microbes?

The research work carried out on cement exhausts centers mostly around vegetation and crop productivity (1-3) with little or no work on root nodulation. Soil plus foliar application of exhaust dusts did not affect soil/nodule rhizobial population, nodule initiation, and possible N₂-fixing capacity inCajanus cajan, Vigna radiata, Vigna mungo,Vigna catjung, andGlycine max. The nodular biochemistry was investigated in detail. The heme protein leghemoglobin was higher compared to the control. The levels of intermediary N compounds like total ureides of the nodules, which may serve as indirect evidence of symbiotic N₂ fixation, were higher in the treated plants. There were also increments in free proline, free amino acids, soluble proteins, soluble starch, soluble sugars, total nitrogen, and phenols in the treated plants. The levels of total nitrates, soluble sucrose, and soluble SH compounds of the nodule of the control and treated plants did not show a significant difference. The activities of ascorbate peroxidase, catalase, glutathione reductase, and Superoxide dismutase were significantly higher, possibly indicating their role in alleviation of H₂O₂ and O ₂ ^- damage by the exhausts. Enzymes like nitrate reductase, nitrite reductase, and glutamine synthetase, and also the activities of acid and alkaline phosphatases were not affected. The presence of beneficial soil microbes likeAzotobacter, Azospirillum, and mycorrhizae was not affected at all.