Title | ISHOD ABLACIJE OSTATNOG TKIVA ŠTITNJAČE S ABLATIVNOM DOZOM OD 30 mCi J-131 U BOLESNIKA LIJEČENIH ZBOG DOBRO DIFERENCIRANIH KARCINOMA ŠTITNJAČE U KLINIČKOM BOLNIČKOM CENTRU SPLIT OD 2008. DO 2010. |
Author | Nikolina Klarić-Kukuz |
Mentor(s) | Vinko Marković (thesis advisor)
|
Abstract | CILJ ISTRAŽIVANJA:
Istražiti ishod radiojodne ablacije ostatnog tkiva štitnjače nakon totalne tireoidektomije s
ablativnom dozom od 30 mCi J-131 u bolesnika operiranih zbog dobro diferenciranih
karcinoma veličine do 4cm, bez ekstratireoidne infiltracije i bez metastaza, te taj ishod
usporediti s ishodom ablativne doze od 100 mCi J-131.
HIPOTEZE ISTRAŽIVANJA:
Ukupna aktivnost J-131 po uspješno provedenoj ablaciji biti će manja u bolesnika u kojih je
primijenjena ablativna doza od 30 mCi J-131 nego u bolesnika u kojih je primijenjena
ablativna doza od 100 mCi J-131. U većine bolesnika kod kojih je provedena uspješna
ablacija s 100 mCi J-131 ista se uspješno mogla provesti i s dozom od 30 mCi J-131. Veću
osjetljivost u detekciji ostatnog tkiva štitnjače ima scintigram s J-131 nego tireoglobulin.
ISPITANICI I METODE:
Provela sam retrospektivno opservacijsko istraživanje u Kliničkom zavodu za nuklearnu
medicinu, Kliničkog bolničkog centra Split, u periodu 2008.-2010., uvidom u medicinsku
dokumentaciju 108 ispitanika koji su dobili ablativnu dozu od 30 mCi J-131 i 113 ispitanika
koji su dobili ablativnu dozu od 100 mCi J-131. Drugi parametar uspješnosti ablacije u
navedenim skupinama ispitanika bila je serumska koncentracia Tg prije ablacije i nakon
uspješne ablacije.
REZULTATI:
U 108 ispitanika koji su dobili ablacijsku dozu od 30 mCi J-131, uspješna ablacija je
provedena u 85 (79%) ispitanika dok je kod 113 ispitanika koji su dobili ablativnu dozu od
100 mCi J-131 uspješna ablacija provedena u 91 (89%) ispitanika. Prosječna aktivnost po
uspješnoj ablaciji u skupini ispitanika koji su dobili ablativnu dozu od 30 mCi J-131 je
iznosila 41 mCi, što je 2,6 puta manje nego prosječna doza u skupini ispitanika koji su dobili
ablativnu dozu od 100 mCi J-13 gdje je iznosila 107 mCi J-131. Veću osjetljivost u detekciji
ostatnog tkiva štitnjače ima scintigram s J-131 nego tireoglobulin (100% vs. 56%). Naime, Tg
se mogao koristiti samo kod 125 bolesnika jer je je 45 ispitanika imalo pozitivna
tireoglobulinska antitijela a 51 ispitanik, s negativnim tireoglobulinskim antitijelima, je imao
negativan nalaz Tg u vrijeme ablacije. Uspjeh ablacije mjeren negativizacijom Tg se nije
razlikovao između dviju ablativnih doza (79% u skupini koja je dobila ablativnu dozu od 30
mCi te 84% u skupini koja je dobila ablativnu dozu od 100 mCi) kao niti prosječno smanjenje Tg (0,8 vs. 0,7 ng/mL). Veću osjetljivost u detekciji ostatnog tkiva štitnjače ima
scintigram s J-131 nego tireoglobulin (100% vs. 56%).
ZAKLJUČCI:
Iako je uspjeh ablacije s ablativnom dozom od 30 mCi J-131 za 10% manji nego uspjeh
ablacije s ablativnom dozom od 100 mCi, prosječna aktivnost po uspješnoj ablaciji je 2,6 puta
manja s ablativnom dozom od 30 mCi J-131 nego s ablativnom dozom od 100 mCi J-131. U
79% ispitanika kod kojih je provedena uspješna ablacija s 100 mCi J-131 ista se uspješno
mogla provesti i s manjom ablativnom dozom od 30 mCi J-131. Veću osjetljivost u detekciji
ostatnog tkiva štitnjače ima scintigram s J-131 nego tireoglobulin (100% vs. 56%). Uspjeh
ablacije mjeren negativizacijom tireoglobulina se ne razlikuje između ablativnih doza no
nalaz tireoglobulina je upotrebljiv samo u 56% ispitanika. |
Keywords | Thyroid Neoplasms Iodine Radioisotopes - therapeutic use |
Parallel title (English) | RESULTS OF ABLATION OF THE RESIDUAL THYROID TISSUE WITH THE ABLATION DOSE OF 30 mCi J-131 IN PATIENTS TREATED FOR WELL-DIFFERENTIATED THYROID CARCINOMA AT THE CLINICAL HOSPITAL CENTRE SPLIT FROM 2008 TO 2010 |
Granter | University of Split School of Medicine |
Place | Split |
State | Croatia |
Scientific field, discipline, subdiscipline | BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Nuclear Medicine
|
Study programme type | university |
Study level | integrated undergraduate and graduate |
Study programme | Medicine |
Academic title abbreviation | dr. med. |
Genre | master's thesis |
Language | Croatian |
Defense date | 2012 |
Parallel abstract (English) | GOAL OF STUDY:
Investigation of radio-iodine ablation of the residual thyroid tissue after a total thyroidectomy
with the ablation dose of 30 mCi J-131 in patients operated for well-differentiated carcinoma
measuring up to 4 cm, without extra-thyroid infiltration and without metastases, and to
compare the results with the ablation dose of 100 mCi J-131.
HYPOTHESIS:
The total activity of J-131 after the successfully conducted ablation is going to be smaller in
patients who received an ablation dose of 30 mCi J-131 than in patients who were treated with
ablation dose of 100 mCi J-131. In most patients who received a successful ablation dose of
100 mCi J-131 the same results could be received with a dose of 30 mCi J-131. Higher
sensitivity level in detection of the residual thyroid tissue is seen with scintigram (J-131) than
with thyroglobulin.
SUBJECTS AND METHODS:
I’ve conducted a retrospective observation research in the Clinical department for nuclear
medicine, Clinical hospital centre Split, in the period from 2008.-2010., by investigating the
medical documentation of 108 test subjects which have received an ablation dose of 30 mCi J-
131 and of 113 test subjects which were given the ablation dose of 100 mCi J-131. Second
success parameter of the ablation in previously named groups of subjects was serum
concentration of Tg before and after the successful ablation was conducted.
RESULTS:
Of 108 test subjects which received the ablation dose of 30 mCi J-131, successful ablation
was observed in 85 (79%) of the subjects while in 113 who were given the ablation dose of
100 mCi J-131 showed success in 91 (89%) test subjects. The average activity of successful
ablation in a group of subjects which were given the ablation dose of 30 mCi J-131 was 41
mCi, which is 2,6 times smaller than the average dose in the group of subject which were
given the ablation dose of 100 mCi J-13, which was 107 mCi J-131. Higher sensitivity in detection of the residual thyroid tissue is seen in a scintigram with J-131 than with
thyroglobulin (100% vs. 56%). In fact, Tg could have been used only in 125 patients because
45 of the test subjects had positive thyroglobulin antibodies and 51 subject,with negative Tg
antibodies, had a negative Tg result at the time of the ablation. The success of the ablation
was measured with the negative Tg results comparison which didn't differ in between the two
ablation doses (79% in the group which was given the ablation dose of 30 mCi and 84% in the
group which was given the ablation dose of 100 mCi) neither did the average reduction of Tg
(0,8 vs. 0,7 ng/ml). Higher sensitivity in detection of the residual thyroid tissue was seen in a
scintigram with J-131 than in thyroglobulin (100% vs. 56%).
CONCLUSION:
Although the success of ablation with the ablation dose of 30 mCi J-131 was 10% smaller
than the success with the ablation dose of 100 mCi, the average activity of successful ablation
was 2,6 times smaller with the ablation dose of 30 mCi J-131 than with the ablation dose of
100 mCi J-131. In 79% of test subjects which went through a successful ablation with a dose
of 100 mCi J-131 the same efficiency could have been conducted with a smaller ablation dose
of 30 mCi J-131. Higher sensitivity in detection of the residual thyroid tissue was seen in a
scintigram with J-131 than in thyroglobulin (100% vs. 56%). The success of ablation
measured by comparing the negative thyroglobulin results doesn’t differ in between the two
ablation doses but the result can be only used in 56% of test subjects. |
Parallel keywords (Croatian) | Novotvorine štitnjače Radioizotopi joda - terapijska primjena |
Resource type | text |
Access condition | Access restricted to students and staff of home institution |
Terms of use |  |
URN:NBN | https://urn.nsk.hr/urn:nbn:hr:171:287450 |
Committer | Linda Ivas |