Iranian Journal of Nuclear Medicine
Volume:3 Issue: 1, 1995

The incidence of mole pregnancy appears to be higher in Iran than in Europe or North America. This gave us an opportunity to study a number of biochemical measurements related to the thyroid. In 14 patients with hydatiform mole، the T3 resin uptake، serum thyroxine (T4)، ETR، T3 RIA، human serum TSH (hTSH) and serum human Chorinic gonadotropin (hCG) were measured. Of the 14 patients 6 showed clinical symtoms of hyperthyroidism. The TBG was increased in all cases، as expected in pregnancy. The T3 resin uptake was low in 4 of the 6 hyperthyroid cases، while the T4 was evevated in all 6 cases. As measured by RIA، each of the 6 hyperthyroid women had high values of T3 (greater than 3 ng/ml). The ETR was elevated in all 6 patients. The hTSH was normal in the 14 cases of mole pregnancy. After removal of the mole، the hTSH slightly rose in the 6 previously hyperthyroid cases. The hCG lev-''، was high in all 14 individuals، due to the molar pregnancy. However، it was not significantly higher in the 6 patients with clinical hyperthyroidism. There was not a direct correlation between the level of hCG and the degree of hyperthyroidism. The hCG fell to zero after removal of the mole. We conclude that a significant portion (6/14) of women with mole pregnancy in Iran have clinical evidence of hyperthyroidism. This does not directly correlate with the total hCG level، but might be related to individual variability in the TSH-like effects of hCG or in sensitivity of the thyrotropin effects of hCG.

Thirty one patients with biologic and clinical diagnosis of hyperparathyroidism were submitted to thallium-technetium scan prior to exploration of the neck. Scan findings were compared with the pathologic results. Surgical exploration of the neck showed a parathyroid adenoma in 24 patients, parathyroid carcinoma in 1 patient, normal parathyroid in another patient and parathyroid hyperplasia in 5 patients. TTS scan correctly detected and localized 19 out of 24(79%) of adenomas, and 7 out of 20(35%) of parathyroid hyperplasia. The scan was negative in a normal case and correctly localized a parathyroid carcinoma. Five false negatives and 3 false positives were found in the adenoma group with specificity of 95.8%. Scan sensitivity did not change with adenoma size and weight or serum calcium, phosphorus or PTH levels, in conclusion, TTS scan is a sensitive and useful procedure for preoperative localization of parathyroid adenoms.

In this study, l-131-MIBG imaging was performed in 44 patients with clinical suspicion of tumors originating from neuro-endocrine system. The patients were referred to our department following plasma and urinary measurement of epinephrine, norepinehrine and vanilmandelic acidfVMA). Radionuclide imaging was performel as a comparative or confirmatory measure in all patients who had previous abdominal sonography and CT scan: This study emphasizes that MIBG imaging is a non-invasive, sensitive, and specially specific method for evaluation of primary, metastatic, and recurrent neuro-endocrine (APUD) tumors.

When Tc-99m-sulfur colloid was introduced as an ideal liver-spleen agent in nuclear medicine, many other types of colloids followed by different manufacturers. They hoped to find a suitable colloidal agent, contrary to sulfur colloid, which is easy to use, and less sensitive to the low contamination of aluminum ions. One of this type of colloid agents, is Tc-99-tin-colloid which is prepared by reduction of pertechnetate ion with stannous ion. In such process the Tc-99m-Tc04 is reduced by stannous ions and in the next step combines with the same stannous ions to form insoluble complex Tc(OH)4, Sn(OH)2. The percipitate, is then converted to colloidal form by using suitable stabilizing agent. To make a suitable colloidal form, the quality and quantity of stabilizing agent play an important role in forming optimum diameters needed for maximum uptake in liver and spleen. In our investigation, PVP-360 and PVP-40t with different molecular weights were used as stabilizing agents. By mixing the above two chemical stabilizers with proper ratios, we obtained a reasonable viscosity necessary for preparing colloids of optimum size particles

During the 6-m period, 24 patients with acute scrotal pain were referred to the Nuclear Medicine Department of Shaheed Labbafi-Nejad hospital. Their age ranged from 9 to 84 (mean 28.8) years. Twelve scans were selected for the study. The scans were performed on angiographic and static phases, using Tc-pertechnetate. Of the above mentioned cases, one had acute testicular torsion (pre and post operative scans), two had epididymitis, six had orchitis, and two had epididymo-orchitis. The results were verified by clinical follow up and surgery. This study indicates that isotopic scan is very sensitive and accurate in evaluation of acute scrotal pain and can be very helpful in emergency cases.

Parathyroid adenomas, or hyperplasia may be present in patients with hypercalcemia. Treatment Is by surgical excision, but about 10% of the lesions may be In ectopic locations. Pre-operative localization of the lesions with non-lvasive imaging, using radionuclides, ultrasound, CT, or MR], may simplify surgery, and reduce patient morbidity. However, the reports of the accuracy of the currently available techniques have shown wide variations. This problem Is reviewed, with emphasis on the radionuclide methods of duai radiopharmaceutical thailium-pertechnetate subtraction, and sestamibi delayed Imaging protocols. The author recommends the routine use of sestamibi, with additional non-Invasive imaging techniques to be added If the original scan Is negative.

An extensive study was undertaken to Investigate on the overall film badge service performance with which occupational radiation, exposures are reported In Iran, The study involved the analysis of film badges exposed to x-and gamma rays and beta particles. For test exposures, x-rays between 60 and 140 KVPCo-60 gamma radiation and Sr-90 beta particles were used. The actual delivered dose equivalents were limited to 0.40-5 mSv which is the range of annual occupational dose reported by many international studies. This study revealed that the reporting on gamma rays, specially for Co-60, was very good. The reports on x-rays were overestimated. The overestimation was considerable at higher kVp''s. The results for beta particles were rather poor.