Iranian Journal of Nuclear Medicine
Volume:2 Issue: 1, 1994

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.

In research institute of nuclear medicine (Tehran University of Medical Sciences) 50 patients with follicular thyroid carcinoma were evaluted retrospectively. The purpose of the study was assesment of the response of iodine-131 therapy. The best result were achieved when the patient treated with iodine-131 for the first time, in the 4th decade of life, with total thyroidectomy and no metastasis. The most common site of distant metastasis was in the lung. The results of this research emphases, nessecity of total thyroidectomy before iodine therapy, and administration of the sufficient dose of 1-131 for the first time. Also there was a fairly good correlation between the results of the treated and nontreated patients with thyroglobulin levels.

The features of Hypertrophic pulmunary osteoarthropathy (HPOA) on radionuclide bone scintigraphy have been well described in case reports and small series of patients. The aim of this study was to investigate prospectively the prevalence and distribution of HPOA in a large series of patients with carcinoma of the lung. Two hundred and eleven patients aged 31-89 years (average age 66 years) male 65%. female 35% with biopsy proven carcinoma of the bronchus were examined with bone scintigraphy prior to treatment. Bony metastases were detected in 41 patients (20%) and HPOA in 14 patients (7%). Both metastases and HPOA were found in 2 patients (1%).HPOA was clinically suspected in 7 patients in oniy 4 of whom was it demonstrated on bone scan. Ten patients had HPOA on bone scintigraphy which was not suspected clinically- HPOA, when present, was localized to the tibia (71%), femur (50%), forearm (43%) and humerus (7%).We conclude that HPOA, as judged by features on radionuclide bone scintigraphy will be detected in only a minority of patients with imaging of the distal limbs in patients with carcinoma of the lung, when not previously suspected. The clinical benefit of imaging the distal limbs in such cases is unlikely to justify its introduction as a standard procedure.

Radiolabeled Microspheres of human serum albumin (MSA) is of great importance in the analysis of regional lung perfusion. Preparation of MSA kit has been installed in our Division recently is carried out in two stages:1. Production of albumin sphere particles with suitable sizes by using the spinning disk technique.2. Formulation of MSA as a radiopharmacutical kit. So it can be labelled simphy with TC - 99m in a short time and uptaken by the lungs within 15 mins when injected intravenously. More than 90% of Microsphere particles of injected dose are trapped by about 0.2% of pulmonary capillaries, which remain cssentialy unchanged within the first two hours after injection.After labelling the suspended Microspheres having a diameter between 10-50 mm and there are about 750000 to 850000 particles by vial. The biological half life of Microspheres in the lungs is 4 hours. All the procedure of preparation is under control and each vial is presented sterile, Pyrogen-free Lyophilized Mixture under vacum. No significant antigenic properties have been observed with denatured Albumin. The observed symptoms were attributed rather to the size and quantity of injected Microsphers. Many patients had repeated lung scans. However, no case of anaphylatoid reaction to human albumin microsphere has been reported.

This study aims to give data concrning phantom material made in Iran i''rom a natural rubber which is used for obtaining calibration data for patient dose measurements in nuclear medicine applications of radionuclides for therapy and diagnosis.Is showed to be a tissue equivalent material cheap (25000 Rials the material itself and 35000 Rials the process of casting and moulding etc.), easily available and can be moulded into the irregular shapes of the human body and is very convenient for developing countries where the availability of the primary materials of the recently introduced phantoms are not so easy

Hepatobiliary scintigraphy is a sensitive method for intra & extera hepatic bile leak diagnosis. Bile lead may be seen after hepatobiliary surgery, trauma, inflammatory disease or malignant neoplasms. Although sonography and CT scanning are useful for diagnosis of peritoneal or perihepatic fluid, they cannot prove bile ascites. Hepatobiliary scintigraphy with Tc-99m-IDA agents is a physiologic and noninvasive test to confirm bile leak.

Four patients with sonographic suggestion of hepatic hemangioma are studied with Tc99m-labeled RBC scan. The scan findings are compaired with other imaging modalities. Lesions as small as 36 mm could be detected by this method.Tc99m labeled RBC scan is a valuable tool to differentiate hepatic hemangioma from other space occupying lesion of the liver.

A 54 years old female with history of total thyroidectomy for papillary carcinoma, treated with lOOmCi of iodine-131 and negative whole body scans was referred for follow up study. Tl-201 scan revealed an area of radiotracer uptake in the neck region, suggestive of a parathyroid adenoma versus recurrence of thyroid carcinoma. The patient was operated, the parathyroid adenoma was removed. In this case report probability of the association of parathyroid adenoma and thyroid carcinoma is being discussed.

Filling defects are often observed on 99mTc sulfur colloid liver scans. Hot spots are much less frequently seen. Superior vena cava syndrome is the most frequent cause of this finding. In this report 3 patients with S.V.C and budd - Chiari syndrome with HOT SPOT on liver scan are presented.Mechanisms of scintigraphic patterns are reviewed.