11. |
- Berg, Gertrud, 1944
(författare)
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Radioiodine treatment for malignant thyroid disease.
- 2006
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 45:8, s. 1041-5
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Tidskriftsartikel (refereegranskat)abstract
- Radioiodine treatment for thyroid disease has been given for half a decade in Sweden. The most common indication for treatment is hyperthyroidism, when iodine uptake is high. The situation in which radioiodine treatment is used in thyroid cancer is less favourable and measures therefore have to be taken to optimize the treatment. Treatment should be performed early in the course of the disease to achieve the highest possible differentiation. Before treatment the iodine and goitrogen intake should be kept low. Stimulation of the thyrocytes by thyroid-stimulating hormone (TSH) should be high. It is conventionally achieved by thyroid hormone withdrawal rendering the patient hypothyroid, or by the recently available recombinant human TSH (rhTSH) which can be recommended for ablation of the thyroid remnant after thyroidectomy and for treatment of metastases in fragile patients unable to undergo hypothyroidism. Finally, stunning--the negative effect of a prior test dose from radioactive iodine--should be avoided.
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12. |
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13. |
- Fjälling, M, et al.
(författare)
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Systemic radionuclide therapy using indium-111-DTPA-D-Phe1-octreotide in midgut carcinoid syndrome.
- 1996
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Ingår i: Journal of nuclear medicine : official publication, Society of Nuclear Medicine. - 0161-5505. ; 37:9, s. 1519-21
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Tidskriftsartikel (refereegranskat)abstract
- A 55-yr-old woman with a midgut carcinoid syndrome due to metastatic spread of an ileal tumor to the liver, paraortic and mediastinal lymph nodes and to the skeleton was given systemic radionuclide therapy with 111In-DTPA-D-Phe1-octreotide. Before therapy, dosimetric calculations were performed on whole-body scintigraphs and 111In retention was shown to be long-lasting. Excretion was mainly seen during the first 24 hr after injection; thereafter whole-body retention remained stationary at 30%. Indium-111 activity in tumor biopsies and blood was measured using a gamma counter. Very high tumor-to-blood ratios were obtained: 150 for the primary tumor and 400-650 for liver metastases, which further justified radiation therapy. Indium-111-DTPA-D-Phe1-octreotide treatment was given on three separate occasions (3.0, 3.5 and 3.1 GBq) 8 and 4 wk apart. After each therapy, the patient experienced facial flush and pain over the skeletal lesions followed by symptomatic relief, even though no objective tumor regression was found radiologically after 5 mo. After initiation of octreotide treatment, there was a 14% reduction of the main tumor marker, urinary 5-HIAA. After three subsequent radionuclide therapies, there was a further 31% reduction of 5-HIAA levels. No adverse reactions, other than a slight decrease in leukocyte counts, were seen. The mean absorbed radiation dose after the three treatments was estimated to be about 10-12 Gy in liver metastases and 3-6 Gy in other tumors, depending on the size and location of the metastases. Assuming internalization of 111In into tumor cells and a radiobiological effect from short range Auger and conversion electrons, there might be a therapeutic effect on the tumor.
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14. |
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15. |
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16. |
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17. |
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18. |
- Hansson, Marie, 1979, et al.
(författare)
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Iodine content and distribution in extratumoral and tumor thyroid tissue analyzed with X-ray fluorescence and time-of-flight secondary ion mass spectrometry.
- 2008
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Ingår i: Thyroid : official journal of the American Thyroid Association. - : Mary Ann Liebert Inc. - 1557-9077. ; 18:11, s. 1215-20
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The thyroid's ability to enrich and store iodine has implications for thyroid cancer genesis, progression, and treatment. The study objective was to investigate thyroid iodine content (TIC) in tumoral and extratumoral tissue in patients with papillary thyroid cancer (PTC) as opposed to thyroid healthy controls using two different techniques: X-ray fluorescence (XRF) and time-of-flight secondary ion mass spectrometry (TOF-SIMS). METHODS: Tissue samples from 10 patients with normal thyroids and 7 patients with PTC were collected. TIC was quantified with XRF, and the iodine stores were located on a histological level with TOF-SIMS. RESULTS: Mean TIC in controls was 0.6 mg/mL (range 0.3-1.2 mg/mL). For the cancer patients, the mean TIC was 0.8 mg/mL (range 0.2-2.3 mg/mL) in extratumoral thyroid tissue, but no iodine was detected in the tumors. TOF-SIMS investigation of the PTC patients showed significantly higher TIC in extratumoral tissue than in tumoral tissue. Iodine in the extratumoral tissue was predominantly located in the follicle lumen with a variation in concentration among follicles. CONCLUSIONS: XRF and TOF-SIMS are two complementary methods for obtaining insight into content and localization of iodine in the thyroid. XRF can be used in vitro or in vivo on a large number of samples or patients, respectively. TOF-SIMS on the other hand provides detailed images of the iodine location. The combined information from the two methods is of value for further studies on iodine metabolism in thyroid malignancy.
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19. |
- Hansson, Marie, 1979, et al.
(författare)
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Iodine Content and Distribution in Thyroid Specimens from Two Patients with Graves' Disease Pretreated with Either Propylthiouracil or Stable Iodine: Analysis Using X-Ray Fluorescence and Time-of-Flight Secondary Ion Mass Spectrometry.
- 2012
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Ingår i: Case reports in endocrinology. - : Hindawi Limited. - 2090-651X .- 2090-6501. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- Patients with Graves' disease can be medically prepared before surgery in different ways, which may have various effects on iodine stores. Thyroid specimens were collected at surgery from two patients pretreated with propylthiouracil (PTU) and stable iodine, respectively. A quantitative analysis of iodine content was performed using X-ray fluorescence (XRF) in frozen tissue and a qualitative analysis of aldehyde-fixed material with Time-of-Flight Secondary Ion Mass Spectrometry (TOF-SIMS). Iodine concentrations were 0.9mg/mL and 0.5mg/mL in the thyroid tissue from the patients treated with PTU and stable iodine respectively. TOF-SIMS showed iodine in the follicle lumina in both. However, in the PTU case, iodine was also seen within the thyrocytes indicating accumulation of iodinated compounds from uninhibited hormone release. XRF and TOF-SIMS can be used to follow iodine distribution within the thyroid and the intricate processes following the different medical treatment alternatives in Graves' disease.
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20. |
- Hansson, Marie, 1979, et al.
(författare)
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Sample preparation for in vitro anallysis of iodine in thyroid tissue using x-ray fluorescence
- 2008
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Ingår i: Cancer Informatics. - 1176-9351. ; 6, s. 51-57
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Tidskriftsartikel (refereegranskat)abstract
- Iodine is enriched and stored in the thyroid gland. Due to several factors, the size of the thyroid iodine pool varies both between individuals and within individuals over time. Excess iodine as well as iodine defi ciency may promote thyroid cancer. Therefore, knowledge of iodine content and distribution within thyroid cancer tissue is of interest. X-ray fl uorescence analysis (XRF) and secondary ion mass spectrometry (SIMS) are two methods that can be used to assess iodine content in thyroid tissue. With both techniques, choice of sample preparation affects the results. Aldehyde fi xatives are required for SIMS analysis while a freezing method might be satisfactory for XRF analysis. The aims of the present study were primarily to evaluate a simple freezing technique for preserving samples for XRF analysis and also to use XRF to evaluate the effi cacy of using aldehyde fi xatives to prepare samples for SIMS analysis. Ten porcine thyroids were sectioned into four pieces that were either frozen or fi xed in formaldehyde, glutaraldehyde, or a modifi ed Karnovsky fi xative. The frozen samples were assessed for iodine content with XRF after 1 and 2 months, and the fi xed samples were analyzed for iodine content after 1 week. Freezing of untreated tissue yielded no signifi cant iodine loss, whereas fi xation with aldehydes yielded an iodine loss of 14–30%, with Karnovsky producing the least loss.
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