Regional Reference Values of Thyroid Gland Volume in Turkish Adults

Introduction It is important to know the size of the thyroid gland, and its normal value may vary among different geographic regions. Objective In this study, we aimed to establish reference ranges for thyroid volume in euthyroid adults and to compare these results with the literature data. Methods Between June 2011 and June 2012, 461 patients with normal laboratory results (serum TSH, anti-TG, anti-TPO antibodies and urine iodine level) that underwent thyroid gland ultrasound examination were retrospectively analyzed. Two hundred and 92 patients were females and 169 were males; the age range was 18-61 years with mean age 30.84 +/- 9.97 years. Length, breadth and thickness were measured, and the volume of each lobe was estimated using the ellipsoid formula. Results The overall mean thyroid volume in all patients who were examined was 12.98 +/- 2.53 mL. The mean thyroid volume in females and males was 12.09 +/- 2.05 mL and 14.53 +/- 2.55, respectively (p<0.05). The right thyroid lobe volume was greater than the left in all patients of both sexes. In addition, the study establishes a significant correlation between the thyroid volume and height, weight and body surface area of the subjects of both sexes (p<0.05). In the light of our findings we can provide reference values in order to evaluate patients who have thyroid hyperplasia or who are considered as normal. Conclusion We consider that further studies are necessary to establish national references thyroid volume for each country

Assessment of procedure related anxiety and depression in oncologic patients before F-18 FDG PET-CT imaging

Background: The aim of this study was to study objectively the level of anxiety and depression in patients undergoing positron emission tomography-computed tomography (PET-CT).One hundred and forty four oncologic out-patients (76 male, 68 female) were included in this study. Methods: All patients were referred to Nuclear Medicine Department for Fluorine-18 fluorodeoxyglucose (F-18 FDG) PET-CT imaging for the assessment of their malignant or possibly malignant diseases. The Hospital Anxiety Depression Scale and the State and Trait Anxiety Inventory I and II were used to evaluate the anxiety and depression levels in these patients. Results: The mean anxiety and depression scores of The Hospital Anxiety Depression Scale prior to F-18 FDG PET-CT were 9.2 ( ± 3.8) and 6.6 ( ± 3.4), respectively. The mean state and trait anxiety scores of the State and Trait Anxiety Inventory I and II prior to F-18 FDG PET-CT were 40.4 (± 8.5) and 46.62 ± 7.8, respectively. The Hospital Anxiety Depression Scale and the State and Trait Anxiety Inventory I and II anxiety scores were found to be significantly higher in female patients, smokers and in patients with higher stage disease. Conclusion: Our results suggest that F-18 FDG PET-CT imaging may at least contribute to patient's baseline anxiety which is already generated by being an oncology patient, and thus nuclear medicine physicians should handle the patients with extra care to minimize this affect. © 2015, Umut Elboga, et al

Heterotopic Ossification in the Paraplegic Patients

Heterotopic ossification is a process characterized by the formation of genuine new bone in soft tissues especially between muscle and joint capsule and frequently encountered after spinal cord and traumatic brain injury. A 35-year-old woman who had developed severe pain and decrease in range of motion in her bilateral hip after 11 months following a spinal cord injury referred to our department for bone scintigraphy is presented

Kliniğimizde yapılan kemik sintigrafisi endikasyonlarının retrospektif analizi

Amaç: Kemik sintigrafisi sık kullanılan radyonüklid görüntüleme yöntemlerindendir ve birçok hastalığın tanı ve takibinde başarıyla kullanılmaktadır. Çalışmamızın amacı kliniğimizde yapılan kemik sintigrafisi çekimlerinin endikasyonlarını ve çekim protokollerini belirlemektir. Gereç ve Yöntem: Çalışmaya Aralık 2011 ve Haziran 2013 tarihleri arasında kliniğimizde kemik sintigrafisi çekimi yapılan 252 hasta (132 erkek, 120 kadın) dahil edildi. Hastaların yaş ortalaması 50.1±20.2 idi (yaş aralığı 6-84). Sintigrafik protokoller hastalığın çeşidine göre geç statik tüm vücut görüntüleme ve üç fazlı kemik sintigrafisi olmak üzere iki şekilde yapıldı. Çekim endikasyonları ve sintigrafik pro- tokoller tesbit edildi. Bulgular: 102 hastaya (% 40,5) metastatik kemik hastalıklarının tanı ve takibi amacıyla, 57 hastaya (% 22,6) ortopedik uygulamalar amacıyla, 29 hastaya (% 11,5) primer kemik tümörlerinin tanı ve takibi amacıyla, 17 hastaya (% 6,7) osteomyelit tanısı amacıyla, 12 hastaya (% 4,8) protez enfeksiyonu ve gevşemesi ayrıcı tanısının yapılması amacıyla, 14 hastaya (% 5,6) gref canlılığının araştırılması amacıyla, 9 hastaya (% 3,6) romatoid artrit-sakroileit gibi romatolojik hastalıklar nedeniyle, 4 hastaya (% 1,6) osteoporoz-vertebralarda patolojik kırık araştırılması amacıyla, 2 hastaya (% 0,8) metabolik kemik hastalığı nedeniyle, 5 hastaya (% 1,98) otitis eksterna tanısı amacıyla ve 1 hastaya (% 0,4) sedimantasyon-CRP yüksekliği gibi nedenlerden dolayı malignite şüphesi nedeniyle kemik sintigrafisi çekimi yapıldı. Hastaların 136’sına (% 54) geç statik tüm vücut görüntüleme, 116’sına (% 46) ise üç fazlı görüntüleme protokolü uygulandı. Tartışma: Kemik sintigrafisinin en sık kullanıldığı alan metastatik kemik hastalıklarının tanı ve takibidir. Bunu ortopedik uygulamalar, primer kemik tümörlerinin tanı-takibi ve oste- omyelit tanısı gibi nedenler takip etmektedir.Aim: Bone scintigraphy is one of the commonly used radionuclide imaging and it is successfully used in the diagnosis and follow-up of many diseases. The aim of this study is to determine the indications and flming protocols of bone scintigraphy which was performed in our clinic. Material and Method: Two hundred and ffy two patients (132 male, 120 female) who was per- formed bone scintigprapy in our clinic between December 2011 and June 2013 included the study. Mean age was 50.1&plusmn;20.2 years. Scintigraphic protocols were made in two ways as late static whole body imaging and three- phase bone scintigraphy according to the type of the diseases. Indications of scintigraphies and scintigraphic protocols were detected. Results: Bone scintigraphy was performed for diagnosis and monitoring of metastatic bone disease to 102 patients (40,5 %), for orthopedic applications to 57 patients (22,6 %), for diagnosis and monitoring of primary bone tumors to 29 patients (11,5 %), for diagnosis of osteomyelitis to 17 patients (6,7 %), for diferential diagnosis of infection and loosening of the prosthesis to 12 patients (4,8 %), investigate the viability of the graf in 14 patients (4,6 %), for rheu- matologic diseases to 9 patients (3,6 %), for investigate the pathological vertebral fractures and osteoporosis to 4 patients (1,6 %), for diagnosis the metabolic bone disease to 2 patients (0,8 %), for diagnosis of otitis externa to 5 patients (1,98 %) and for for suspicion of malignancy to 1 patient (0,4 %). Late static whole body imaging protocol was applied to 136 patients (54 %) and three-phase imaging protocol was applied to 116 patients (46 %). Discussion: The most common use of bone scintigraphy is the diagnosis and follow-up of metastatic bone disease. It is followed by reasons such as orthopedic applications, monitoring and diagnosis of primary bone tumors and diagnosis of osteomyelitis