Normal Adrenal Glands in Multidetector Computed Tomography

Objective: To characterize normal adrenal glands in an adult Thai population using multidetector computed tomography (MDCT). Methods: We retrospectively reviewed the scans of 175 consecutive patients who underwent renal CT angiography for potential kidney donation with attention to the location, morphology, and enhancement of both adrenal glands. Each reader measured the body and limb thickness in the axial and coronal planes, and the length in the axial plane. The interclass correlation coefficient (ICC) between the two readers was generated. We employed mean, SD, and 95th percentile of normal adrenal gland size by using pooled data of both reviewers. Results: The 95th percentiles of normal adrenal glands, which might be useful as cutoff values to distinguish between normal and pathological adrenal gland size, were calculated. The right adrenal gland was more often relatively cephalad to the left adrenal (58.9%). The most common morphology of both adrenal glands was the inverted Y, with inverted V and linear shapes less common. Both adrenal glands showed homogeneous enhancement (100%) in the arterial and nephrographic phases. Conclusion: The majority of normal adrenal glands were right relatively cephalad to left, inverted Y shape, and homogenous enhancement, using the 95th percentile of size normal adrenal gland as a cutoff value to differentiate between normal and thickened limbs and body

Recurrence Factors and Characteristic Trends of Papillary Thyroid Cancer over Three Decades

Background. The prevalence of thyroid cancer is rising worldwide. Although thyroid cancer has a favorable prognosis, up to 20% of patients experienced recurrent disease during the follow-up period. The present study aimed to examine the trend of incidence and factors associated with recurrence and outcomes of papillary thyroid cancer (PTC) in Thai patients over the last 30 years. Methods. We reviewed the clinical data of all patients with PTC who were treated between 1987 and 2019 at Theptarin Hospital. Clinical characteristics, epidemic trend, factors associated with the persistence/recurrence of the disease, overall disease-specific survival rate, and overall disease-free survival rate were analysed. Results. A total of 235 patients with PTC who were registered between 1987 and 2019 were reviewed. The mean age was 42.5 ± 14.3 years, with a mean follow-up of 9.5 years. Papillary thyroid microcarcinoma (PTMC) was consistently increased and accounted for 21.4% (50/235) of total cases. The American Thyroid Association (ATA) risk stratification was high in 24% of all PTMCs in the last decade, and 16.0% of these patients experienced local recurrence during the follow-up period. Coexistence with Hashimoto’s thyroiditis (HT) was found in one-fifth of the patients with PTC and was correlated with a low recurrence rate (HR: 0.16, P=0.013). Only age ≥55 years associated with the persistence/recurrence of the disease. The overall disease-free survival and disease-specific survival rates were 77.4% and 98.3%, respectively. Conclusions. The prognosis of PTC is generally considered favorable. However, approximately one-fourth of patients with PTMC demonstrated more aggressive clinical behavior, particularly in the last decade of the study. Coexistence of HT contributed to a better prognosis