Ihsen Slim

Estimation of Radiation Dosimetry for some Common SPECT-CT Exams

Single photon emission computed tomography associated to X ray computed tomography (SPECT-CT) is a nuclear medicine tomographic imaging technique which improves diagnostic accuracy for particular clinical indications due to the possible attenuation and/or scatter correction of the SPECT functional images and the availability of helpful anatomic information. However, the introduction of CT in the nuclear diagnostic process results in a significant increase of the patient dose. Ideally is to establish sufficient image quality for a specific diagnostic task with the lowest effective dose to the patient in order to reduce stochastic effects. Indication of SPECT-CT should be made to adhere to the “As Low as Reasonably Achievable (ALARA)” principle and ensure that the patient is not subjected to unnecessarily high levels of radiation. In this study, we evaluate effective doses received during some standard nuclear medicine exams from 100 patients who underwent SPECT-CT in our department and analyze parameters involved in variation of these doses according to the literature data.

Malar Bone Metastasis Revealing a Papillary Thyroid Carcinoma

Papillary thyroid carcinoma is the most common form of differentiated thyroid carcinoma. It is generally confined to the neck with or without spread to regional lymph nodes. Metastatic thyroid carcinomas are uncommon and mainly include lung and bone. Metastases involving oral and maxillofacial region are extremely rare. We described a case of malar metastasis revealing a follicular variant of papillary thyroid carcinoma, presenting with pain and swelling of the left cheek in a 67-years-old female patient with an unspecified histological left lobo-isthmectomy medical history. To our knowledge, this is the first recorded instance of a malar metastasis from a follicular variant of papillary thyroid carcinoma.

Differentiated Thyroid Cancer in Children: The Contribution of RadioiodineTherapy

Differentiated thyroid carcinoma (DTC) is rare in children but has a relatively good prognosis. We report 10 pediatric thyroid carcinomas, addressed to our department for additional radioiodine therapy. Lung metastases were detected in all of them by the post therapeutic Iodine131-Whole body scan. Also, all of them under went serum thyroglobulin, chest radiography and / or cervico-thoracic computed tomography (CT). Therapeutic efficacy was observed in the all cases after radioiodine treatment. According to our results, we recommend iodine therapy for remnant ablation or residual disease for most children with DTC and a long-term follow-up because disease can recur decades after initial diagnosis and therapy.