BACKGROUND: PET of the somatostatine receptors (SSR) is a well-established functional imaging modality in the dia-gnosis of the neuroendocrine tumours (NET) of the gastro-entero-pancreatic origin (GEP). However, it can have a major impact also in other clinical entities. PURPOSE: To present a literature review focusing on the effectivity of SSR PET in the dia-gnosis beyond GEP NET. CONCLUSION: SSR PET provides an accurate dia-gnosis of pulmonary NET, pheochromocytoma and paraganglioma, it may have an important impact on their treatment and clinical management. It allows a detailed estimation of the extent of meningeoma, contributes to precise target volumes for radiotherapy delineation and is sensitive in its residuum or recurrence detection. It can be a valuable method in the syndromes of multiple endocrine neoplasia and in the localization of the source of the ectopic Cushing syndrome. It can be used in the medullary thyroid cancer. An important role of SSR PET lies in the planning and monitoring of the peptide-receptor radionuclide therapy embraced in the theranostic concept.

• Klíčová slova
• PET, PET/CT, PET/MR, PET/MRI, Somatostatin, magnetic resonance,
• MeSH
• feochromocytom diagnostické zobrazování   MeSH
• gastrointestinální nádory diagnostické zobrazování   MeSH
• lidé MeSH
• mnohočetné endokrinní neoplazie diagnostické zobrazování   MeSH
• nádory nadledvin diagnostické zobrazování   MeSH
• nádory plic diagnostické zobrazování   MeSH
• nádory štítné žlázy diagnostické zobrazování   MeSH
• neuroendokrinní karcinom diagnostické zobrazování   MeSH
• neuroendokrinní nádory diagnostické zobrazování   MeSH
• paragangliom diagnostické zobrazování   MeSH
• plánování radioterapie pomocí počítače MeSH
• počítačová rentgenová tomografie MeSH
• pozitronová emisní tomografie metody   MeSH
• receptory somatostatinu * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• receptory somatostatinu * MeSH

The aim of this prospective study was the validation of the risk stratification of thyroid nodules using ultrasonography with the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR TI-RADS) and partly in comparison to American Thyroid Association (ATA) guidelines in a secondary referral center. Fine needle aspiration biopsy (FNA) (n=605) and histological examinations (n=63) were the reference standards for the statistical analysis. ACR TI-RADS cut-off value: TR4 with sensitivity 85.7 %, specificity 54.1 %, PPV 58.5 %, accuracy 67.7 % (AUC 0.738; p<0.001). ATA cut-off value: "high suspicion" with sensitivity 80 %, specificity 83.3 %, PPV 80 %, accuracy 81.8 % (AUC 0.800; p=0.0025). 18.4 % nodules (3 malignant) could not be assigned to a proper ATA US pattern group (p<0.0001). Both ACR TI-RADS and ATA have allowed fair selection of nodules requiring FNA with superiority of ACR TI-RADS according to classification of all thyroid nodules to the proper group. According to ACR TI-RADS almost one third of the patients were incorrectly classified with 17.9 % missed thyroid carcinomas, exclusively micropapillary carcinomas, even though, the amount of FNA would be reduced to 48 %.

• MeSH
• centra sekundární péče normy   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory štítné žlázy diagnóza   diagnostické zobrazování   chirurgie   MeSH
• prospektivní studie MeSH
• referenční standardy MeSH
• štítná žláza diagnostické zobrazování   patologie   chirurgie   MeSH
• tenkojehlová biopsie MeSH
• ultrasonografie metody   MeSH
• uzle štítné žlázy diagnóza   diagnostické zobrazování   chirurgie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Radioiodine (131 I, RAI) has traditionally been used in thyroid cancer treatment but its benefit should be balanced against possible risks. Among them, salivary gland dysfunction has often been discussed, although the reported data have been inconsistent. The aim of our prospective study was to evaluate salivary gland function in 31 thyroidectomised patients (6 men, 25 women; median age 52 yr) before and 4-6 months after RAI remnant ablation (RRA), using activity of 3.7 GBq 131 I-NaI. Salivary gland uptake and excretion fractions were quantitatively assessed with 99m Tc - pertechnetate salivary gland scintigraphy. Pre- and post-treatment values were compared using Wilcoxon signed rank test. No statistically significant difference in the pre- and post-treatment values was observed in parotid or submandibular glands uptake, or in the parotid or submandibular excretion fractions. The calculated power for minimum relevant difference of 25% with the sample size of 31 ranged between 86% and 96% for the individual variables, making our negative results reasonably reliable. The results suggest that RRA with the most commonly used activity of 3.7 GBq has no important impact on salivary gland function. Therefore, the concerns about putative salivary gland functional deterioration following RRA are probably unjustified.

• Klíčová slova
• 99mTc - pertechnetate, radioiodine remnant ablation, salivary gland dynamic scintigraphy, thyroid cancer, xerostomia,
• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory štítné žlázy * diagnostické zobrazování   radioterapie   MeSH
• podčelistní slinná žláza MeSH
• prospektivní studie MeSH
• radioisotopová scintigrafie MeSH
• radioizotopy jodu MeSH
• slinné žlázy diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• radioizotopy jodu MeSH

Thyroid nodules are a very frequent pathology among common population. Despite the vast majority of them are of benign origin, the incidence of thyroid cancer is currently rather rising. Although there are several risk factors of thyroid cancer and several clinical, ultrasound, biochemical and molecular diagnostic markers, the exact mechanisms of thyroid oncogenesis and the linkage between thyroid nodule ultrasound appearance and its biological character remain unclear. While ionizing radiation is the only one well-known risk factor for thyroid cancer, the significance of some others remains unclear. The aim of our review was to discuss some not completely known pathophysiological mechanisms involved in thyroid oncogenesis as hypothyroidism, mutations of genes regulating cell proliferation, thyroid autoimmunity and pregnancy and to describe pathophysiological background of some ultrasound markers of thyroid cancer (size, echogenicity, vascularization, calcifications and stiffness). Better knowledge in this field is crucial for development of novel diagnostic techniques and therapeutic approaches. For example, the analysis of BRAF, RAS and other mutations in cytological samples may help to distinction between follicular thyroid carcinoma and follicular thyroid adenoma and may significantly decrease the number of unnecessary surgery among patients with thyroid nodules. Alternatively, the different malign cells growth, angiogenesis, destructions of thyroid follicles, reparative changes, growth retardation, fibrosis and increased interstitial fluid pressure implicate the typical ultrasound appearance of papillary thyroid cancer (hypoechogenicity, irregular vascularization, microcalcifications, stiffness) which is essential to catch the suspicious nodules on the basis of their ultrasound appearance among large amount of benign nodules.

• MeSH
• genetická predispozice k nemoci MeSH
• lidé MeSH
• nádorová transformace buněk * genetika   metabolismus   patologie   MeSH
• nádory štítné žlázy diagnostické zobrazování   etiologie   metabolismus   patologie   patofyziologie   MeSH
• prediktivní hodnota testů MeSH
• prognóza MeSH
• rizikové faktory MeSH
• signální transdukce MeSH
• ultrasonografie MeSH
• uzle štítné žlázy diagnostické zobrazování   etiologie   metabolismus   patologie   patofyziologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

OBJECTIVES: Two cases of an extremely rare paraganglioma-like variant of medullary thyroid carcinoma (MTC) are reported. METHODS: The patients were a 65-year-old male (case 1) and a 14-year-old female (case 2). Unilateral thyroid nodule and homolateral cervical lymphadenopathy was present in case 1; bilateral thyroid nodules were seen in case 2. Fine needle aspiration cytology (FNAC) was performed from thyroid nodules (in both cases) and from a cervical lymph node (in case 1). RESULTS: The cytological smears contained predominantly ovoid to spindled epithelial cells arranged in cohesive three-dimensional clusters with sharp margins; isolated individual cells were seen only rarely. No colloid or other material was present in the background. The tumour cells showed significant nuclear atypia with occasional bizarre and/or binucleated cells. The nuclear chromatin was coarse and granular, sometimes with grooves and intranuclear inclusions. The cytoplasm was inconspicuous. Polygonal or triangular cells, amyloid and azurophillic cytoplasmic granules were absent in both cases. Calcitonin expression was demonstrated in case 2. Histological examination confirmed the paraganglioma variant of MTC in both cases. Mutation of RET proto-oncogene in exon 16 (Met918Thr) - germline in case 2 and somatic in case 1 was detected by sequencing of DNA in both cases. CONCLUSIONS: This is the first description of cytological findings in the paraganglioma-like variant of MTC. Despite its rarity, it can be reliably diagnosed by FNAC if material for immunocytochemistry is obtained.

• MeSH
• fatální výsledek MeSH
• lidé MeSH
• medulární karcinom diagnóza   diagnostické zobrazování   genetika   patologie   MeSH
• mladiství MeSH
• mutace MeSH
• mutační analýza DNA MeSH
• nádory plic sekundární   MeSH
• nádory štítné žlázy diagnóza   diagnostické zobrazování   genetika   patologie   MeSH
• paragangliom diagnóza   diagnostické zobrazování   genetika   patologie   MeSH
• protoonkogen Mas MeSH
• protoonkogenní proteiny c-ret genetika   MeSH
• sekvence nukleotidů MeSH
• senioři MeSH
• tenkojehlová biopsie * MeSH
• ultrasonografie MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• MAS1 protein, human MeSH Prohlížeč
• protoonkogen Mas MeSH
• protoonkogenní proteiny c-ret MeSH

The radioisotope department in Motol was established on the 1st of June 1957 as the part of The Research Institute of Endocrinology founded by Assoc. Prof. Karel Silink. In the beginning, the department included 20 beds and its main activity consisted of radioiodine treatment of hyperthyroidism. Since 1965 the attention has been paid to the treatment of thyroid cancer, and this tradition continues till this time. The article reviews the main directions of development of this department since the very beginning to present.

• MeSH
• dějiny 20. století MeSH
• dějiny 21. století MeSH
• lidé MeSH
• nádory štítné žlázy diagnostické zobrazování   dějiny   radioterapie   MeSH
• nemocnice dějiny   MeSH
• radioisotopová scintigrafie MeSH
• radioizotopy jodu dějiny   terapeutické užití   MeSH
• rentgendiagnostika MeSH
• Check Tag
• dějiny 20. století MeSH
• dějiny 21. století MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• historické články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• radioizotopy jodu MeSH

Radiation-navigated reoperations of the thyroid gland for the differenciated carcinoma are reserved for such cases of the thyroid gland reoperations aiming to complete a total thyroidectomy and, also, to extirpate metastatically affected lymphonodes. The authors discuss this part of the above surgical procedure, its therapeutic prospects, as well as its cons. They recommend already the primary surgical procedure on the thyroid gland to be conducted carefully--i.e. to conduct at least a lobectomy of the thyroid gland followed by visualization and examination of the recurrent laryngeal nerve and the parathyroid glands. They recommend the reoperations to be concentrated in specialized centres.

• MeSH
• dospělí MeSH
• gama kamery MeSH
• karcinom diagnostické zobrazování   chirurgie   MeSH
• lidé MeSH
• lymfatické metastázy MeSH
• nádory štítné žlázy diagnostické zobrazování   chirurgie   MeSH
• radioisotopová scintigrafie MeSH
• radioizotopy jodu * MeSH
• reoperace MeSH
• reziduální nádor MeSH
• tyreoidektomie * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• radioizotopy jodu * MeSH

Surgery remains the basic therapeutical method of the thyroid gland papillary carcinoma treatment. It is complemented by the adjacent thyro-eliminating therapy. A remarkable number of the thyroid gland carcinoma cases is still being diagnosed accidentally during the surgery for the thyroid gland benign disorders. The above mentioned patients, then, must undergo a reoperation, in order for the total thyroidectomy (TTE) and the lymphonodes dissection (LU) to be finished. The reoperations should be conducted in specialized clinics by sufficiently proficient teams. Our study reviews a case of a patient who underwent three surgeries on his thyroid gland.

• MeSH
• dospělí MeSH
• lidé MeSH
• lymfadenektomie MeSH
• lymfatické metastázy diagnostické zobrazování   MeSH
• lymfatické uzliny diagnostické zobrazování   MeSH
• nádory štítné žlázy diagnostické zobrazování   patologie   chirurgie   MeSH
• papilární karcinom diagnostické zobrazování   sekundární   chirurgie   MeSH
• radioisotopová scintigrafie MeSH
• radioizotopy jodu * MeSH
• reoperace MeSH
• reziduální nádor MeSH
• tyreoidektomie * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• radioizotopy jodu * MeSH

The aim of the study was to evaluate the possibility of detecting thyroid cancer recurrences without the need for withdrawal of thyroid suppressive treatment. Upper-body or whole-body scintigraphy was performed in a group of 200 patients evaluated for differentiated thyroid cancers in 1993 and 1994 using technetium-99m sestamibi. Scans were performed 20-30min following i.v. administration of 500MBq of 99mTc-methoxyisobutylisonitrile (MIBI). Bone and lung metastases were detected with very high sensitivity and specificity, with a very high predictive value of negative results and a somewhat lower predictive value of positive results. The sensitivity and specificity of findings in the neck were lower but the predictive value of negative results was high. Whole-body scans with 99mTc-MIBI are a useful tool in the follow-up of patients with differentiated thyroid cancer, for the detection of distant metastatic lesions.

• MeSH
• lidé MeSH
• nádory kostí diagnostické zobrazování   sekundární   MeSH
• nádory plic diagnostické zobrazování   sekundární   MeSH
• nádory štítné žlázy diagnostické zobrazování   patologie   MeSH
• prediktivní hodnota testů MeSH
• radioisotopová scintigrafie MeSH
• senzitivita a specificita MeSH
• technecium 99mTc sestamibi * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• technecium 99mTc sestamibi * MeSH

99Tcm-tetrofosmin imaging was performed in 23 thyroid cancer patients and compared with whole-body 131I scans, neck ultrasonography and plasma thyroglobulin levels. Of 22 patients with differentiated thyroid cancer, 8 showed identical images on 131I scan and tetrofosmin; 1 patient with medullary cancer had identical images with 99Tcm-DMSA and 99Tcm-tetrofosmin, the findings being confirmed by sonography. The potential usefulness of 99Tcm-tetrofosmin imaging in the follow-up of thyroid cancers is discussed.

• MeSH
• kyselina dimerkaptojantarová MeSH
• lidé MeSH
• lymfatické metastázy MeSH
• metastázy nádorů MeSH
• nádorové biomarkery krev   MeSH
• nádory štítné žlázy krev   diagnostické zobrazování   patologie   MeSH
• následné studie MeSH
• organofosforové sloučeniny * MeSH
• organotechneciové sloučeniny * MeSH
• radioisotopová scintigrafie MeSH
• radioizotopy jodu MeSH
• technecium 99mTc dimerkaptojantarová kyselina MeSH
• thyreoglobulin krev   MeSH
• ultrasonografie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• kyselina dimerkaptojantarová MeSH
• nádorové biomarkery MeSH
• organofosforové sloučeniny * MeSH
• organotechneciové sloučeniny * MeSH
• radioizotopy jodu MeSH
• technecium 99mTc dimerkaptojantarová kyselina MeSH
• technetium tc-99m tetrofosmin MeSH Prohlížeč
• thyreoglobulin MeSH