Association of Thyroid Antibodies with Occurrence of Hypothyroidism after Radio-iodine Therapy in Patients with Graves’ Disease Attending a Tertiary Level Hospital of Bangladesh, 2024
Background: Graves' disease (GD) is an autoantibody-mediated autoimmune disease caused by direct ... more Background: Graves' disease (GD) is an autoantibody-mediated autoimmune disease caused by direct stimulation of the thyroid epithelial cells. Thyrotropin Receptor Antibody and Thyroid Peroxidase Antibody are among the best-characterized autoantibodies for this pathology. Among different treatment modalities, radioiodine therapy (RAIT) is a proven safe and highly cost-effective therapeutic option, with the frequent side effect of developing hypothyroidism. Serum concentrations of various autoantibodies before and after RAIT may be used to predict the early or late onset of hypothyroidism. Objective: To measure and statistically analyze the thyrotropin receptor antibody (TRAb) and thyroid peroxidase antibodies (TPOAb) in a group of hyperthyroid patients who did or did not develop early hypothyroidism after RAIT.
Melorheostosis is an atypical sclerosing bone dysplasia also known as "candle bone disease,&... more Melorheostosis is an atypical sclerosing bone dysplasia also known as "candle bone disease," "melting wax syndrome," or "Leri disease," with an incidence rate of less than one in every million. The diagnosis is usually made by the radiographic appearance of "dripping candle wax" on the affected bone cortex. We describe the case of a 35-year-old male patient who presented with a long history of different joint swelling, notably in the small joints of the right hand, left foot, and ankle. He was thoroughly investigated to rule out all other possible causes of swelling before being diagnosed with melorheostosis with osteopoikilosis based on radiological patterns. The patient was referred to our institute for a bone scan, which not only showed correlation with X-ray findings but also revealed involvement of the axial skeleton, which is a rare incidence in this disorder. Bangladesh J. Nuclear Med. 25(2): 147-150, 2022
Background: Invasive Ductal Carcinoma (IDC) is the most common of all diagnosed breast cancers, a... more Background: Invasive Ductal Carcinoma (IDC) is the most common of all diagnosed breast cancers, and it frequently presents with metastatic spread to the bone as well as other viscera. Bone scintigraphy is the primary tool for detecting bone metastases, while different imaging modalities can be useful in detecting visceral metastases. The purpose of this study was to determine the relationship between skeletal and visceral metastases in female patients with IDC referred to INMAS, Mitford, for bone scintigraphy. Patients and Methods: This observational study was conducted at the Institute of Nuclear Medicine and Allied Sciences (INMAS), Mitford, Dhaka, from July 2020 to July 2021. Bone scintigraphy was done with a Siemens dual-head gamma camera after an intravenous injection of 20 mCi of 99mTc-MDP. Both anterior and posterior views were obtained, with additional SPECT images when needed. Images were interpreted and analysed by Nuclear Medicine (NM) physicians of this institute. Data a...
Thyroid tissue may be found in an abnormal location along the thyroglossal duct tract or other si... more Thyroid tissue may be found in an abnormal location along the thyroglossal duct tract or other sites due to abnormal embryologic development and migration. Thyroid ectopia is an uncommon but well-documented clinical entity. In the event of any neck swelling, it should be kept as a differential diagnosis. Thyroid scintigraphy plays a very important role in diagnosing ectopic thyroid, with the complementary primary role of high-resolution neck ultrasonography (HRUS). Reported case of an 18-year-old male referred to INMAS for evaluation of a slowly enlarging submental swelling with no history of dysphagia or dyspnea was biochemically hypothyroid. Patient had a history of submental swelling that was misdiagnosed as an abscess, creating a diagnostic dilemma, as he was found to have glandular tuberculosis after surgical drainage of the lesion. Bangladesh J. Nuclear Med. 25(2): 125-127, 2022
Thyroid disorders are among the most common endocrinopathies, and a wide array of patients are re... more Thyroid disorders are among the most common endocrinopathies, and a wide array of patients are referred to Nuclear Medicine (NM) institutes for different thyroid-related investigations. In this study, we analyzed the findings of thyroid scintigraphy, high-resolution thyroid gland ultrasound, and thyroid hormone assays of 279 referred patients in the thyroid division of the Institute of Nuclear Medicine and Allied Sciences (INMAS), Mitford. The complementary role of the aforementioned investigations not only helped portray the pattern of thyroid disease in the historic southern part of Dhaka but also once again emphasized the importance of multidisciplinary diagnostic tools in disease management. Bangladesh J. Nuclear Med. 26(1): 31-33, 2023
Background: Normalized perfusion scores allow uniform interpretation of both 17 and 20-segment mo... more Background: Normalized perfusion scores allow uniform interpretation of both 17 and 20-segment models. This is a report on the additional prognostic implications of normalized perfusion scores beyond their conventional roles in clinical management. Patients and methods: Patients undergoing gated SPECT myocardial perfusion imaging (GSMPI) with Adenosine stress from April 2018 to February 2019, were included in the study whose risk stratification and management recommendations were made using SS% and SD% respectively. The occurrence of cardiac events, quality of life (QOL), and management strategy were inquired about through a telephone interview in August 2020. An exploratory analysis was performed to find the significant interactions among imaging biomarkers, diabetes (DM), and the follow-up variables. Results: Imaging data from 17 patients (seven having DM) with a mean age of 49.8±10.4 were included. SS% was ≤14 in three patients and >14 in 14 patients. SD% was <10 in 12 pati...
Objectives: Glomerular filtration rate (GFR) is generally considered to be the best index of rena... more Objectives: Glomerular filtration rate (GFR) is generally considered to be the best index of renal function in both healthy and diseased kidneys. Calculation of GFR plays a vital role in the management of patients having renal diseases. Clinicians can make their final decision regarding the potential need for kidney transplantation and also selection of a potential kidney donor. Many methods have been developed in order to obtain more accurate GFR values. The most popular radionuclide method is camera based Gates method using 99mTc DTPA (Diethylene triaminepentaacetic acid). This method can provide immediate calculation of individual kidney function as well as of global renal function. But several sources of errors may reduce the reliability of this method. Measurement of multiple blood samples offers almost real values of GFR, which have become the gold standard in clinical research. The aim of this research work was to study the agreement between Gates method and dual plasma sampl...
Background: It had been a general observation that the number of female patients undergoing SPECT... more Background: It had been a general observation that the number of female patients undergoing SPECT myocardial perfusion imaging (MPI) is lower per week.This study was done to find out their proportionand association among their symptoms, history of (h/o) acute coronary syndrome (ACS) and corresponding myocardial perfusion. Patients and methods:This cross sectional retrospective study was conducted in 2017 on a group of patients who underwent gated SPECT myocardial perfusion imaging (GSMPI)from February 2005 to October 2016. Clinical record files and image files of all female patients were selected for analysis. The symptoms were retrospectively categorized according to New York Heart Association (NYHA) class while the patients were categorized according to their h/o ACS and myocardial perfusion in each patient was categorized as normal or perfusion defect. Data were analyzed using SPSS v.20. Results:Among 1347 patients undergoing GSMPI 196 (14.6%) were female with a 4.4-fold increase...
Background: Staging of multiple myeloma (MM) requires quantification of lesions and serum biomark... more Background: Staging of multiple myeloma (MM) requires quantification of lesions and serum biomarkers. Sestamibi (MIBI) scan can detect medullary and extra-medullary lesions whereas pathological fracture of MM when associated with osteoblastic activity which can be imaged by methyl diphosphonate (MDP). Patients and methods: This case report is of a biopsy proven case of MM with serum biomarkers inconclusive for staging. With evidence of multiple pathological rib fractures on conventional radiography, the patient was sent for MDP scan as she was unable to afford any other modality for whole body survey. A complimentary MIBI scan was therefore done. Results: MDP scan revealed multiple osteoblastic lesions in spine and ribs. The MIBI scan was conclusive for stage II active disease. Conclusions: MIBI scan added to diagnostic information and aided an inexpensive staging. MIBI scan can be an affordable work-up tool for MM. Bangladesh J. Nuclear Med. 22(2): 150-154, Jul 2019
Background: Breast carcinoma is a common type of malignancy in women worldwide. Radionuclide bone... more Background: Breast carcinoma is a common type of malignancy in women worldwide. Radionuclide bone scintigraphy is recognized choice of investigation for the detection of bone metastases both in asymptomatic and symptomatic patients. Biomarkers like Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal growth factor -2 (HER-2) also play important role in the management and prognosis of breast cancer. The study was aimed to find out the relationship between the MDP bone scan findingsand hormone receptor and HER-2 status of breast carcinoma patients referred to the Institute of Nuclear Medicine and Allied Sciences (INMAS), Mitford, Dhaka. Patients and Methods: This cross sectional study was conducted among 301 breast carcinoma patients between January 2018 and December 2019. Planar bone scan and SPECT (if needed) was done to all the patients after intravenous injection of 99mTc-MDP. Receptor status (ER, PR and HER-2) were documented from the patient’s medical records. Bre...
Objective: Lung carcinoma is the most common cancer worldwide with high potentiality of being met... more Objective: Lung carcinoma is the most common cancer worldwide with high potentiality of being metastasized to bone. Technetium-99m methylene diphosphonate (99mTc MDP) bone scintigraphy is a sensitive nuclear medicine imaging study to detect the skeletal metastases. The utilization of bone scan upon diagnosis of lung cancer appears to help in accurate staging of patients and planning treatment. The aim of the present study was to see the role of baseline bone scintigraphy in the newly diagnosed lung carcinoma patients and also to see the number, pattern and sites of involvement of bone as well as to evaluate the skeletal metastases according to the different histological types of lung carcinoma.Patients and Methods: This observational study was carried out at the Institute of Nuclear Medicine & Allied Sciences (INMAS), Sylhet during the period of July 2014 to June 2015. A total number of 59 lung carcinoma patients who attended at the scintigraphy division of INMAS, Sylhet within thr...
Association of Thyroid Antibodies with Occurrence of Hypothyroidism after Radio-iodine Therapy in Patients with Graves’ Disease Attending a Tertiary Level Hospital of Bangladesh, 2024
Background: Graves' disease (GD) is an autoantibody-mediated autoimmune disease caused by direct ... more Background: Graves' disease (GD) is an autoantibody-mediated autoimmune disease caused by direct stimulation of the thyroid epithelial cells. Thyrotropin Receptor Antibody and Thyroid Peroxidase Antibody are among the best-characterized autoantibodies for this pathology. Among different treatment modalities, radioiodine therapy (RAIT) is a proven safe and highly cost-effective therapeutic option, with the frequent side effect of developing hypothyroidism. Serum concentrations of various autoantibodies before and after RAIT may be used to predict the early or late onset of hypothyroidism. Objective: To measure and statistically analyze the thyrotropin receptor antibody (TRAb) and thyroid peroxidase antibodies (TPOAb) in a group of hyperthyroid patients who did or did not develop early hypothyroidism after RAIT.
Melorheostosis is an atypical sclerosing bone dysplasia also known as "candle bone disease,&... more Melorheostosis is an atypical sclerosing bone dysplasia also known as "candle bone disease," "melting wax syndrome," or "Leri disease," with an incidence rate of less than one in every million. The diagnosis is usually made by the radiographic appearance of "dripping candle wax" on the affected bone cortex. We describe the case of a 35-year-old male patient who presented with a long history of different joint swelling, notably in the small joints of the right hand, left foot, and ankle. He was thoroughly investigated to rule out all other possible causes of swelling before being diagnosed with melorheostosis with osteopoikilosis based on radiological patterns. The patient was referred to our institute for a bone scan, which not only showed correlation with X-ray findings but also revealed involvement of the axial skeleton, which is a rare incidence in this disorder. Bangladesh J. Nuclear Med. 25(2): 147-150, 2022
Background: Invasive Ductal Carcinoma (IDC) is the most common of all diagnosed breast cancers, a... more Background: Invasive Ductal Carcinoma (IDC) is the most common of all diagnosed breast cancers, and it frequently presents with metastatic spread to the bone as well as other viscera. Bone scintigraphy is the primary tool for detecting bone metastases, while different imaging modalities can be useful in detecting visceral metastases. The purpose of this study was to determine the relationship between skeletal and visceral metastases in female patients with IDC referred to INMAS, Mitford, for bone scintigraphy. Patients and Methods: This observational study was conducted at the Institute of Nuclear Medicine and Allied Sciences (INMAS), Mitford, Dhaka, from July 2020 to July 2021. Bone scintigraphy was done with a Siemens dual-head gamma camera after an intravenous injection of 20 mCi of 99mTc-MDP. Both anterior and posterior views were obtained, with additional SPECT images when needed. Images were interpreted and analysed by Nuclear Medicine (NM) physicians of this institute. Data a...
Thyroid tissue may be found in an abnormal location along the thyroglossal duct tract or other si... more Thyroid tissue may be found in an abnormal location along the thyroglossal duct tract or other sites due to abnormal embryologic development and migration. Thyroid ectopia is an uncommon but well-documented clinical entity. In the event of any neck swelling, it should be kept as a differential diagnosis. Thyroid scintigraphy plays a very important role in diagnosing ectopic thyroid, with the complementary primary role of high-resolution neck ultrasonography (HRUS). Reported case of an 18-year-old male referred to INMAS for evaluation of a slowly enlarging submental swelling with no history of dysphagia or dyspnea was biochemically hypothyroid. Patient had a history of submental swelling that was misdiagnosed as an abscess, creating a diagnostic dilemma, as he was found to have glandular tuberculosis after surgical drainage of the lesion. Bangladesh J. Nuclear Med. 25(2): 125-127, 2022
Thyroid disorders are among the most common endocrinopathies, and a wide array of patients are re... more Thyroid disorders are among the most common endocrinopathies, and a wide array of patients are referred to Nuclear Medicine (NM) institutes for different thyroid-related investigations. In this study, we analyzed the findings of thyroid scintigraphy, high-resolution thyroid gland ultrasound, and thyroid hormone assays of 279 referred patients in the thyroid division of the Institute of Nuclear Medicine and Allied Sciences (INMAS), Mitford. The complementary role of the aforementioned investigations not only helped portray the pattern of thyroid disease in the historic southern part of Dhaka but also once again emphasized the importance of multidisciplinary diagnostic tools in disease management. Bangladesh J. Nuclear Med. 26(1): 31-33, 2023
Background: Normalized perfusion scores allow uniform interpretation of both 17 and 20-segment mo... more Background: Normalized perfusion scores allow uniform interpretation of both 17 and 20-segment models. This is a report on the additional prognostic implications of normalized perfusion scores beyond their conventional roles in clinical management. Patients and methods: Patients undergoing gated SPECT myocardial perfusion imaging (GSMPI) with Adenosine stress from April 2018 to February 2019, were included in the study whose risk stratification and management recommendations were made using SS% and SD% respectively. The occurrence of cardiac events, quality of life (QOL), and management strategy were inquired about through a telephone interview in August 2020. An exploratory analysis was performed to find the significant interactions among imaging biomarkers, diabetes (DM), and the follow-up variables. Results: Imaging data from 17 patients (seven having DM) with a mean age of 49.8±10.4 were included. SS% was ≤14 in three patients and >14 in 14 patients. SD% was <10 in 12 pati...
Objectives: Glomerular filtration rate (GFR) is generally considered to be the best index of rena... more Objectives: Glomerular filtration rate (GFR) is generally considered to be the best index of renal function in both healthy and diseased kidneys. Calculation of GFR plays a vital role in the management of patients having renal diseases. Clinicians can make their final decision regarding the potential need for kidney transplantation and also selection of a potential kidney donor. Many methods have been developed in order to obtain more accurate GFR values. The most popular radionuclide method is camera based Gates method using 99mTc DTPA (Diethylene triaminepentaacetic acid). This method can provide immediate calculation of individual kidney function as well as of global renal function. But several sources of errors may reduce the reliability of this method. Measurement of multiple blood samples offers almost real values of GFR, which have become the gold standard in clinical research. The aim of this research work was to study the agreement between Gates method and dual plasma sampl...
Background: It had been a general observation that the number of female patients undergoing SPECT... more Background: It had been a general observation that the number of female patients undergoing SPECT myocardial perfusion imaging (MPI) is lower per week.This study was done to find out their proportionand association among their symptoms, history of (h/o) acute coronary syndrome (ACS) and corresponding myocardial perfusion. Patients and methods:This cross sectional retrospective study was conducted in 2017 on a group of patients who underwent gated SPECT myocardial perfusion imaging (GSMPI)from February 2005 to October 2016. Clinical record files and image files of all female patients were selected for analysis. The symptoms were retrospectively categorized according to New York Heart Association (NYHA) class while the patients were categorized according to their h/o ACS and myocardial perfusion in each patient was categorized as normal or perfusion defect. Data were analyzed using SPSS v.20. Results:Among 1347 patients undergoing GSMPI 196 (14.6%) were female with a 4.4-fold increase...
Background: Staging of multiple myeloma (MM) requires quantification of lesions and serum biomark... more Background: Staging of multiple myeloma (MM) requires quantification of lesions and serum biomarkers. Sestamibi (MIBI) scan can detect medullary and extra-medullary lesions whereas pathological fracture of MM when associated with osteoblastic activity which can be imaged by methyl diphosphonate (MDP). Patients and methods: This case report is of a biopsy proven case of MM with serum biomarkers inconclusive for staging. With evidence of multiple pathological rib fractures on conventional radiography, the patient was sent for MDP scan as she was unable to afford any other modality for whole body survey. A complimentary MIBI scan was therefore done. Results: MDP scan revealed multiple osteoblastic lesions in spine and ribs. The MIBI scan was conclusive for stage II active disease. Conclusions: MIBI scan added to diagnostic information and aided an inexpensive staging. MIBI scan can be an affordable work-up tool for MM. Bangladesh J. Nuclear Med. 22(2): 150-154, Jul 2019
Background: Breast carcinoma is a common type of malignancy in women worldwide. Radionuclide bone... more Background: Breast carcinoma is a common type of malignancy in women worldwide. Radionuclide bone scintigraphy is recognized choice of investigation for the detection of bone metastases both in asymptomatic and symptomatic patients. Biomarkers like Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal growth factor -2 (HER-2) also play important role in the management and prognosis of breast cancer. The study was aimed to find out the relationship between the MDP bone scan findingsand hormone receptor and HER-2 status of breast carcinoma patients referred to the Institute of Nuclear Medicine and Allied Sciences (INMAS), Mitford, Dhaka. Patients and Methods: This cross sectional study was conducted among 301 breast carcinoma patients between January 2018 and December 2019. Planar bone scan and SPECT (if needed) was done to all the patients after intravenous injection of 99mTc-MDP. Receptor status (ER, PR and HER-2) were documented from the patient’s medical records. Bre...
Objective: Lung carcinoma is the most common cancer worldwide with high potentiality of being met... more Objective: Lung carcinoma is the most common cancer worldwide with high potentiality of being metastasized to bone. Technetium-99m methylene diphosphonate (99mTc MDP) bone scintigraphy is a sensitive nuclear medicine imaging study to detect the skeletal metastases. The utilization of bone scan upon diagnosis of lung cancer appears to help in accurate staging of patients and planning treatment. The aim of the present study was to see the role of baseline bone scintigraphy in the newly diagnosed lung carcinoma patients and also to see the number, pattern and sites of involvement of bone as well as to evaluate the skeletal metastases according to the different histological types of lung carcinoma.Patients and Methods: This observational study was carried out at the Institute of Nuclear Medicine & Allied Sciences (INMAS), Sylhet during the period of July 2014 to June 2015. A total number of 59 lung carcinoma patients who attended at the scintigraphy division of INMAS, Sylhet within thr...
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