Purpose: To investigate the capacity of Superb Microvascular Imaging (SMI) to detect microvascular details and to explore the different SMI features in various focal liver lesions (FLLs) and the correlation between SMI and microvessel density (MVD). Method: Eighty-three liver lesions were enrolled in our study, including 35 hepatocellular carcinomas (HCCs) and 48 non-HCCs. All patients underwent color Doppler flow imaging (CDFI) and SMI examination and were categorized into subgroups according to Adler semiquantitative grading (grade 0–3) or the microvascular morphologic patterns (pattern a-f). The correlation between SMI blood flow signal percentage and MVD was assessed. Results: Compared with CDFI, SMI detected more high-level blood flow signals (grade 2–3) and more hypervascular supply patterns (pattern e-f) in HCCs (p < 0.05). Furthermore, more hypervascular supply patterns and fewer hypovascular supply patterns were detected in HCC compared with non-HCC (p < 0.05). Based on Adler’s grading or microvascular morphologic patterns, the areas under the receiver operating characteristic curve were 0.696 and 0.760 for SMI, 0.583 and 0.563 for CDFI. The modality of “SMI-microvascular morphologic pattern” showed the best diagnostic performance. There was significant correlation between MVD and the SMI blood flow signal percentage (vascular index, VI) in malignant lesions (r = 0.675, p < 0.05). Conclusion: SMI was superior to CDFI in detecting microvascular blood flow signals. More hypervascular supply patterns were depicted in HCC than in non-HCC, suggesting a promising diagnostic value for SMI in the differentiation between HCC and non-HCC. Meanwhile, we were the first to demonstrate that SMI blood flow signal percentage (VI) was correlated with MVD in malignant lesions.

Hepatic dysfunction is often observed in patients with Graves’ hyperthyroidism. The aims of this study were to investigate the risk factors for hepatic dysfunction and to analyze the efficacy of 131I (radioactive iodine-131) treatment. In total, 2385 patients with Graves’ hyperthyroidism (478 males, 1907 females; age 42.8 ± 13.5 years) were involved in our study. Of these, 1552 cases with hepatic dysfunction received 131I treatment. All clinical data were retrospectively reviewed to explore the risk factors associated with hepatic dysfunction using logistic regression analysis. Furthermore, we observed thyroid and liver function indices for the 1552 subjects at 3, 6 and 12 months after 131I treatment, in order to evaluate efficacy. Overall, 65% patients were affected by hepatic dysfunction. The most common abnormality was elevated alkaline phosphatase (ALP), of which the prevalence was 52.3%. The percentages of hepatocellular injury type, bile stasis, and mixed type were 45.8%, 32.4%, and 21.8%, respectively. Both univariate and multivariate analyses demonstrated that age, duration of Graves hyperthyroidism, free triiodothyronine (FT3)level, and thyrotrophin receptor antibody (TRAb) concentration were the most significant risk factors predicting hepatic dysfunction. Additionally, the patients with mild hepatic dysfunction, or hepatocellular injury type were more likely to attain normal liver function after 131I treatment. Furthermore, after 131I treatment, liver function was more likely to return to normal in the cured group of patients compared with the uncured group. Older patients and cases with a longer history of Graves’ hyperthyroidism, higher FT3 or TRAb concentration were more likely to be associated with hepatic dysfunction, and the prognosis of hepatic dysfunction was closely associated with the outcomes of Graves’ hyperthyroidism after 131I treatment.

Introduction Anti-epidermal growth factor receptor (EGFR)-targeted nanoparticles can be used to deliver a therapeutic and imaging agent to EGFR-overexpressing tumor cells. ¹³¹I-labeled anti-EGFR nanoparticles derived from cetuximab were used as a tumor-targeting vehicle in radionuclide therapy. Methods This paper describes the construction of the anti-EGFR nanoparticle EGFR–BSA–PCL. This nanoparticle was characterized for EGFR-targeted binding and cellular uptake in EGFR-overexpressing cancer cells by using flow cytometry and confocal microscopy. Anti-EGFR and non-targeted nanoparticles were labeled with ¹³¹I using the chloramine-T method. Analyses of cytotoxicity and targeted cell killing with ¹³¹I were performed using the MTT assay. The time-dependent cellular uptake of ¹³¹I-labeled anti-EGFR nanoparticles proved the slow-release effects of nanoparticles. A radioiodine therapy study was also performed in mice. Results The EGFR-targeted nanoparticle EGFR–BSA–PCL and the non-targeted nanoparticle BSA–PCL were constructed; the effective diameters were approximately 100 nm. The results from flow cytometry and confocal microscopy revealed significant uptake of EGFR–BSA–PCL in EGFR-overexpressing tumor cells. Compared with EGFR–BSA–PCL, BSA–PCL could also bind to cells, but tumor cell retention was minimal and weak. In MTT assays, the EGFR-targeted radioactive nanoparticle ¹³¹I–EGFR–BSA–PCL showed greater cytotoxicity and targeted cell killing than the non-targeted nanoparticle ¹³¹I–BSA–PCL. The radioiodine uptake of both ¹³¹I-labeled nanoparticles, ¹³¹I–EGFR–BSA–PCL and ¹³¹I–BSA–PCL, was rapid and reached maximal levels 4 h after incubation, but the ¹³¹I uptake of ¹³¹I–EGFR–BSA–PCL was higher than that of ¹³¹I–BSA–PCL. On day 15, the average tumor volumes of the ¹³¹I–EGFR–BSA–PCL and ¹³¹I–BSA–PCL groups showed a slow growth relationship compared with that of the control group. Conclusion The EGFR-targeted nanoparticle EGFR–BSA–PCL demonstrated superior cellular binding and uptake compared with those of the control BSA–PCL. The EGFR-targeted radioactive nanoparticle ¹³¹I–EGFR–BSA–PCL exhibited favorable intracellular retention of ¹³¹I. Radionuclide therapy using ¹³¹I–EGFR–BSA–PCL, which showed excellent targeted cell killing, suppressed cancer cell growth caused by EGFR overexpression.

To assess scintigraphic pattern, clinical indication and relevance of dual ectopic thyroid tissue (ETT). Literature is reviewed for such cases. In this 5-year retrospective study, we reviewed all thyroid scintigraphies in our data base. Patients diagnosed with suspected ETT were identified. Literature is reviewed. Statistics were done by one-way analysis of variance and least significant difference test. From 11905 thyroid scintigraphies during the 5-year period, we retrieved 121 patients eligible for analysis. The top two indications were assessing a palpable front neck mass to determine whether it was an ETT, and primary hypothyroidism. Patients were divided into 3 groups. Group 1 with single ETT (83 cases); group 2 with dual ETT (6 cases) and group 3 with athyroid (32 cases). Age and thyroid hormones were highest in group 2, and lowest in group 3. Thyrotropin was highest in group 3, and lowest in group 2. Thyroxine was given to hypothyroid patients, while no surgery was performed. There were 42 published cases with dual ETT, most of whom were under 30 years old. 38.10% of them were euthyroid, 33.33% hypothyroid, and 21.43% subclinical hypothyroid. Most frequent ectopic positions included lingual (33.73%), sublingual (27.71%) and subhyoid (22.89%). In our cohort, incidence of dual ETT was 0.05% if the denominator was total number of thyroid scintigraphies. The incidence was 4.96% if the denominator was the number of patients with suspected ETT. Important clinical indication is a front neck palpable mass suggestive of an ETT. Important clinical relevance of recognizing the dual ETT pattern is to avoid inappropriate surgery. After reviewing all published cases, we find dual ETT is often seen in young patients. Most of such patients are euthyroid or mildly hypothyroid. Thyroid ectopia often resides in lingual, sublingual and subhyoid areas.

Objectives Technetium-99m (^99mTc)-sestamibi is the current radionuclide of choice for parathyroid localization in primary hyperparathyroidism (PH). However, there are only sporadic reports about brown tumor visualization in whole-body ^99mTc-sestamibi scans. This study aimed to systematically evaluate brown tumor uptake in whole-body ^99mTc-sestamibi scans and in whole-body bone scans as well. Clinical factors were statistically analyzed for imaging outcome predictions. Methods Forty-two patients with PH were recruited consecutively. A dual-tracer, dual-phase parathyroid imaging protocol was applied. A ^99mTc-sestamibi whole-body scan was performed immediately after delayed phase acquisition. A ^99mTc-methylene diphosphonate bone scan was performed on day 3. Parathormone (PTH), calcium, alkaline phosphatase (ALP), and parathyroid lesion volume were compared. The t-test, one-way analysis of variance, and receiver operating characteristic curves were performed for statistical analyses. Results Brown tumors showed ^99mTc-sestamibi uptake in 10 cases, and ^99mTc-methylene diphosphonate uptake in 17 cases. All parameters in double-scan positive cases were significantly higher than in double-scan negative cases; PTH and ALP were significantly higher in only bone scan positive cases than in double-scan negative cases. Data from receiver operating characteristic curves showed the order of PTH>ALP>Ca>parathyroid lesion volume for diagnostic accuracies of both positive ^99mTc-sestamibi scans and positive bone scans. PTH showed the best positive predictive value and ALP showed the best negative predictive value. Conclusion A ^99mTc-sestamibi whole-body scan could be used to assess brown tumors in PH, although it may be less sensitive than a bone scan. PTH possessed the best diagnostic accuracy and predictive value for a positive imaging outcome. ALP was useful for negative imaging outcome prediction.