2018.26 (3)

2018, vol XXVI, # 3, page 139

O. I. SOLODIANNYKOVA, D. L. SAHAN, V. V. TRATSEVSKYI, V. V. DANYLENKO, V. L. TURYTSYNA

National Cancer Institute of Health Ministry of Ukraine, Kiev

THYROID DIFFERENTIATED MICROCARCINOMAS: TREATMENT AND MONITORING FEATURES

The paper deals with posthoc analysis of treatment and monitoring of patients with thyroid differentiated cancer microcarcinomas. In order to make an assessment of treatment outcomes of patients after surgical treatment, associated with thyroid differentiated cancer microcarcinomas, who had undergone radioactive iodine therapy in combination with suppressive L-thyroxin hormonotherapy and only with suppressive hormonotheray, the analysis of comprehensive treatment efficacy in 153 petients aged from 19 to 70 (15 male and 141 female patients) was carried out. It has been established, that the presence of signs of metastasis to regional lymph nodes in 16.2% of patients with thyroid differentiated cancer microcarcinomas, obtained by pathohistological study and in 5.2% by scintigraphic study, requires obligatory postoperative diagnostic scintigraphy with 131I that will make it possible to clarify whether radioactive iodine therapy should be administered.

Keywords: thyroid microcarcinoma, thyroid differentiated cancer, radioactive iodine therapy, suppressive hormonotherapy.

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2018, vol XXVI, # 3, page 142

O.V. KAMINSKYI, O.V. KOPYLOVA, O.A. STEPANENKO, L.O. TSVET, K.V. GRYSCHENKO

SE «National Research Center for Radiation Medicine of NAMS of Ukraine», Kyiv

ASSOCIATIVE LINK BETWEEN THYROID DISEASE AND PARATHYROID GLANDS STATE IN CHILDREN BORN OF PARENTS EXPOSED TO IONIZING RADIATION AFTER THE ChNPP ACCIDENT

Purpose. To evaluate interconnection between parathyroid structural-functional abnormalities and thyroid disorders in children born of parents irradiated as a result of the Chornobyl accident.

Materials and methods. Clinical examination, hormonal assay and ultrasound scan of thyroid and parathyroid glands were conducted. The 142 children, aged from 12 to 17, born of parents irradiated as a result of the Chornobyl accident were examined. Blood serum content of the pituitary thyroid-stimulating hormone (TSH), free thyroxine (FT4), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TpAb), and 25-hydroxyvitamin D was assayed. Thyroid and parathyroid ultrasound scan was performed on the Logiq-100 unit.

Oucomes. Examination of thyroid and parotid glands in 142 children, aged from 12 to 17, born of parents irradiated as a result of the Chornobyl accident revealed a range of thyroid disease, namely diffuse nontoxic goiter grade I-II in 73.2%, chronic autoimmune thyroiditis (ChAT) in 19.7%, and nodular goiter in 7.1%. Primary hypothyroidism was detected in the 11 (39.2%) cases of ChAT, and subclinical hypothyroidism was diagnosed in 12 (11.5%) children. Parathyroid ultrasound indicated the glandular enlargement in 32.5% of children living on territories contaminated with radionuclides. Parathyroid enlargement was found in all the surveyed subjects with a verified ChAT diagnosis, which confirms our assumption about the interconnection between thyroid immune-inflammatory diseases and state of parathyroids. Assay of 25-hydroxyvitamin D level showed some lack of it in all children with enlarged parathyroids, requiring some corrective interventions.

Conclusions. Parathyroid ultrasound scan oucomes indicated a priority of the group of children living in radioactively contaminated territories (parathyroid enlargement for >10 mm was found in 26.4% of children). Serum assay of 25(OH)D showed its low level (12.29 ± 1.24) indicating a probable lack of consumption that can finally lead to health disorders in the offspring of parents exposed to ionizing radiation as a result of the ChNPP accident.

Keywords: parathyroid, thyroid disease, children, Chornobyl accident.

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2018, vol XXVI, # 3, page 146

M. TKACHENKO, P. KOROL

Bogomolets National Medical University, Kyiv

Kyiv City Clinical Hospital N 12

THE ROLE OF RENOSCINTIGRAPHY IN PATIENTS WITH HEPATOCELLULAR CARCINOMA WHO UNDERWENT IMMUNOSUPPRESSIVE THERAPY AFTER LIVER TRANSPLANTATION

Purpose. To determine the diagnostic role of dynamic renoscintigraphy in a general complex of methods for examining patients with hepatocellular carcinoma (HCC) after liver transplantation applying immunosuppressive therapy.

Materials and methods. Renoscintigraphy was performed in dynamic mode after intravenous administration of 99mTc-pentatech at a rate of 0,7-1,0 MBq/kg, followed by calculation of digital parameters reflecting the secretoryexcretory function of the kidneys.

Outcomes. From 2013 to 2017, 168 patients with HCC who underwent liver transplantation were examined using renoscintigraphy. In the group of patients taking Ciclosporin, there was a significant decrease in parenchymal functional activity and secretory-excretory function of the kidneys (p <0.05), compared with the group of patients who used Tacrolimus in the postoperative period. After Tacrolimus therapy, a stable long-term function of the hepatic transplant was achieved, and no signs of chronic nephrotoxicity were detected.

Conclusions. Renoscintigraphy is a sensitive method of dynamic monitoring of the evaluation of the effectiveness of postoperative treatment of patients with HCC and pathogenetic correction of immunosuppressive therapy.

Keywords: renoscintigraphy, liver transplantation, immunosuppressive therapy.

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2018, vol XXVI, # 3, page 150

A. V. ZELINSKAYA, A. N. KVACHENUK, G. N. KULINICHENKO, A. YA. USTIMENKO, YU. M. ВOZHOK

SI «V. P. Komisarenko Institute of Endocrinology and Metabolism of National Academy of Medical Sciences of Ukraine», Kyiv

RADIOIODINE-REFRACTORY METASTASES OF PAPILLARY THYROID CARCINOMA AS A MANIFESTATION OF INTRA-TUMOR PHENOTYPIC HETEROGENEITY

The phenomenon of intra-tumor phenotypic heterogeneity can be the source of multifocal growth and the cause of ineffective treatment of malignant tumors. We revealed signs of phenotypic heterogeneity (difference in cytological and immunocytochemical characteristics of thyrocytes) between the tumor sites of the same patient in 14% of papillary carcinoma with metastases and 70% of patients with recurrent papillary carcinomas with repeated metastases. The study demonstrates the possibility of identification of cytological and immunocytochemical signs of phenotypic intra-tumor heterogeneity, which is the basis of early preoperative prediction of aggressive behavior of thyroid papillary carcinoma and development of special therapeutic approaches to such tumors.

Keywords: papillary thyroid carcinoma, fine needle aspiration biopsy, cytological diagnosis, recurrence of papillary cancer, radioiodine-refractory metastases, intra-tumor phenotypic heterogeneity, subclones.

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2018, vol XXVI, # 3, page 154

I.V. NOVERKO, V.YU. KUNDIN, M.V. SATYR

SI «Heart Institute of Ministry of Health of Ukraine», Kyiv

SCINTIGRAPHY WITH 99mTC-PERTECHNETATE IN DIAGNOSIS OF FUNCTIONAL AUTONOMY OF THE THYROID GLAND

Summary. The purpose of our work was studying the possibilities of using and effectiveness of scintigraphy with 99mTc-pertechnetate in diagnosis of functional autonomy of the thyroid gland. Fifty-three patients with functional autonomy of thyroid gland were examined. In 51 patients (96.2%) with a single-node toxic goiter and 2 patients (3.8%) with multinodular toxic goiter, the 99mTc-pertechnetate capture in autonomous functioning nodes was visualized with suppression of radiotracer absorption in the surrounding thyroid tissue with different degree of severity. The conclusions regarding high diagnostic significance of scintigraphy with 99mTc-pertechnetate in diagnosis of thyroid nodal pathology, determining the nature of nodular toxic goiter, and also in assessing the functional activity of thyroid tissue were made.

Keywords: nodular goiter, toxic adenoma, functional autonomy of the thyroid gland, scintigraphy, 99mTc-pertechnetate.

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2018, vol XXVI, # 3, page 158

M. M. FIRSOVA1, O. M. KLIUSOV2, N. I. POLIAKOVA2, O. V. KASHCHENKO2

1 P. L. Shupyk National Medical Academy of Postgraduate Education, Radiology Department

2 Kyiv City Clinical Oncology Center, Nuclear Medicine unit of Radiology Department

IMPORTANCE OF RESORPTION MARKER TRAP-5b FOR MULTIPLE BONE PATHOLOGY METASTASES TREATMENT BY SYSTEMIC RADIONUCLIDE THERAPY

Objective. To analyze changes in index of resorption marker TRAP-5b while planning courses of radionuclide therapy, as well as during respective courses in patients with multiply bone metastases.

Materials and methods. Ten medical cases of patients with multiply bone metastases were analyzed: 8 patients with prostate cancer and 2 female patients with breast cancer.

Results. Only one patient with multiply bone metastases of prostate cancer had elevated level of bone resorption marker– 7,86 U/L before the course of radionuclide therapy. The rest of patients, both male and female, had level of bone resorption marker registered within the reference values before radionuclide therapy courses. At the same time results of osteoscintigraphy and PET-CT were indicative of multiple bone metastases with different qualitative level of lesion in percentage, as well as in SUV index that could be caused by response of skeletal system to specific treatment (bisphosphonates and hormone-, hemo- and radiotherapy)

Conclusions. TRAP-5b bone marker could not be used as a self- sufficient indicator to plan systemic radionuclide therapy courses. Taking into account multiple levels of changes in skeletal system, complex examination of bone remodeling markers is required to evaluate and prognosis of malignant dissemination.

Keywords: multiply bone metastases, resorption marker TRAP-5b, radionuclide therapy.

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2018, vol XXVI, # 3, page 162

T. G. NOVIKOVA1, N. A. NIKOLOV2, S. S. MAKEYEV1, S. S. KOVAL1, L. L. CHEBOTARYOVA1, M. V. GLOBA1

1 The State Institution Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine

2 National Technical University of Ukraine Kyiv Polytechnic Institute

CHANGES OF CEREBRAL BLOOD FLOW BASED ON SCINTIGRAPHIC AND ULTRASOUND DATA IN PATIENTS WITH CHRONIC ISCHEMIA IN THE VETEBROBASILAR REGION

Purpose. To investigate the possibility and feasibility of using the technique of quantitative assessment of cerebral blood flow based on SPECT with 99mTc-HMPAO in patients with chronic ischemia in the vetebrobasilar region. Materials and methods. The study enrolled 14 patients with chronic ischemia in the vetebrobasilar region. The patients were divided into groups based on ultrasound (US) criteria of presence (group I) or absence (group II) of structural changes in vertebral arteries. Each group consisted of 7 patients. The data of ultrasound studies of the vessels of the neck and head and the results of scintigraphic studies of the brain with 99mTc-HMPAO were analyzed. The volume cerebral blood flow (CBF), according to scintigraphic studies, was calculated by the method of N.A. Lassen and based on a developed original method that treats the brain as a flow system. Processing and analysis of scintigraphic data was performed by the developed software «ScintiBrain» (SB).

Outcomes. It has been shown that the average CBF of patients of Group I differs from that one in Group II: by 1.82 ± 0.06 times for CBFSB and 0.95 ± 0.04 for CBFLassen. This indicates that CBFLassen did’t show a significant difference between the two groups, although the total blood flow in Group I patients was significantly reduced according to the US data. There are a correlation relationships between CBF based on ultrasound and scintigraphic data.

Conclusions. The outcomes make it possible to characterize the severity of cerebral hypoperfusion in patients with chronic ischemia in the vetebrobasilar region. The introduction into practice of joint neuroimaging and ultrasound studies allows us to identify the features of cerebral and regional perfusion.

Keywords: chronic brain ischemia, brain, cerebral blood flow, SPECT, 99mTc-HMPAO, vertebral artery, carotid artery, duplex scanning of vessels of the head and neck.

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2018, vol XXVI, # 3, page 168

H.V. LAVRYK

National Cancer Institute of Health Ministry of Ukraine, Kiev

DIAGNOSTIC RADIOLOGIC IMAGING IN ASSESSMENT OF THE LIVER AFTER SURGICAL INTERVENTION (RESULTS OF OWN EXPERIENCE)

Purpose. To make am assessment of the visual, structural and hemodynamic changes of liver after surgical treatment of metastatic colorectal cancer.

Materials and methods. The analysis of the findings (ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI)) of 112 patients who had undgone liver resections for metastatic liver disease at National Cancer Institute was carried out. In all patients the process in the liver was of metastatic character. Primary tumor was colorectal cancerin all patients, located across the colon. The diagnosis of primary tumor was pathologically confirmed and it was adenocarcinoma G2-G3.

In 27 (24.1 %) patients, liver resection was combined with resection of primary tumor; 48 (42.8 %) patients underwent liver resection as the second stage of treatment for synchronous metastasis; 37 (33.9 %) patients had resection concerned with distant recurrence – metachronous metastasis.

Anatomic resections were most frequently performed (67.8 %) and included: segmental (31.5 %), sectional (28.9 %) resections and hemihepatectomy (26.3 %). Liver preserving resections were performed in conjunction with radiofrequent ablation.

Outcomes. In postoperative period, local decrease of echogenecity/density/intensivity of liver parenchyma at the resection site, liver periphery in subdiaphragmatic space were observed. The anatomic resection margin was revealed to be irregular as a result of forming scar and hypertrophic process. The defects size and contour deformations characterized the volume of removed segments. The principle difference in liver imaging after wide resections was the change in liver vasculature, as a result of liver segments removal with vascular structures. The configuration of portal vein and its braches was the major criteria to determine resectability.

The findings obtained due to dynamic liver studies demonstrate that after completion of liver regeneration, its primary structure is completely restored if recurrence does not occur.

Conclusions. Applying the complex diagnostic examination and diagnostic monitoring of the operated liver associated with metastatic liver disease has made it possible to make an assessment of anatomic features and to determine main postoperative changes after resection.

Keywords: colorectal cancer liver metastasis, diagnostic radiology, diagnostic monitoring, liver surgery.

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2018, vol XXVI, # 3, page 179

N. E. PROKHACH

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

PSYCHOSOMATIC DISORDERS IN COMBINED TREATMENT IN ENDOMETRIAL CANCER PATIENTS WITH DIFFERENT TYPES OF AUTONOMIC REGULATION

Purpose. To identify the peculiarities of the manifestation of psychosomatic disorders at the stages of combined treatment in endometrial cancer patients with different types of autonomic regulation

Materials and methods. A total of 54 patients with I–II stage endometrial cancer (T1b-cN0M—T2a-bN0M0) were examined in 3 stages of combined treatment: before the beginning of all types of antitumor treatment, after radical surgery and after radiation treatment. To assess the severity of psychosomatic disorders, the QLQ-C30 questionnaire was used. The analysis of heart rate variability was carried out using the diagnostic complex Spectrum+. The results were processed using the STATISTICA 6.0 software package (Russified version).

Results. According to the stress index and the value of a very low-frequency component of the spectrum (VLF), all patients were divided into 6 groups. In patients of these groups, the quality of life and the manifestations of psychosomatic disorders at the stages of combined therapy were analyzed. At the end of treatment in patients with a significant imbalance of autonomic and central regulation, the lowest level of quality of life and the highest severity of psychosomatic disorders in comparison with patients of other groups were found.

Conclusion. For patients with a significant imbalance of sympathetic and parasympathetic influences, the worst prognosis of development of psychosomatic disorders of high severity аfter the combined treatment is expected.

Keywords: endometrial cancer, combined treatment, psychosomatic disorders, types of autonomic regulation.

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2018, vol XXVI, # 3, page 185

G. A. ZAMOTAYEVA, N. M. STEPURA, M. D. TRONKO

SI «V. P. Komisarenko Institute of Endocrinology and Metabolism of National Academy of Medical Sciences of Ukraine», Kyiv

BLOOD LEUKOCYTE POPULATION IN THYROID CANCER PATIENTS AFTER RADIOIODINE THERAPY WITH RECOMBINANT HUMAN THYROID-STIMULATING HORMONE (THYROGEN)

Purpose. To compare the effect of 131-I on the leukocyte composition of peripheral blood in patients with differentiated thyroid cancer after Thyrogen-aided versus thyroid hormone withdrawal-aided radioiodine treatment. Materials and methods. We measured the blood leukocyte population in 29 euthyroid patients who underwent Thyrogen therapy (group A) and 35 hypothyroid patients with levothyroxine withdrawal (group B) prior to radioiodine remnant ablation in thyroid cancer. All thyroid cancer patients did not have distant metastases. The study was conducted just before iodine-131 treatment and in 6 days, one and six months. The venous heparinized blood was tested. The total number of leukocytes and the leukocyte formula were determined by conventional methods.

Outcomes. Patients who received 131-I radioiodinetherapy with Thyrogen, demonstrated moderate changes in the blood leukocyte types only in the early periods (on the sixth day). In contrast, the administration of radioactive iodine to hypothyriod patients (group 2) caused significant disturbances of the white blood cells throughout whole investigated period, with a maximum level of changes in one month after radioiodine therapy.

Conclusions. The degree of violations of the leukocyte composition of the blood is less, and the indices recover faster for those thyroid cancer patients who received radioiodine therapy with131-I using Thyrogen. This fact could be explained by the decrease of the radiation exposure of peripheral blood cells in euthyroid patients.

Keywords: thyroid cancer, radioiodine therapy, recombinant human thyroid-stimulating hormone (Thyrogen), hypothyroidism, peripheral blood leukocyte population.

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2018, vol XXVI, # 3, page 190

M. V. SATYR, A. V. KHOHLOV, V. V. KUNDINA, I. V. NOVERKO, M. V. SHYMANKO

SІ «Heart Institute of Ministry of Health of Ukraine», Kyiv

APPLYING OF STRESS TESTS IN SCINTIGRAPHIC STUDY OF MYOCARDIAL PERFUSION

Summary. Roenthen CT, MRT and selective coronarography (as a «gold standard») are used for structure changes visualization.

Myocardioscintigraphy (MSG) is used for determination of myocardial functional state depending on coronary blood flow (CBF) on the microcirculatory level. Mechanisms of CBF regulation are activated when the myocardial upload and oxygen demand goes up. The MSG informativity increases at that moment too. Stress testing, which increases the myocardial oxygen demand (physical exercise and pharmacological stressors – vasodilators and sympathomimetic drug) is used for detection of the regulatory blood flow disorders. In this article the mechanisms, indications, contra-indications, side effects each of stress tests have been analyzed. 

Ergometry is the first choice stress test. If exercise is not feasible, a vasodilator stress test is the primary alternative, the second one is sympathomimetic.

Keywords: myocardial perfusion, blood flow regulation, ergometry, pharmacological tests with vasodilators and sympathomimetic drug.

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2018, vol XXVI, # 3, page 196

S. S. KOVAL1, S. S. MAKEYEV1, M. F. LEVCHENKO2, T. G. NOVIKOVA1

1 SI «Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine», Kiev 

2 CH «Feofaniya», Kiev

RADIONUCLIDE IMAGING OF INFLAMMATORY AND INFECTIOUS LESIONS

Abstract.This review is aimed at briefly summarizing the main indications for use, advantages, disadvantages and some technical aspects of conducting radionuclide imaging of inflammatory and infectious lesions using radiolabeled leukocytes (111In-oxine/99mTc-HMPAO), 67Ga-citrate, 18F-FDG and 99mTc-(V)DMSA.

Keywords: Radionuclide imaging of inflammatory and infectious lesions, radiolabeled leukocytes (111In-oxine/99mTcHMPAO), 67Ga-citrate, 18F-FDG, 99mTc-(V)DMSA.

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2018, vol XXVI, # 3, page 200

P. P. SOROCHAN, A. S. DUDNICHENKO, I. A. GROMAKOVA, N. E. PROKHACH, I. S. GROMAKOVA

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine»

USE OF GENETICALLY MODIFIED T-LYMPHOCYTES EXPRESSING CHIMERIC ANTIGENIC RECEPTORS IN ONCOLOGY

The review summarizes the clinical experience of CAR T-cell therapy using for patients with non-Hodgkin’s lymphoma, chronic lymphocytic leukemia, acute lymphoblastic leukemia, and solid tumors. The problems associated with CAR T-cell therapy of solid tumors and toxic effects of immunotherapy have been described.

Keywords: CAR T-cell, immunotherapy, оnсology.

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2018, vol XXVI, # 3, page 208

V. YU. KUNDIN

GI «Heart Institute Ministry of Health of Ukraine», Kiev

SEMIOTICS OF SCINTIGRAPHIC IMAGING OF KIDNEY DISEASES

The article deals with the semiotics of scintigraphic imaging of the kidneys, such as the syndrome of urodynamic disorders, syndromes of diffuse and focal changes of renal parenchyma, syndrome of parenchyma sclerotic changes and changes in the renal pyelocaliceal complex. Scintigraphic syndromes were analyzed with inflammatory diseases of the kidneys (glomerulonephritis, pyelonephritis), hypoplasia of the kidneys, hydronephrosis, urolithiasis, vesicoureteral reflux, and chronic renal failure.

Keywords: radionuclide diagnostics, semiotics, urodynamics, diffuse and focal changes of renal parenchyma, the renal pyelocaliceal complex.

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2018, vol XXVI, # 3, page 213

YU. V. HRABOVSKYI, O. V. VLADIMIROV

Mechnikov Dnipropetrovsk Regional Hospital, Dnipro

CASE OF USE 131I IN TREATMENT OF EXTRATIREOID GROWTH OF THYROID FOLICULAR CANCER

The paper deals with the description of late diagnosis of differentiated thyroid cancer in a 67-year-old patient. In 2015 the patienr underwent surgical treatment associated with mass lesion locating in the mandible. Due to histological and immunohistochemical studies, the thyreogenic nature of the process was established. When scanning using 120 MBq 131І, the areas of its accumulation in the right sections of the lower jaw, 8, 9 thoracic, 4, 5 lumbar vertebrae, sacrum have been revealed. After oncological team meeting, thyroidectomy was carried out – follicular adenoma; thyroid disease, follicular form, pT0rN0M0 was diagnosed. Later the patient underwent 5 courses of radioiodine therapy applying 6000 MBq 131І. Decreased intensity of indicator accumulation in the lesion areas was observed over time. Thyroglobulin high level was constantly observed, which indicated a lack of radioiodine resistance.

The complexity of the case results from late diagnosis of cancer associated with an atypical nature of extrathyroid tumor growth, which has led to long-term treatment of the patient with relatively high radiation exposure and disability of the patient.

Keywords: differentiated thyroid cancer, radioiodine therapy.

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RECOMMENDATIONS FOR PRACTITIONERS

2018, vol XXVI, # 3, page 215

YU. V. HRABOVSKYI, O. V. VLADIMIROV

Mechnikov Dnipropetrovsk Regional Hospital, Dnipro

EXPERIENCE OF I131  APPLICATION IN TREATMENT OF TYROTOXYMIC STATES  AT MECHNIKOV DNIPROPETROVSK REGIONAL HOSPITAL

Purpose. Conducting an analysis focused on the use of I131 iodine isotope for radioiodine therapy of diffuse toxic goiter. Determination of criteria of choosing methods for controlling quality diagnosis after treatment.

Materials and methods. The study enrolled 12 paper histories of the disease which were analyzed as well as the information regarding the course of the disease, the nature of treatment performed with the use of I131 was added to the electronic database. Statistical processing was carried out using nonparametric statistics by means of Statistica Basic Academic 13 for Windows package.

Outcomes. After radioiodine therapy the patients with diffuse toxic goiter undergo a control scanning on residual activity in 1 month. Scanning in 4, 10 months using 4-8 MBq I131 is carried out. Controlled ultrasound of the thyroid gland and determination of thyroid hormones level is made every month.

According to the outcomes of control observations, the effect of treatment was found to be satisfactory in all patients: the thyroid gland volume decreased in 100% of cases. Euthyroid condition was achieved in 10 patients, hypothyroidism – in 2 patients. In 1 month, according to ultrasound investigations, the thyroid gland volume decreased from 6% to 15%. In 4 months –23-130%, in 10 months – 27-145%.

Relapse of a hyperthyroid state has not been recorded in any patient within the period of 3 years.

Conclusions. Radioiodine therapy as a highly effective non-invasive method should be more widely implemented in medical practice for treatment of thyrotoxic conditions in diffuse toxic goiter.

It is necessary to develop standards for determining the optimal therapeutic doses, depending on the size of the thyroid gland, the level of thyroid hormones and the stage of the disease.

Keywords: thyrotoxicosis, diffuse toxic goiter, radioiodine therapy.

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2018, vol XXVI, # 3, page 219

D. S. MECHEV1, O. V. SHCHERBYNA1, YU. P. SEVERIN2, V. V. ANDREEVA3

P.L. Shupyk National Medical Academy of Postgraduate Education

Kyiv City Clinical Oncological Centre

National Cancer Institute of Health Ministry of Ukraine, Kiev

WORKSHOP

25-YEAR LONG MONITORING OF PATIENTS WITH PAPILLARY THYROID CANCER WHO UNDERWENT RADIOACTIVE IODINE TREATMENT

The purpose of our workshop is to give an analysis of longterm monitoring (up to 25 years) of patients with differentiated thyroid cancer (DTC), who were treated at Kyiv Oncological Cеnter with the aid of 131I. We demonstrated the patient’s medical history of disease with 25-year long monitioring along with complications and problems resulting from this analysis depending on risk factors – prognostic factors. The recommendations regarding the further development of this clinical oncology challenging issue of monitioring the patients with papillary thyroid cancer were provided.

Keywords: differentiated thyroid cancer, 131I-therapy, patient monitoring, prognostic factors, medical histoty.

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URG Ukrainian Journal of Radiology © 2020