Biomedical subjects

P Raineri

Publications and source records attributed to P Raineri.

9 recordsLinked to original sources

PubMed1993

Comparison of pertechnetate and radioiodine thyroid scintiscans in thyroid disease.

In a retrospective study, thyroid scintiscan with technetium-99m-pertechnetate at 30 minutes was compared with the iodine-131 scan at 24 hours in 273 patients with various thyroid diseases. The pertechnetate scan showed normal or diffusely enlarged thyroid glands in 64 patients, cold nodules in 36, and hot or warm nodules in 173. The radioiodine and pertechnetate scintiscans were concordant in all patients without nodules and in those with cold nodules. Minor discrepancies were observed in 24 patients with hot or warm nodules. Only 2 patients, both euthyroid, showed major discrepancies in which nodules appeared hot with pertechnetate and cold with radioiodine. Sequential scintiscans with radioiodine performed in both of these patients, and a perchlorate test performed in one, demonstrated organification defects in the nodules. The data indicate that there is a high correlation between the results of scintiscans using the two tracers; discrepancies in results with the two imaging techniques were rare.

Adult↗

PubMed1992

Percutaneous intranodular ethanol injection: a new treatment for autonomous thyroid adenoma.

Established methods for definitive ablation of autonomous thyroid nodules are surgery and radioiodine. Since it has been demonstrated that percutaneous ethanol injection can inactivate parathyroid adenomas and small hepatocellular carcinomas, we started a trial of this treatment in patients with autonomous thyroid nodules. Twenty-eight patients, 22 toxic and 6 nontoxic, all with undetectable thyrotropin serum levels and suppressed extranodular tissue on scintigraphy, were treated. Treatment consisted of percutaneous intranodular ethanol injection under ultrasound guidance. The total amount of alcohol injected ranged from 0.4 to 2.2 times the estimated nodule volume, divided into 4 to 9 injections performed at 2 to 7 day intervals. Most patients were treated with a single cycle of injections, but 7 of them required 2 cycles. The signs and symptoms of hyperthyroidism disappeared in all cases. Apparently complete cure (normal serum free thyroid hormones, thyrotropin in basal conditions and after thyrotropin releasing hormone, reactivation of extranodular tissue on scintigraphy with nodule no longer visible) was obtained in 17 patients (13 after 1 cycle and 4 after 2 cycles). Partial cure (normal serum free thyroid hormone levels, detectable thyrotropin levels with normal or blunted response to thyrotropin releasing hormone and partial reactivation of extranodular tissue on scintigraphy with nodule or parts of it still visible) was obtained in 10 patients (8 after 1 cycle and 2 after 2 cycles). In 1 patient with a very large nodule thyrotropin levels remained undetectable, but thyroid hormone levels eventually became normal. No recurrences were observed after a follow-up of 12 to 32 months (mean 20 months). No serious side effects were encountered. A clinically valuable result was obtained in all patients. These data suggest that this form of treatment could constitute an alternative to surgery and radioiodine for the ablation of autonomous thyroid nodules.

Adenoma↗

PubMed1990

Treatment of autonomous thyroid nodules with percutaneous ethanol injection: preliminary results. Work in progress.

Eight patients with autonomous thyroid nodules 2.4-4.3 cm in diameter received percutaneous ethanol injections (PEIs) under guidance by means of ultrasound (US). Sterile ethanol at 95% was injected with a 22-gauge needle and a 7.5-MHz probe with a guide device. Each patient received one or two treatments, with 1-3 mL of alcohol (depending on the nodule size) per treatment, each week for a total of three to six injections per lesion. After a total of 36 injections in all eight patients, there were no complications. Follow-up ranged from 2 to 10 months. After therapy, symptoms subsided and hormonal levels became normal or reached the range of subclinical hypothyroidism. Scintigrams showed that the previously suppressed thyroid tissue had resumed functioning. At US, all nodules had shrunk. PEI was risk free and easy to perform. If these preliminary results are confirmed in a larger study with longer follow-up, the new treatment may become an alternative to surgical or radioiodine ablation of autonomous thyroid nodules.

Adult↗

PubMed1970