Patients exposed to diagnostic head and neck radiation for the management of shunted hydrocephalus have a significant risk of developing thyroid nodules

Aldrink, Jennifer H.; Adler, Brent; Haines, Jesse; Watkins, Daniel J.; Matthews, Mika A.B.; Lubeley, Lacey; Wang, Wei; King, Denis R.

doi:10.1007/s00383-016-3894-1

Cited by 7 publications

(4 citation statements)

References 36 publications

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“…In case of focal uptake on the PET scan and an increased maximum standardized uptake value, the risk of malignancy may increase to 55% . Risk factors for malignancy include childhood irradiation (mainly head and neck and whole body radiation), exposure to ionizing radiation from fallout in childhood or adolescence, family history of thyroid cancer or hereditary syndromes that include thyroid cancer (eg, multiple endocrine neoplasia syndrome type 2, familial adenomatous polyposis), rapid nodule growth, or hoarseness . Insufficient evidence is available for other factors proposed to be associated with nodule formation or malignancy, such as serum levels of thyrotropin, thyroid autoantibodies, obesity, and metabolic syndrome …”

Section: Methodsmentioning

confidence: 99%

The Diagnosis and Management of Thyroid Nodules

Durante

Grani

Lamartina

et al. 2018

JAMA

574

396

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Section: Methodsmentioning

confidence: 99%

The Diagnosis and Management of Thyroid Nodules

Durante

Grani

Lamartina

et al. 2018

JAMA

574

396

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show abstract

“…Recognized risk factors for thyroid malignancy are medical irradiation during childhood ( 44 ), accidental exposure to ionizing radiation from fallout in childhood or adolescence ( 45 , 46 ), a family history of thyroid cancer, or hereditary syndromes that include a predisposition to thyroid cancer (e.g., PTEN hamartoma tumor syndrome, Carney complex, Werner syndrome) ( 13 ). Nodules that are firm, fixed, or rapidly growing require prompt evaluation ( 47 ).…”

Section: Clinical Risk Factorsmentioning

confidence: 99%

Contemporary Thyroid Nodule Evaluation and Management

Grani

Sponziello

Pecce

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

192

140

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Context Approximately 60% of adults harbor 1 or more thyroid nodules. The possibility of cancer is the overriding concern, but only about 5% prove to be malignant. The widespread use of diagnostic imaging and improved access to health care favor the discovery of small, subclinical nodules and small papillary cancers. Overdiagnosis and overtreatment is associated with potentially excessive costs and nonnegligible morbidity for patients. Evidence Acquisition We conducted a PubMed search for the recent English-language articles dealing with thyroid nodule management. Evidence Synthesis The initial assessment includes an evaluation of clinical risk factors and sonographic examination of the neck. Sonographic risk-stratification systems (e.g., Thyroid Imaging Reporting and Data Systems) can be used to estimate the risk of malignancy and the need for biopsy based on nodule features and size. When cytology findings are indeterminate, molecular analysis of the aspirate may obviate the need for diagnostic surgery. Many nodules will not require biopsy. These nodules and those that are cytologically benign can be managed with long-term follow-up alone. If malignancy is suspected, options include surgery (increasingly less extensive), active surveillance or, in selected cases, minimally invasive techniques. Conclusion Thyroid nodule evaluation is no longer a 1-size-fits-all proposition. For most nodules, the likelihood of malignancy can be confidently estimated without resorting to cytology or molecular testing, and low-frequency surveillance is sufficient for most patients. When there are multiple options for diagnosis and/or treatment, they should be discussed with patients as frankly as possible to identify an approach that best meets their needs.

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“…Exposure of the thymus to low doses of ionizing radiation may lead to changes and disrupt the immune system's function and mechanism (44). Moreover, radiation exposure to the head and neck can result in thyroid dysfunction and may increase the incidence of benign and malignant thyroid nodules (45). Breasts are known as the most radiosensitive organ in the human body (46).…”

Section: Discussionmentioning

confidence: 99%

Impact of Eye and Breast Shielding on Organ Doses During Cervical Spine Radiography: Design and Validation of MIRD Computational Phantom

Elshami

Tekın

Issa

et al. 2021

Front. Public Health

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Purpose: The study aimed to design and validate computational phantoms (MIRD) using the MCNPX code to assess the impact of shielding on organ doses.Method: To validate the optimized phantom, the obtained results were compared with experimental results. The validation of the optimized MIRD phantom was provided by using the results of a previous anthropomorphic phantom study. MIRD phantom was designed by considering the parameters used in the anthropomorphic phantom study. A test simulation was performed to compare the dose reduction percentages (%) between the experimental anthropomorphic phantom study and the MCNPX-MIRD phantom. The simulation was performed twice, with and without shielding materials, using the same number and locations of the detector.Results: The absorbed dose amounts were directly extracted from the required organ and tissue cell parts of output files. Dose reduction percentages between the simulation with shielding and simulation without shielding were compared. The highest dose reduction was noted in the thymus (95%) and breasts (88%). The obtained dose reduction percentages between the anthropomorphic phantom study and the MCNPX-MIRD phantom were highly consistent and correlated values with experimental anthropomorphic data. Both methods showed Relative Difference (%) ranges between 0.88 and 2.22. Moreover, the MCNPX-MIRD optimized phantom provides detailed dose analysis for target and non-target organs and can be used to assess the efficiency of shielding in radiological examination.Conclusion: Shielding breasts and eyes during cervical radiography reduced the radiation dose to many organs. The decision to not shield patients should be based on research evidence as this approach does not apply to all cases.

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Patients exposed to diagnostic head and neck radiation for the management of shunted hydrocephalus have a significant risk of developing thyroid nodules

Cited by 7 publications

References 36 publications

The Diagnosis and Management of Thyroid Nodules

The Diagnosis and Management of Thyroid Nodules

Contemporary Thyroid Nodule Evaluation and Management

Impact of Eye and Breast Shielding on Organ Doses During Cervical Spine Radiography: Design and Validation of MIRD Computational Phantom

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