The Recording and Prognostic Prediction of Thyroid Diseases - Digital Infrared Thermal Imaging and Computerized Morphometry
Date Issued
2012
Date
2012
Author(s)
Shih, Shyang-Rong
Abstract
Dysfunction and anatomic abnormalities of the thyroid are among the most common diseases of the endocrine glands. On the aspect of thyroid dysfunction, Graves’ disease (GD) is the most common form of throtoxicosis. It is characterized by thyrotoxicosis and goiter. Patients may have ophthalmopathy and pretibial myxedema (PM). Currently, there is no satisfactory tool to record and investigate PM, and to describe the inflammatory status of Graves’ ophthalmopathy (GO). It limits the choice and development of therapy. As to the anatomic abnormality of the thyroid, papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Currently, prognostic evaluation tools can be performed only after surgery because they depend on the observation and records of operation and pathology reports. They are not helpful for the operation planning for the extent of thyroidectomy and lymph node dissection. This study aimed to solve these important clinical issues.
Digital infrared thermal imaging (DITI) detects surface temperature. We tried to appliy it to help observe and record GD complications. On the aspect of PM, eighty-seven GD patients with or without PM and 14 normal volunteers were recruited for observation of lower legs with DITI. DITI showed abnormally low focal temperature over PM lesions and in some GD patients without obvious PM. Thyrotropin receptor antibody level correlated positively and significantly with adjusted temperature difference between the center of temperature defect and the surrounding skin (p=0.033). We demonstrated that DITI is helpful in recording and may be a useful tool to detect early changes of PM.
On the aspect of GO, forty-six patients with GO receiving intravenously methylprednisolone pulse therapy (MPT) were included for observation of the eye temperature with DITI. Local temperatures of the eyes decreased after MPT. Temperature difference (△T) significantly negative-correlated with basal mean temperature (MT) (p= 0.004). We demonstrated that DITI is valuable in the prediction of prognosis after MPT.
As to PTC, we tried to analyze cytologic features with computerized morphometry (CM) to help predicting prognosis preoperatively. Cytologic features of 142 patients with usual-type PTC were studied with CM retrospectively. Multivariate logistic analysis indicated that nucleus-to-cell ratio, variation of nuclear area, tumor size, and patients’ age were significantly related to cancer recurrence in 10 years. We demonstrated that CM helped to predict prognosis preoperatively.
In summary, according to current preliminary reports, DITI is useful in recording PM and predicting the prognosis of GO after MPT; and CM is useful in predicting the prognosis of PTC. Further large scale studies are necessary to help applying these methods clinically.
Subjects
Graves’ disease
pretibial myxedema
Graves’ ophthalmopathy
Digital infrared thermal imaging
papillary thyroid carcinoma
computerized morphometry
SDGs
Type
thesis
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