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Abstract: Background. Iodine is an essential element for the synthesis of thyroid hormones. Therefore, a reliable marker of iodine supply is important. Iodine is predominantly excreted via kidneys, but also via salivary glands. Our aim was to introduce a new and simple method for determination of salivary iodine concentration (SLIC). Materials and methods. Self-prepared chemicals and standards for Sandell-Kolthoff reaction on microplate with ammonium peroxydisulfate (AP) in the range 0−400 µg/L were used. Suitability of water-based standards (WBS) and artificial saliva-based standards (ASS) for standard curve were tested. We followed standards for method validation, defined concentration of used AP and compared our results with Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Results. WBS gave more reliable results than ASS as an underestimation of iodine concentration was found for ASS. LoB was 6.5 µg/L, LoD 12.0 µg/L, therefore analytical range was 12−400 µg/L. Intra- and inter-assay imprecisions at iodine concentrations, namely 20, 100, 165, and 350 µg/L were 18.4, 5.1, 5.7, and 2.8%, respectively, and 20.7, 6.7, 5.1, and 4.3%, respectively. Suitable molarity of AP was 1.0 mol/L and showed no difference to 1.5 mol/L (P values for samples with concentration 40, 100, and 150 µg/L, were 0.761, 0.085, and 0.275, respectively), whereas there was a significant change using 0.5 mol/L (P<0.001). Saliva samples could be diluted up to 1:8. There was no interference of thiocyanate and caffeine up to 193.5 mg/L. Our original method was comparable to ICP-MS. Spaerman coefficient was 0.989 (95% CI: 0.984−0.993). Conclusions. The new method for SLIC determination is in excellent agreement with ICP-MS and easy-to-use.
Keywords: iodine, salivary iodine concentration, Sandell-Kolthoff reaction
Published in DiRROS: 26.06.2026; Views: 190; Downloads: 132
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Abstract: Background. Myocardial perfusion imaging (MPI) with single photon emission computed tomography is an established non-invasive technique for assessing myocardial ischemia. This method involves the intravenous administration of a radiopharmaceutical that accumulates in the heart muscle proportional to regional blood flow. However, image quality and diagnostic accuracy can be compromised by various technical and patient-related factors, including high non-specific radiopharmaceutical uptake in abdominal organs such as the stomach, intestines, liver, and gallbladder, leading to subdiaphragmatic artifacts. These artifacts are particularly problematic for evaluating inferior wall perfusion and often necessitate repeated imaging, which decreases gamma camera availability and prolongs imaging times. Conclusions. Despite numerous investigated techniques to reduce interfering gastrointestinal activity, results have been inconsistent, and current MPI guidelines provide scant information on effective procedures to mitigate this issue. Based on our experience, some possible approaches to reducing artifacts include choosing stress testing with an exercise stress test, when possible, late imaging, fluid intake, and consuming carbonated water immediately before imaging
Keywords: myocardial perfusion imaging, artifacts, subdiaphragmatic activity, single photon emission computed tomography, intervention
Published in DiRROS: 24.06.2026; Views: 207; Downloads: 137
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Abstract: Background: Simple cysts are a common form of thyroid nodules. If the cyst is symptomatic, recurs after fine needle aspiration or increases in size, sclerotherapy of the cyst is indicated. Polidocanol can be used as a sclerosing agent, but there are few studies evaluating the efficacy of polidocanol in the sclerotherapy of thyroid cysts. Patients and methods: We conducted a clinical retrospective study in adult patients diagnosed with a simple thyroid cyst with largest diameter greater than 15 mm. Patients were treated with thyroid cyst sclerotherapy with polidocanol (group A, N = 36), ultrasound-guided fine-needle evacuation of the cyst (group B, N = 41) or they received no treatment and were managed only by follow-up (group C, N = 28). Thereafter, the size of the thyroid cyst at least 12 months after the baseline evaluation was recorded. Results: The three groups of patients did not differ significantly in terms of gender, thyrotropin level, thyroid antibody positivity or thyroglobulin level. However, they differed significantly in age (46.5 ± 15.8 years for group A, 51.2 ± 17.4 years for group B and 65.8 ± 13.7 years for group C, p < 0.001). The three patient groups differed significantly in the initial volume of cysts (20.1 ± 13.8 mL for group A, 15.0 ± 17.8 mL for group B and 4.2 ± 4.5 mL for group C, p < 0.001). In groups A and B, the final volume of the cyst was significantly lower than the initial volume (7.6 ± 12.1 mL, p < 0.001, and 6.1 ± 10.4 mL, p < 0.001, respectively), but not in group C (5.3 ± 7.9 mL). There was no significant difference in final cyst volume between the three groups (p = 0.764). Conclusions: The results of our study show that sclerotherapy of thyroid cysts with polidocanol is an effective and safe method for the treatment of large thyroid cysts. Currently, such treatment is more commonly used in younger patients.
Keywords: thyroid, cyst, sclerotherapy, polidocanol
Published in DiRROS: 18.06.2026; Views: 176; Downloads: 122
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Abstract: Background: We aimed to comprehensively investigate the occurrence of thyroid nodules in a nationally representative population as well as in women of reproductive age from a geographic area with adequate iodine intake over the last two decades. Patients and methods: This prospective cross-sectional study included 653 adult participants from three groups: a nationally representative gender-mixed group (205 participants) and women of reproductive age, including non-pregnant (306 participants) and pregnant (142 participants) women. For each participant, demographic data were collected, thyroid-stimulating hormone (TSH) levels were measured, thyroid volume was estimated, and the presence and size of thyroid nodules were recorded with high-resolution ultrasound. The ultrasound characteristics were analysed. Results: Among the nationally representative participants, nodules were detected in 44.9%, with 39.0% larger than 5 mm and 13.7% larger than 0.5 mL. Among women of reproductive age, nodules were detected in 22.5%, with 14.1% larger than 5 mm and only 2.0% greater than 0.5 mL. The prevalence and size of nodules increased significantly with age in all groups, being significantly lower in non-pregnant women than in pregnant women, who were also older. In non-pregnant women of reproductive age, the number of nodules increased significantly after the age of 25, with the number of nodules larger than 5 mm increasing only after the age of 40. Conclusions: Thyroid nodules are prevalent in the population, but are rarely clinically significant. Therefore, screening for thyroid nodules in asymptomatic individuals with normal thyroid findings on clinical examination should be avoided.
Keywords: pregnancy, reproductive period, thyroid nodule
Published in DiRROS: 24.04.2026; Views: 345; Downloads: 322
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Abstract: Due to the frequent diagnosis of benign thyroid nodules, it is necessary to deviate from the traditional paradigm based on frequent surgical treatment. This article highlights the evolution of diagnosis and treatment in recent years, beginning from standardization of ultrasound assessment of nodules and cytology results to minimally invasive techniques to reduce the size of symptomatic thyroid nodules. These achievements reduce the number of surgeries, enable more individualized care for patients with benign thyroid disease, reduce long-term complications, and promote cost-effectiveness within healthcare systems. Furthermore, although the use of minimally invasive techniques significantly decreases thyroid nodule volume, the thyroid nodule usually does not disappear and the challenges in this field are discussed (the efficacy of thermal ablation, a variable part of thyroid nodules that remains viable after thermal ablation, some of the nodules treated with thermal ablation may require a second treatment over time and the efficacy of thermal ablation in nodules with different phenotypes). However, although surgery still represents the "gold standard" for establishing the final histopathologic diagnosis, it is associated with lifelong thyroid hormone substitution need and serious complications in rare cases. Therefore, it should represent the ultima ratio only after a detailed diagnostic procedure. In the future, artificial intelligence-assisted programs for the evaluation and management of nodules are expected.
Keywords: laser ablation, minimally invasive techniques, thyroid nodules, thyroid ultrasound
Published in DiRROS: 16.03.2026; Views: 426; Downloads: 307
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