Thyroid Cancer Related To Radiology

Thyroid cancer related to radiology

At the level of many practices in clinics there are doubts about the risks to which health workers who participate in the diagnostic process with ionizing radiation are exposed.

Ionizing radiation is potentially an etiological agent of thyroid cancer, taking into account that there are both occupational and non -occupational factors that increase the risk in certain radiology technologists.

However, after the baseline of the study, the occurrence of thyroid cancer in general is not associated with employment as a radiology technologist. It was found that the occupational factor of greatest impact is to accompany in several sessions patients during radiology studies.

INTRODUCTION:

Ionizing radiation is a carcinogen agent, which produces chromosomal disorders, and the formation of micronCleos in the cell cytoplasm. Several epidemiological investigations have demonstrated risks of radiation related to thyroid cancer, breast, brain and skin, as well as leukemia. 

The thyroid gland is an important organ of the endocrine system, it is one of the largest glands in the human body, its location is located in the front region of the neck, just below the larynx. 

It is considered both in childhood and in adolescence, one of the most sensitive radio organs of the body (considerable amount of radiation) with respect to the dental level, since when performing . Its relative risk will be higher so it can cause a possible thyroid carcinoma.

In the development of oncogenesis it should be taken into account that open a series of genetic and environmental events that alter control of cell propagation and differentiation;It is specular elementary that the only etiological agent solidly related to its increase are ionizing radiation.

There are evidence that has demonstrated the expansion of CT irrigation in the face of radiation exhibition, mainly in child20-40 years on the exhibition, these tumors are usually multifocal, but with slow and favorable growth.

They are mainly observed in medullary carcinomas, they can be developed in isolation by 75% or associated with the remaining MEN2% syndrome, these are inherited automaticly authoritarianly, mainly with the germinal mutation in the RET Protooncogen20. It has also explained family thyroid cancer, which is a heterogeneous condition that incorporates so many tumors associated with isolated syndromes and tumors;The first set covers family adenomatous polyposis, Cowder syndrome and Carney Complex and the second group has been determined as the presence of three or more first -class relatives with a very characteristic thyroid cancer.

On oral radiography the influence of this as an effect of exposure of this radiation is low thanks to the proportion of limited dose. Different etiological factors are determined, the first in relation to X -rays, second associated with occupation and third at the time of exposure. 

If the risk of the patient to develop a carcinoma is measured, it is determined that the risk tends to increase when the dose and exposure time increase. 

On the other hand, it can be stated that thyroid cancer tends to affirm women mostly, raising a percentage comparison between men and women, in them increases from 1 to 6 % instead in men is 2 %.

In recent decades this type of cancer has increased comparing with previous years in all parts of the world.

Thyroid carcinoma has demonstrated the most rushed growth in the balance rate in balance with all other types of cancer during the last decades, from 8,74 / 100,000 between women and 3.38 / 100,000 among theMen in 1994 to 21.82 /100 000 between women and 7,37 / 100,000 among men in 2011 . It is currently the fifth most frequent cancer among women in the USA.UU. 

It has been proposed that the widening of the incidence of thyroid cancer in the USA.UU, it is predominantly due to the increase in the discovery of subclinical disease, instead of due to an increase in the existing appearance of thyroid cancer, since the immense of the cases have been small tumors and the mortality of the condition of the conditionOther researchers have been stable, however, they have offered various opinions. 

Due to this exposure risk potential, there are different principles of radiological protection where the primary objective is the decrease in the dose, also inform the patient about any procedure to be performed evaluating the risk-benefit that the radiographic exams has.

There must be preventive measures to perform the radiographic procedure:

• A good beam collimation.
• Use of digital equipment. 
• Use of adequate protections.
• The use of the appropriate parameters of the equipment and use of fast films. 

The use of protections for radiographs is of great importance since they are a barrier against the emitted radiation, thus avoiding the radiosensitive tissues of the body, to protect the thyroid glands to exposure to X -rays, areYou must place the thyroid collar, since it protects the gland when it is inside the beam radiation range. 

Epidemiologically thyroid cancer appears up to 1% of the different malignant neoplasms that the human being can present, and is in 90% representing endocrine malignant neoplasms, thus being the most frequent of all endocrine cancers, including the cutaneous. 

Thyroid nodules constitute the most frequent thyroid alteration, with an incidence that increases with age, carcinogenic nodules tend to occur asymptomatically, in addition to that they have a slow progression.

This type of cancer should be diagnosed with first instance with a complete neck evaluation, after this, a serum thyropine (TSH) and a neck ultrasound determination will be performed. 

There are different associated factors that could be used to determine the methods and treatments to be used in the future, among these we find: age, degree of differentiation, tumor size and extension of the same.

The initial symptomatology present in this type of cancer, should be built after making a previous interrogation to the patient, then different clinical symptoms such as:

• Increased volume of the front of the neck 
• Dyspnea, lack of air that appears due to the compression of the trachea due to the growth of the gland
• Pain, it manifests due to the compression of the structures surrounding the gland
• Dysphonia 
• Asymptomatic: Patient who at the time of the diagnosis of the nodule did not refer symptoms and/or signs of thyroid disease.

The associated radiographic characteristics when thyroid cancer are suffered can be specified as the following:

Carcinoma inside the thyroid almost appears as a lonely mass, radiolucent is observed, ultrasound-

It presents an irregular edge, located in the subcapsular region and showing its vascularity.These may be present in small pointed regions of ecogenicity that represent microcalcifications, which will be observed radio. 

Intramedular micro that, irregular or micro lobed margins, vascularization of intramedular and irregular predominance, solid and hypoecogenic appearance with respect to the parenchyma and rounded morphology, with anteroposterior axis greater than the transverse, that is, nodule "higher than wide".

METHODOLOGY

A search for Pubmed, Google Academic, Redalyc and Scielo was conducted, with keywords such as: radiography, cancer, carcinoma, prevalence. The documents will be only research articles, in total 26 articles, of which 20 have been selected with an age of 10 to 5 years, with Spanish and English languages.

DISCUSSION:

Worldwide, medical and dental X -rays constitute the most common type of medical diagnosis exposure

The study of medical exposure to radiation and thyroid cancer of SJ Schonfeld, raised the hypothesis on the increase in the incidence of thyroid cancer based on changes in environmental factors, including population exposure to the ionizing radiation of the ionizing radiation of theprecipitation, diagnostic and treatment tests for benign and malignant diseases. Exposure to ionizing radiation, especially during childhood, is one of the few risk factors established for thyroid cancer.

In the different studies it was determined that the female gender was the most affected. "The studies of structural alterations of the thyroid gland after the radiotherapy" of Verdecia charity in the study 43 patients, 19 (44.2 %) of which were female and 24 (55.8 %) of the male. The age groups from 1 to 4 and 5 to 9 years old had greater female representation, while groups from 10 to 14 and 15 to 19 years old had a greater male representation (12). The structural alterations of the thyroid gland are rare in childhood, especially the thyroid gland cancer, which has an incidence of 0.2 to 5 cases per million children born alive, says the study.

The study of "thyroid nodule: frequency of malignancy" of DR.Felipe Rafael Z. I determine that of the 630 patients, 425 corresponded to subjects with benign pathology (67.5%) and 205 to Maligna (32.5%);Most were women (592) and only 38 men.

SJ Schonfeld determined that in 2008, the estimated incidence rates throughout the world standardized by the age of thyroid cancer were 4.7 and 1.5 per 100,000 women and men respectively. 

CONCLUSION:

X -rays constitute electromagnetic radiation that are generated after the excitation of the electrons of the internal orbit of an atom, with the ability to cross opaque bodies.

Radiation is emitted energy that is transferred through space, which can be classified into non -ionizing and ionizing radiation. Non -ionizing radiations include ultraviolet rays (UV), infrared and microwave. In cells, the possibility that they can generate heat decomposition, but is still unknown if they can generate microscopic effects have been considered. The ionizing term refers to an interaction between radiation and matter. Ionizing radiation includes X -rays, gamma, alpha and beta. These types of radiation are able to create significant or not damage in human cells.

Dentists use X -rays to have a greater observation field in the patient, in order to determine better diagnoses.

Type X radiation can be considered significant or not, its effect will depend on the absorbed dose, time and type of tissue exposed to radiation. The patient’s risk to develop a carcinoma depends quite a lot on increases in the exposure dose.

This potential risk requires applying the principles of radiological protection where the main objective is to reduce the dose as much as possible and also keep the patient informed about any procedure to be performed evaluating the risks such as the benefits involved in the procedure for the patient.

The above also highlights the importance of training professionals and students in these areas, to create awareness of the subject and improve their registration, taking into account that in the professional practice of dentistry and medicine, iatrogenic acts can be presented in front of whichIt is necessary to react, taking the necessary solution measures and given the case, requesting institutions to adopt measures aimed at making their performance safer, which benefits both patients and those who make up the work team, highlighting that in addition, in additionThere is a legal basis for the development of these professions, which must always provide a service according to morality, avoiding the risk, uncertainty and other circumstances that can understand the good result of the patient’s treatment. 

From the results obtained and analyzed, we highlight the importance of the use of low radiation doses and the proper positioning of the equipment to perform the radiological incidents of the exams. 

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