Evaluation of Quantitative Thyroid Scintigraphy for Diagnosis of Hyperthyroidism.
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| Title: | Evaluation of Quantitative Thyroid Scintigraphy for Diagnosis of Hyperthyroidism. |
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| Authors: | Cinar A; Department of Nuclear Medicine, Etlik City Hospital, Ankara, Turkey., Cayir D; Department of Nuclear Medicine, Etlik City Hospital, Ankara, Turkey.; Department of Nuclear Medicine, University of Health Sciences, Ankara, Turkey. |
| Source: | Nigerian journal of clinical practice [Niger J Clin Pract] 2025 Aug 01; Vol. 28 (8), pp. 962-968. Date of Electronic Publication: 2025 Aug 30. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Medknow Publications Country of Publication: India NLM ID: 101150032 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1119-3077 (Print) NLM ISO Abbreviation: Niger J Clin Pract Subsets: MEDLINE |
| Imprint Name(s): | Publication: Mumbai : Medknow Publications Original Publication: [Lagos?] : Medical and Dental Consultants' Association of Nigeria |
| MeSH Terms: | Hyperthyroidism*/diagnostic imaging , Radionuclide Imaging*/methods , Thyroid Gland*/diagnostic imaging , Thyroid Gland*/pathology, Humans ; Female ; Male ; Adult ; Middle Aged ; Adolescent ; Sodium Pertechnetate Tc 99m ; Aged ; Young Adult ; Ultrasonography ; Radiopharmaceuticals ; Thyrotropin/blood |
| Abstract: | Background: This study compared the dimensions of the thyroid gland measured by the scintigraphic method with those measured by the ultrasonographic method. Additionally, the correlation between the technetium uptake level of the thyroid gland and the thyroid-stimulating hormone (TSH) values of the patient was investigated. Aim: The aim of this study was to measure the uptake values and scintigraphic dimensions of the thyroid gland by using Technetium 99m pertechnetate and to investigate the relationship between these values in euthyroid and hyperthyroid states. Methods: The data of patients referred to the Nuclear Medicine Clinic at the Health Sciences University Gulhane Training and Research Hospital for thyroid scintigraphy (TS) between January 2019 and December 2021 were examined. In total, 100 patients (67 female and 33 male) aged 18-77 (mean ± SD: 42.3 ± 15.6) years were examined. According to the thyroid scintigraphic appearances, the patients were classified into five groups: normal thyroid gland, hypoactive nodular thyroid gland, hyperactive nodular thyroid gland, diffuse hyperplastic thyroid gland, and mixed nodular thyroid gland. The region of interest (ROI) covering both thyroid lobes was drawn. The ROI covering both submandibular glands and background activity was also drawn, and count measurements from these two areas were compared. Results: Following the thyroid scintigraphic evaluation of patients in the five groups, the following results were obtained: 13/100 (13%) were within normal ranges, 7/100 (7%) were hypoactive nodular, 31/100 (31%) were hyperactive nodular, 20/100 (20%) were diffuse hyperplasia, and 29/100 (29%) were mixed nodular. The thyroid/background activity ratio of cases reported as having a normoactive thyroid gland, with TSH values within normal limits, was calculated to be between 2.08 and 2.2 based on the scintigraphic images included in the study. Conclusions: Tc-99m pertechnetate TS is a reliable method that can be used for various nuclear medicine applications, such as evaluating thyroid gland morphology and calculating its size. (Copyright © 2025 Nigerian Journal of Clinical Practice.) |
| References: | Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al.American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167–214. Hurtado-López LM, Monroy-Lozano BE, Martínez-Duncker C. TSH alone is not sufficient to exclude all patients with a functioning thyroid nodule from undergoing testing to exclude thyroid cancer. Eur J Nucl Med Mol Imaging 2008;35:1173–8. Rieu M, Bekka S, Sambor B, Berrod JL, Fombeur JP. Prevalence of subclinical hyperthyroidism and relationship between thyroid hormonal status and thyroid ultrasonographic parameters in patients with non-toxic nodular goitre. Clin Endocrinol (Oxf) 1993;39:67–71. Fiore E, Rago T, Provenzale MA, Scutari M, Ugolini C, Basolo F, et al. Lower levels of TSH are associated with a lower risk of papillary thyroid cancer in patients with thyroid nodular disease: Thyroid autonomy may play a protective role. Endocr Relat Cancer 2009;16:1251–60. Schneider PB. Simple, rapid thyroid function testing with 99mTc-pertechnetate thyroid uptake ratio and neck/thigh ratio. AJR Am J Roentgenol 1979;132:249–53. Selby JB, Buse MG, Gooneratne NS, Moore DO. The anger camera and the pertechnetate ion in the routine evaluation of thyroid uptake and imaging. Clin Nucl Med 1979;4:233–7. Schicha H, Bude L. TcU-Abhängigkeit von Akquisitionszeitpunkt, ROI und Untergrundsubtraktion [The dependence of Tc uptake on time of acquisition, ROI and background subtraction]. Nuklearmedizin 1990;29:166–9. German. Duck SC, Sty J. Technetium thyroid uptake ratios in pediatric Graves disease. J Pediatr 1985;107:905–9. Sucupira MS, Camargo EE, Nickoloff EL, Alderson PO, Wagner HN Jr. The role of 99mTc pertechnetate uptake in the evaluation of thyroid function. Int J Nucl Med Biol 1983;10:29–33. Chami R, Moreno-Reyes R, Corvilain B. TSH measurement is not an appropriate screening test for autonomous functioning thyroid nodules: A retrospective study of 368 patients. Eur J Endocrinol 2014;170:593–9. Walsh JP. Managing thyroid disease in general practice. Med J Aust 2016;205:179–84. Ianni F, Perotti G, Prete A, Paragliola RM, Ricciato MP, Carrozza C, et al. Thyroid scintigraphy: An old tool is still the gold standard for an effective diagnosis of autonomously functioning thyroid nodules. J Endocrinol Invest 2013;36:233–6. Paschke R, Hegedüs L, Alexander E, Valcavi R, Papini E, Gharib H. Thyroid nodule guidelines: Agreement, disagreement and need for future research. Nat Rev Endocrinol 2011;7:354–61. Görges R, Kandror T, Kuschnerus S, Zimny M, Pink R, Palmedo H, et al. Szintigraphisch mehranreichernde Schilddrüsenknoten gehen überwiegend mit normwertigem TSH einher [Scintigraphically “hot” thyroid nodules mainly go hand in hand with a normal TSH]. Nuklearmedizin 2011;50:179–88. German. Meller J, Becker W. Scintigraphic evaluation of functional thyroidal autonomy. Exp Clin Endocrinol Diabetes 1998;106 Suppl 4:S45–51. Song X, Luo Z, Sun H, Hao L. Systematic review and meta-analysis of the diagnostic value of radionuclide imaging for thyroid nodules. Gland Surg 2021;10:3351–61. Sollmann L, Eveslage M, Danzer MF, Schäfers M, Heitplatz B, Conrad E, et al. Additional value of pertechnetate scintigraphy to american college of radiology thyroid ımaging reporting and data systems and European Thyroid Imaging Reporting and Data Systems for Thyroid Nodule Classification in Euthyroid Patients. Cancers (Basel) 2024;16:4184. Wesche MF, Tiel-van Buul MM, Smits NJ, Wiersinga WM. Ultrasonographic versus scintigraphic measurement of thyroid volume in patients referred for 131I therapy. Nucl Med Commun 1998;19:341–6. Javadi H, Pashazadeh AM, Mogharrabi M, Nabipour I, Kalantarhormozi M, Assadi M. Comparison of thyroid blood flow and uptake indices using technetium-99m pertechnetate in patients with graves’ disease and euthyroid subjects. Mol Imaging Radionucl Ther 2014;23:96–100. Li H, Yuan X, Liu L, Zhou J, Li C, Yang P, et al. Clinical evaluation of various thyroid hormones on thyroid function. Int J Endocrinol 2014;2014:618572. Trzepacz PT, Klein I, Roberts M, Greenhouse J, Levey GS. Graves’ disease: An analysis of thyroid hormone levels and hyperthyroid signs and symptoms. Am J Med 1989;87:558–61. Pearce EN, Hennessey JV, McDermott MT. New American Thyroid Association and American Association of Clinical Endocrinologists guidelines for thyrotoxicosis and other forms of hyperthyroidism: Significant progress for the clinician and a guide to future research. Thyroid 2011;21:573–6. |
| Contributed Indexing: | Keywords: TSH; Tc-99m pertechnetate; thyroid scintigraphy; uptake |
| Substance Nomenclature: | A0730CX801 (Sodium Pertechnetate Tc 99m) 0 (Radiopharmaceuticals) 9002-71-5 (Thyrotropin) |
| Entry Date(s): | Date Created: 20250830 Date Completed: 20250830 Latest Revision: 20250902 |
| Update Code: | 20250903 |
| DOI: | 10.4103/njcp.njcp_39_25 |
| PMID: | 40884326 |
| Database: | MEDLINE |
| Abstract: | Background: This study compared the dimensions of the thyroid gland measured by the scintigraphic method with those measured by the ultrasonographic method. Additionally, the correlation between the technetium uptake level of the thyroid gland and the thyroid-stimulating hormone (TSH) values of the patient was investigated.<br />Aim: The aim of this study was to measure the uptake values and scintigraphic dimensions of the thyroid gland by using Technetium 99m pertechnetate and to investigate the relationship between these values in euthyroid and hyperthyroid states.<br />Methods: The data of patients referred to the Nuclear Medicine Clinic at the Health Sciences University Gulhane Training and Research Hospital for thyroid scintigraphy (TS) between January 2019 and December 2021 were examined. In total, 100 patients (67 female and 33 male) aged 18-77 (mean ± SD: 42.3 ± 15.6) years were examined. According to the thyroid scintigraphic appearances, the patients were classified into five groups: normal thyroid gland, hypoactive nodular thyroid gland, hyperactive nodular thyroid gland, diffuse hyperplastic thyroid gland, and mixed nodular thyroid gland. The region of interest (ROI) covering both thyroid lobes was drawn. The ROI covering both submandibular glands and background activity was also drawn, and count measurements from these two areas were compared.<br />Results: Following the thyroid scintigraphic evaluation of patients in the five groups, the following results were obtained: 13/100 (13%) were within normal ranges, 7/100 (7%) were hypoactive nodular, 31/100 (31%) were hyperactive nodular, 20/100 (20%) were diffuse hyperplasia, and 29/100 (29%) were mixed nodular. The thyroid/background activity ratio of cases reported as having a normoactive thyroid gland, with TSH values within normal limits, was calculated to be between 2.08 and 2.2 based on the scintigraphic images included in the study.<br />Conclusions: Tc-99m pertechnetate TS is a reliable method that can be used for various nuclear medicine applications, such as evaluating thyroid gland morphology and calculating its size.<br /> (Copyright © 2025 Nigerian Journal of Clinical Practice.) |
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| ISSN: | 1119-3077 |
| DOI: | 10.4103/njcp.njcp_39_25 |
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