How can we investigate the nodular thyroid diseases using thyroid scan?

Congress:

ECR 2019

Poster Number:

C-0012

Type:

Educational Exhibit

Keywords:

Head and neck, Nuclear medicine conventional, Diagnostic procedure, Education and training

Authors:

L. H. Aung; Moscow/RU

DOI:

10.26044/ecr2019/C-0012

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-0012

Table 1: Differential Diagnosis of thyroid nodules. According to types of nodules seen...

Fig. 2: Diagram of investigation of solitary thyroid nodule

Fig. 3: Hot thyroid nodule seen as hot foci showing scintigraphy signs of...

Fig. 4: Large multinodular thyroid gland which can be seen on thyroid scan showing...

Learning objectives

To describe the differential diagnosis in nodular thyroid diseases along with imaging features and to know the imaging findings that can help the clinicians to change the therapeutic approach.

Background

The thyroid gland is located within the visceral space of the infrahyoid neck.Thyroid is butterfly shaped gland that is located in anterior part of the neck.The thyroid has two side lobes, connected by isthmus in the middle and it is rich with blood supply.The thyroid secretes several hormones (T3, T4, TSH). Imaging Protocols 1. I-123 thyroid scan It is trapped by thyroid follicular cells and incorporated into thyroglobulin for thyroid hormone production.(organification).I-123 provides more comprehensive asessment of iodine metabolism by the thyroid. 2.Tc-99m pertechnetate thyroid...

Findings and procedure details

Before thyroid scan patient need to stop antithyroid medications, amiodarone, IV contrast agents, cough medicines, vitamins. For lactating patient use Tc-99m pertechnetate but need to pumped out breast milk for 24 hrs. After IV injection of 74 MBq Tc-99m pertechnetate, both lobes of thyroid glands are visualized within 5-30 mins. On thyroid scan thyroid nodules can have following uptakes: 1. Hyperfunctioning(hot) 2. Isofunctioning(warm) 3. Nonfunctioning(cold) Cold nodules can be seen as absence of activity and the other hand, hot nodules demonstrate focally increased activity in...

Conclusion

Thyroid scintigraphy is an important preliminary test in the evaluation of patients with thyroid diseases. More than 80% of soliatary nodules are hypofunctioning cold nodules and up to 20% of these are tumors. Ultrasound and fine needle aspiration of suspicious nodules have replaced thyroid scan to investigate thyroid nodules for malignancy potential.

Personal information

Dr. Lwin Htoo Aung Residency in training Russian Research Center of Radiology and Nuclear Medicine Russian National Research Medical University Email: [email protected]

References

1.Diagnostic Imaging of Nuclear Medicine second edition of Paige Bennett and Umesh D.Oza 2.Russain Research Center of Radiology and Nuclear Medicine