No abstract available.
Radionuclide Imaging* ; Sodium Pertechnetate Tc 99m* ; Thyroid Gland* ; Thyroid Neoplasms*

Enlargement of the thyroid gland is the most frequently encountered disorder of the endocrine system. A clinical evaluation is helpful in diagnosis but has its limitation. Until recently, surgical excision has been the only means by which a precise diagnosis of thyroid nodule is made, based upon the histopathologic evaluation. Authors studied 117 cases of thyroid nodule operated at Department of Surgery, College of Medicine, Hallym University, from January 1985 to July 1994. The results were analyzed with X2-test and summarized as follows. 1. The thyroid nodules were most frequently seen in third and fourth decades (57.3%), and more in female (5.9:1). 2. The most common symptoms and duration were palpable mass (97.4%) and within 3 months (41.1%). 3. Most cases of thyroid nodules were treated with lobectomy (41.0%). 4. On the radioisotope scanning, the incidence of malignant nodule with cold nodules was 17.9% and the incidence of benign nodule with hot nodule was 91.7%. 5. The overall postoperative and specific complications were only related to the histopathologic finding (P=0.0026, P=0.0207), and not related to the type of operation and size of the thyroid nodules.
Diagnosis ; Endocrine System ; Female ; Humans ; Incidence ; Radionuclide Imaging ; Thyroid Gland* ; Thyroid Nodule*

To evaluate the utility of I-131, T1-201 scintigraphy, and serum thyroglobulin(Tg) in the follow-up of differentiated thyroid cancer, we compared retrospectively the data from 33 patients who underwent total or subtotal thyroidectomy. I-131 scintigraphy was performed after optimal endogenous TSH stimulation (TSH>50microgram/ml). Total 41 cases of I-l3l and T1-201 scintigraphy pairs were examined. Concomitant serum thyroglobulin levels were measured for 41 pairs of scan. Tg-off levels(that measured after discontinuation of the thyroid hormone) higher than 40ng/ml were considered positive, and Tg-on levels(that measured during the thyroid hormone replacement) higher than 5ng/ml were considered positive. The concordance rates between I-131 therapeutic scintigraphy and T1-201 scintigraphy was 48% in the 38 case of total scan pairs(59% in the 17 cases of postoperative preablation group, and 38% in the 21 cases of postoperative postablation group), Of 17 studies before the I-131 ablation therapy (preablation group), 7 showed positive I-131 therapeutic scintigraphy despite of negative T1-201 scintigraphy. Among patients with negative I-131 therapeutic scintigraphy, no patients had abnormal T1-201 uptake. However, of 21 studies which were done after radioiodine therapy(postablation group) 6 had abnormal uptake on T1-201 scintigraphy which were not seen on I-131 therapeutic scintigraphy, and Tg-off levels also elevated in this 4 of 6 cases. As a result, I-131 therapeutic scintigraphy showed highest positive rate at postoperative preablation follow-up study in differentiated thyroid cancer patients. T1-201 scintigraphy may be useful in postablation studies, and the use of the combined modalities(T1-201 and Tg levels) provides a higher diagnostic yield.
Follow-Up Studies* ; Humans ; Radionuclide Imaging* ; Retrospective Studies ; Thyroglobulin* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

No abstract available.
Biopsy, Fine-Needle* ; Diagnosis, Differential* ; Radionuclide Imaging* ; Thyroid Gland* ; Thyroid Nodule* ; Ultrasonography*

PURPOSE: Parathyroid adenoma detection with dual-phase (99m)Tc-sestamibi (MIBI) scintigraphy depends on differential MIBI washout from thyroid. However, autoimmune thyroid disease (AITD) may cause MIBI to be retained in the thyroid gland and reduce parathyroid detection.We evaluated the impact of AITD on MIBI thyroid retention and additional benefit of SPECT/CT in these patients.METHODS: Dual phase planar MIBI and SPECT/CT was performed on 82 patients. SPECT/CTwas performed immediatelyafter delayed planar scan. Thyroid density (Hounsfield unit, CT-HU) and size were measured on CT component of SPECT/CT. MIBI uptake in early scans and retention in delayed scans were visually graded and correlated with clinical factors and CT findings. Finally, planar and SPECT/CT findings were compared for parathyroid lesion visualization according to thyroid MIBI retention.RESULTS: In early scan, multivariate analysis showed only thyroid size predicted early uptake. In delayed scan, multivariate analysis showed higher visual grade in early scan, lower CTHU or AITD were significant predictors for delayed thyroid parenchymal retention. Overall, ten more parathyroid lesions were visualized on SPECT/CT compared to planar scans (57 vs. 47, p = 0.002). SPECT/CT was especially more useful in patients with thyroidal MIBI retention, as eight out of the ten additional lesions detected were found in patients with thyroid MIBI retention.CONCLUSION: AITD is an important factor for MIBI thyroid parenchymal retention on delayed scans, and may impede parathyroid lesion detection. Patients with MIBI retention in the thyroid parenchyma on delayed scans are likely to benefit from an additional SPECT/CT.
Humans ; Multivariate Analysis ; Parathyroid Neoplasms ; Radionuclide Imaging ; Thyroid Diseases ; Thyroid Gland

Single-photon emission computed tomography with integrated computed tomography (SPECT/CT) systems has been applied in a wide range of clinical circumstances, and differentiated thyroid cancer (DTC) is one of the most important indications of SPECT/CT imaging. In the treatment of DTC, SPECT/CT images have been reported to have many advantages over conventional planar whole-body scintigraphy based on its precise localization and characterization of abnormal foci of radioactive iodine (RAI) accumulation, influencing the staging, risk stratification, and clinical management as well as reader confidence. On the other hand, SPECT/CT has limitations including additional radiation exposure from the CT component, additional imaging time, and cost-related issues. Each SPECT/CT image acquired at different time points throughout the management of DTC may have a different clinical meaning and significance. This review article addresses the clinical usefulness of RAI SPECT/CT images acquired during the pre-ablation period, post-therapy period, and long-term follow-up period, respectively.
Follow-Up Studies ; Hand ; Iodine ; Radiation Exposure ; Radionuclide Imaging ; Thyroid Gland ; Thyroid Neoplasms ; Tomography, Emission-Computed

Planar scintigraphy using Tc-99mpertechnetate is useful for snapshot evaluation of hot thyroid nodules, which are pathologically follicular adenoma and seldom, if ever, malignant. The autonomy of the hot nodules has been demonstrated by the presence of thyroid-stimulating hormone-dependent extra-nodular thyroid tissue besides the hot nodules. Here, we present two cases of hot thyroid nodules in patients who underwent quantitative single-photon emission computed tomography/computed tomography (SPECT/CT). In addition to the nodules, contralateral normal thyroid parenchyma was evaluated based on standardized uptake values. One patient had a traditional follicular adenoma suppressing other thyroid tissue, whereas the other patient seemed to have a nodule erupting from underlying hyperfunctioning, not suppressed, thyroid tissue. This novel approach using quantitative SPECT/CT unveils a new pathology of hot thyroid nodule that does not suppress, but coincides with hyperfunctioning thyroid tissue.
Adenoma ; Humans ; Pathology ; Radionuclide Imaging ; Sodium Pertechnetate Tc 99m ; Thyroid Gland ; Thyroid Nodule

urpose: Misonidazole is a radiosensitizer that binds in hypoxic cells. The purpose of this study was to find out the feasibility of I-131-Iodomisonidazole (IMISO) for imaging of tumor hypoxia. MATERIALS AND METHODS: Tosyl precursor was dissolved in acetonitrile and I-131-NaI was added to synthesize IMISO. Balb/c mice inoculated with CT-26 adenocarcinoma were injected with IMISO. Mice were sacrificed at 1,2,4,24 hr and % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy and MRI, mouse bearing CT-26 adenocarcinoma was administered with IMISO and imaging was performed 4 hr after. Then, mouse body was fixed and microtomized slice was placed on radiographic film for autoradiography. RESULTS: %ID/g of tumor was 1.64 (1h), 0.98 (2h), 0.85 (4h) and 0.20 (24h), respectively. At 24h, %ID/g of tumor was higher than that of all other tissues except thyroid. Tumor to muscle ratio increased with time and tumor to blood ratio also increased with time and reached 1.53 at 24 hr. On autoradiogram, tumor was well visualized as an increased activity in central hypoxic area of the tumor which corresponds to the area of high signal intensity on T2-weighted MR image. On scintigraphy, tumor uptake was visualized. CONCLUSION:: This RESULTS suggest that IMISO may have a potential for tumor hypoxia imaging in mouse model. However, further study is needed to improve it's localization in tumor tissue and to achieve acceptable images of tumor hypoxia.
Adenocarcinoma* ; Animals ; Anoxia* ; Autoradiography ; Magnetic Resonance Imaging ; Mice* ; Misonidazole ; Radionuclide Imaging ; Thyroid Gland ; X-Ray Film

To evaluate the potential contribution of high resolution ultrasonography(US) and 99mTc scintigraphy in the routine diagnosis of thyroid nodules, we performed thyroid function tests, US, thyroid scintigraphy, and fine-needle aspiration cytology (FNAC) in all 54 patients who initially visit our surgical department for thyroid masses from March 1995 to February 1996. The final diagnoses were made by either repeated FNAC (n=39) or thyroid operations (n=15). Final diagnoses were adenomatous goiters (n=41), simple cysts (n=3), follicular adenoma (n=1), papillary carcinomas (n=8), follicular carcinoma(n=1). The diagnostic impacts of US and 99mTc scintigraphy in all 54 patients were assessed and scored according to the following criteria: when the information provided by either test supported or confirmed (and/or gave some other information for management of thyroid nodules) the final diagnosis, it received a scores of 2 or 3 respectively, while a score 1 was given when the test itself was useless for the differential diagnosis. The scores of US were higher than those of scintigraphy in the diagnoses of adenomatous goiters, cysts, adenomas and carcinomas. However, after statistical analysis with Wilcoxon's signed rank test, US was statistically superior to scintigraphy only in diagnosing adenomatous goiters. These results indicate that current findings in US for differential diagnosis of thyroid nodules are not absolutely superior to those in scintigraphy, but have some benefits in detection of occult nodules in malignancy and differential diagnosis of adenomatous goiters.
Adenoma ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Diagnosis, Differential ; Goiter ; Humans ; Radionuclide Imaging* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Nodule*

Autoantibodies ; blood ; immunology ; Child ; Diagnosis, Differential ; Humans ; Radiography ; Radionuclide Imaging ; Thyroid Diseases ; blood ; diagnosis ; diagnostic imaging ; Thyroid Function Tests ; methods ; Thyroid Gland ; diagnostic imaging ; immunology ; Thyroid Hormones ; blood