scholarly journals Evaluation of the effectiveness of the double indicator method of scintigraphy in the differential diagnosis of thyroid nodules

2012 ◽  
Vol 93 (3) ◽  
pp. 447-450
Author(s):  
L A Timofeeva
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Indicator Method ◽  
Negative Results ◽  
99Mtc Pertechnetate ◽  
Double Phase ◽  
Sonographic Patterns ◽  
Histological Data ◽  
99Mtc Mibi

Aim. To evaluate the effectiveness of double indicator scintigraphy in the differential diagnosis of thyroid nodules. Methods. Analyzed was the data of radionuclide investigations of 25 patients with thyroid disease at the age of 36 to 72 years, who were operated on in 2009-2011. The radioisotope study was conducted in two stages. Evaluation of the scintigraphic uptake pattern of the radiopharmaceutical in the studied areas was performed visually and quantitatively. Results. The scintigraphic results were compared with cytological and histological studies. In the diagnosis of papillary thyroid cancer the sensitivity of the radioisotope investigation was 95%, specificity - 92%, diagnostic accuracy - 94%. The method was less precise and specific in the diagnosis of follicular cancer and macro-micro follicular adenomas (it gave positive results in the cases of adenoma and negative results in cases of follicular thyroid cancer). On average, the specificity of the double-phase radioisotope scintigraphy method using 99mTc-pertechnetate and technetril (99mTc-MIBI) in our study was 69%, accuracy - 75%, sensitivity - 79%. Conclusion. Radionuclide double-phase scintigraphy with the usage of 99mTc-pertechnetate and technetril (99mTc-MIBI) - is a highly informative method for the differential diagnosis of thyroid nodules, which can be used during atypical sonographic patterns and in the absence of clear histological data.

scholarly journals RADIOISOTOPE DIAGNOSTIC ALGORITHM FOR THE RELAPSE AND METASTASES DETECTION IN THE IODINE-NEGATIVE DIFFERENTIATED THYROID CANCER

2020 ◽  
Vol 25 ◽  
pp. 579-591
Author(s):  
O. Solodyannikova ◽  
◽  
Y. Kmetyuk ◽  
V. Danilenko ◽  
G. Sukach ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Ct Scan ◽  
Surgical Management ◽  
Differentiated Thyroid Cancer ◽  
Whole Body ◽  
Technetium 99M ◽  
99Mtc Pertechnetate ◽  
18Fdg Pet ◽  
Pet Ct ◽  
99Mtc Mibi

Objective. Developing of algorithm for the post-surgical management of patients with iodine-negative metastases of differentiated thyroid cancer (DTC). Materials and methods. The DTC patients with iodine-negative metastases (n = 115) were enrolled in the study. Of them the whole body scintigraphy (WBS) was performed with technetium-99m-hexakis-2-methoxyisobutylisonitrile (99mTc-MIBI) (n = 30), WBS with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) (n = 30), 18FDG PET (n = 30), and computer tomography (CT-scan) (n = 25). Complex 99mTc-pertechnetate scans including the dynamic and static scintigraphy was performed supplementary to 99mTc-MIBI WBS in 10 patients to obtain the angiographic curves from DTC metastatic foci. The non-radioiodine radiopharmaceutical technologies, namely the labeled 99mTc-MIBI, 99mTc-DMSA, 99mTc-pertechnetate, and 18FDG were applied to detect the iodine-negative DTC metastases. Radioisotopic examinations were performed at the dual-head gamma camera (Mediso Medical Imaging Systems Ltd., Hungary) and single photonemission computed tomography (SPECT) scanner «E.CAM» (Siemens, Germany). PET/CT scans were performed on the «Biograph 64 TruePoint» imaging platform (Siemens, Germany) in accordance with the European Association of Nuclear Medicine (EANM) recommendations for the Siemens imaging devices with 3D-mode data acquisition. Results. The conducted research suggested that it is feasible to use the non-radioiodine (99mTc-MIBI and 99mTc-DMSA) radiopharmaceutical technologies to detect the iodine-negative DTC metastases. 18FDG PET is a highly informative technology for the detection of iodine-negative DTC metastases in case of lung involvement in the process. Compare of the non-radioiodine radiopharmaceuticals, CT scan and 18FDG-PET/CT indicated the highest sensitivity of 18FDG PET/CT (p < 0.05). WBS with 99mTc-MIBI and 99mTc-DMSA featured the highest specificity (100 %, p < 0.05). X-ray CT is marked by the significantly lower either sensitivity, specificity, and accuracy rate (p > 0.05). Developing and application of algorithm for the post-surgical management of patients with iodine-negative forms of DTC will allow for the betimes detection of relapses and metastases with administration of adequate surgical, radiation, and targeted treatment. Conclusions. Obtained results offer the opportunity to optimize the post-surgical management of patients with iodine-negative DTC forms using the options of radionuclide diagnostics with non-radioiodine radiopharmaceuticals. The latter are readily available providing the cost-cutting of diagnostic support in these patients. Place of morphological methods of diagnosis is determined and stage of monitoring of patients with the iodine-negative metastases is established. Possibility of the 18FDG-PET tests for the early diagnosis of iodine-negative metastases in DTC for the first time have been studied and substantiated in Ukraine. A comprehensive radiation algorithm for the long-term monitoring of this category of patients will allow the timely detection of recurrences and metastases of DTC and appropriate surgery, radiation and targeted therapy administration. Data obtained as a result of the study allowed to improve the overall and recurrence-free survival rates in the able-bodied DTC patients and reduce the costs of follow-up of patients with iodine-negative forms of DTC. Key words: differentiated thyroid cancer, radioiodine-negative metastases, non-radioiodine radiopharmaceuticals, 18FDG-PET/CT.

Preoperative localization of parathyroid lesions

2008 ◽  
Vol 47 (04) ◽  
pp. 158-162 ◽  
Author(s):  
E. Mirallié ◽  
T. Carlier ◽  
H. Abbey-Huguenin ◽  
F. Aubron ◽  
F. Kraeber-Bodéré ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Accurate Method ◽  
Sex Characteristics ◽  
Double Phase ◽  
Imaging Results ◽  
Parathyroid Lesions ◽  
99Mtc Mibi ◽  
The Impact ◽  
Pth Level ◽  
Mibi Spect

SummaryThe aim of our study was to assess retrospectively the value of 99mTc-MIBI SPECT in the localization of parathyroid lesions in primary hyperparathyroidism and to determine the impact of PTH level, age, sex, characteristics of the lesions and thyroid nodules on the sensitivity of imaging. Patients, methods: Fifty nine patients who were cured after the resection of 60 lesions (50 adenomas, 9 hyperplasias and 1 carcinoma, 9 of them in ectopy) were selected. 99mTcO4-, early and late 99mTc-MIBI planar images (n = 59), 99mTc-MIBI SPECT (n = 58) and ultrasound (n = 50) performed preoperatively were analyzed. The imaging results were compared to surgical and histological findings and correlated to different factors suspected of influencing the imaging's sensitivity. Results: Sensitivity of double phase 99mTc-MIBI/99mTcO4- scintigraphy was higher than that of early or late scintigraphy alone. SPECT increased the sensitivity of scintigraphy from 85% to 92% and was useful to confirm doubtful foci and to localize ectopic lesions. Ultrasound (US) had the lowest sensitivity (56%) and the highest rate of false-positive results (n = 10), but identified 2 adenomas which were not detected by scintigraphy. Combining all imaging modalities, sensitivity reached 96%. Better sensitivities were observed when age < 69 years, preoperative PTH level ≥155 pg/ml, weight of the gland ≥0.80 g and in the absence of thyroid nodules. US was more influenced by these factors than scintigraphy. Conclusion: Combination of US, double-phase 99mTc- MIBI/99mTcO4- planar scintigraphy and SPECT is the most accurate method for the detection of parathyroid lesions and should be performed before minimally invasive surgery, especially when PTH level is low, in older patients and in cases of multinodular goiter.

Thyroiditis, Goiter, Thyroid Nodules, and Thyroid Cancer

2020 ◽  
Author(s):  
Paul W. Ladenson
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Cancer ◽  
Celiac Disease ◽  
Thyroid Nodules ◽  
Graves Disease ◽  
Thyroid Disorders ◽  
Munchausen Syndrome ◽  
Life Threatening ◽  
Almost All ◽  
Key Words Hypothyroidism

Thyroid disorders are the most common endocrine conditions encountered in clinical practice. Persons of either sex and any age can be affected, although almost all forms of thyroid disease are more frequent in women than in men, and many thyroid ailments increase in incidence with age. The presentation of thyroid conditions can range from clinically obvious to clinically silent. Their consequences can be widespread and serious, even life-threatening. With proper testing, the diagnosis and differential diagnosis can be established with certainty, and effective treatments can be instituted for almost all patients. This review contains 1 figure, 7 tables, and 31 references. Key Words: Hypothyroidism, Thyrotoxicosis, Thyrotropin, celiac disease, vitiligo, pernicious anemia, Sjögren syndrome, Graves disease, Munchausen syndrome

Thyroiditis, Goiter, Thyroid Nodules, and Thyroid Cancer

2020 ◽  
Author(s):  
Paul W. Ladenson
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Cancer ◽  
Celiac Disease ◽  
Thyroid Nodules ◽  
Graves Disease ◽  
Thyroid Disorders ◽  
Munchausen Syndrome ◽  
Life Threatening ◽  
Almost All ◽  
Key Words Hypothyroidism

Thyroid disorders are the most common endocrine conditions encountered in clinical practice. Persons of either sex and any age can be affected, although almost all forms of thyroid disease are more frequent in women than in men, and many thyroid ailments increase in incidence with age. The presentation of thyroid conditions can range from clinically obvious to clinically silent. Their consequences can be widespread and serious, even life-threatening. With proper testing, the diagnosis and differential diagnosis can be established with certainty, and effective treatments can be instituted for almost all patients. This review contains 1 figure, 7 tables, and 31 references. Key Words: Hypothyroidism, Thyrotoxicosis, Thyrotropin, celiac disease, vitiligo, pernicious anemia, Sjögren syndrome, Graves disease, Munchausen syndrome

The Accuracy of ACR TI-RADS Classification of Neck Ultrasound as a First-Line Diagnostic Approach for Thyroid Neoplasms in Pediatric Patients: A Retrospective Study

2018 ◽  
Vol 5 (1) ◽  
pp. 13-23
Author(s):  
Nikolai S. Grachev ◽  
Elena V. Feoktistova ◽  
Igor N. Vorozhtsov ◽  
Natalia V. Babaskina ◽  
Ekaterina Yu. Iaremenko ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Pediatric Patients ◽  
Thyroid Neoplasms ◽  
Diagnostic Methods ◽  
Diagnostic Approach ◽  
First Line ◽  
Neck Ultrasound

Background.Ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) is the gold standard in diagnosing the pathological nature of undetermined thyroid nodules. However, in some instances limitations and shortcomings arise, making it insufficient for determining a specific diagnosis.Objective.Our aim was to evaluate the effectiveness of ACR TI-RADS classification of neck ultrasound as a first-line diagnostic approach for thyroid neoplasms in pediatric patients.Methods.A retrospective analysis was made of FNA and US protocols in 70 patients who underwent the examination and treatment at Dmitry Rogachev National Research Center between January 2012 and August 2017. In the retrospective series 70% (49/70) of patients undergone FNA and 43% (30/70) of them undergone repeated FNA. All US protocols were interpreted according to ACR TI-RADS system by the two independent experts. The clinical judgment was assessed using the concordance test and the reliability of preoperative diagnostic methods was analized.Results.According to histologic examination protocols, benign nodules reported greater multimorbidity 29% (20/70), compared with thyroid cancer 17% (12/70), complicating FNA procedure. A statistically significant predictor of thyroid cancer with a tumor size ACR TI-RADS showed a significant advantage of ACR TI-RADS due to higher sensitivity (97.6 vs 60%), specificity (78.6 vs 53.8%), positive predictive value (87.2 vs 71.4%), and negative predictive value (95.7 vs 41.2%). Concordance on the interpreted US protocols according to ACR TI-RADS classification between two experts was high, excluding accidental coincidence.Conclusion.The data support the feasibility of US corresponding to the ACR TI-RADS classification as a first-line diagnostic approach for thyroid neoplasm reducing the number of unnecessary biopsies for thyroid nodules.

On the Classification of TI-RADS and Stratification of Signs of Thyroid Cancer According to Ultrasound Data

2017 ◽  
pp. 29-38 ◽  
Author(s):  
E. P. Fisenko ◽  
J. P. Sich ◽  
N. N. Vetsheva
Keyword(s):  
Thyroid Cancer ◽  
Retrospective Analysis ◽  
Thyroid Nodules ◽  
Thyroid Ultrasound ◽  
High Reproducibility ◽  
System 1

Objective:a comparative “blind” assessment of the thyroid nodules identified by ultrasound, according to the TI-RADS scale in various modifications.Materials and methods.Retrospective analysis of 149 echograms  of thyroid nodules by three independent experts was performed (the  experience of ultrasound of thyroid ultrasound for more than 7 years).Results. In solid nodules, high-specific large (more than 94%) and  small (more than 90%) ultrasound signs of thyroid cancer have been identified. The nodes are stratified according to the TI-RADS system: 1 – in the modification J.Y. Kwak et al. (2011), 2 – according to the  proposed system, taking into account small ultrasound signs of  thyroid cancer. High reproducibility of both systems are obtained. In the first system 13.7% of cancer nodes fell into the category of TI- RADS 3 (benign formations), in the second system only 5% of  cancers fell into the category of TI-RADS 3, which is important for  biopsy selection. The sensitivity of the first system was TI-RADS  82.05%, of the second system – 94.87%.Conclusions.Classification of TI-RADS can be used to interpret the  ultrasound results of thyroid nodules, taking into account both the  main large and small ultrasound signs of cancer. For its validation in  our country, it is necessary to further broad discussion of the proposed TI-RADS system.

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