Thyroid Imaging With Tc-99m MIBI in Patients With Solitary Cold Single Nodules on Pertechnetate Imaging

• Published in: Clinical nuclear medicine 1996-05, Vol.21 (5), p.363-367
• Main Authors: ALONSO, OMAR, LAGO, GRACIELA, MUT, FERNANDO, HERMIDA, JUAN C, NUNEZ, MARGARITA, DE PALMA, GUSTAVO, TOUYA, EDUARDO
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Follicular - diagnostic imaging; Adenocarcinoma, Follicular - metabolism; Adenocarcinoma, Follicular - pathology; Adolescent; Adult; Biological and medical sciences; Biopsy, Needle; Carcinoma, Papillary - diagnostic imaging; Carcinoma, Papillary - metabolism; Carcinoma, Papillary - pathology; Cysts - diagnostic imaging; Cysts - metabolism; Cysts - pathology; Endocrine glands. Genital system. Mammary gland; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Preoperative Care; Probability; Radionuclide Imaging; Radionuclide investigations; Sodium Pertechnetate Tc 99m - pharmacokinetics; Technetium Tc 99m Sestamibi - pharmacokinetics; Thyroid Gland - diagnostic imaging; Thyroid Gland - metabolism; Thyroid Gland - pathology; Thyroid Neoplasms - diagnostic imaging; Thyroid Neoplasms - metabolism; Thyroid Neoplasms - pathology; Thyroid Nodule - diagnostic imaging; Thyroid Nodule - metabolism; Thyroid Nodule - pathology
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/00003072-199605000-00002

Thyroid imaging was performed in 30 patients with the standard pertechnetate technique, as well as with Tc-99m MIBI using a double-phase acquisition protocol. All patients had normal thyroid function confirmed by hormone measurements and cold solitary thyroid nodules, which were evaluated by pertechnetate scanning. Tc-99m MIBI scans were reported as showing cold (N = 14), warm (N = 7), or hot (N = 9) nodules. Nodule classification was made according to fine needle aspiration biopsy findings in 20 patients. The remaining 10 proceeded to surgery and had histopathologic confirmation of their lesions. Although all cold nodules with Tc-99m MIBI were cystic, six of the warm nodules were benign lesions. No histologically proven benign nodule was hot with Tc-99m MIBI. Of the hot nodules, seven were suspicious for follicular carcinoma with fine needle aspiration biopsy (N = 3), or had histologically proven papillary carcinoma (N = 4). Delayed images in five of seven of these lesions showed nodular retention of the radiopharmaceutical. In conclusion, double-phase Tc-99m MIBI scanning of the thyroid gland could be helpful in the preoperative assessment of patients with cold solitary thyroid nodules in order to evaluate the malignancy probability of these lesions.