title: 99Tc(m)-MIBI scanning of the thyroid gland in patients with markedly decreased pertechnetate uptake.
abstract: Diffusely reduced 99Tc(m)-pertechnetate uptake is a relatively infrequent but annoying finding that impairs evaluation of the thyroid gland. We studied 32 female patients aged 19-85 years with markedly reduced pertechnetate uptake. The following causes of reduced pertechnetate uptake were recognized: treatment with iodinated pharmaceuticals (n = 15), suppression therapy with T4 (n = 11), subacute thyroiditis (n = 5) and massive tumour replacement (n = 1). 99Tc(m)-MIBI thyroid scintigraphy was performed within 24 h of the pertechnetate study. The results were correlated with neck ultrasound, serum TSH (n = 25) and surgical findings in patients who had been operated on. The technique identified the following conditions: normally sized thyroids (n = 4), diffuse goitres (n = 8), multinodular goitres (n = 17) and solitary thyroid nodules (n = 3). Moreover, substernal goitres were identified in nine patients. This condition was confirmed at surgery in seven patients. Ultrasonography was concordant in 29 of 32 patients in terms of thyroid size and structure, but failed to demonstrate substernal thyroid tissue. Our results suggest that 99Tc(m)-MIBI scintigraphy may contribute to the diagnosis of thyroid pathology and treatment planning in patients with diffusely decreased 99Tc(m)-pertechnetate uptake.
authors.affiliation: Nuclear Medicine Centre, Clinical Hospital of the University of Uruguay, Montevideo.
authors.forename: O
authors.initials: O
authors.lastname: Alonso
authors.forename: F
authors.initials: F
authors.lastname: Mut
authors.forename: G
authors.initials: G
authors.lastname: Lago
authors.forename: A
authors.initials: A
authors.lastname: Aznarez
authors.forename: M
authors.initials: M
authors.lastname: Núñez
authors.forename: J
authors.initials: J
authors.lastname: Cánepa
authors.forename: E
authors.initials: E
authors.lastname: Touya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006042:Goiter / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D013670:Sodium Pertechnetate Tc 99m / Q000493:pharmacokinetics*; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics; D013959:Thyroid Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013961:Thyroid Gland / Q000000981:diagnostic imaging*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000601:surgery; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000009:adverse effects; D014463:Ultrasonography
chemical_list: D019275:Radiopharmaceuticals; D013972:Thyrotropin; D017256:Technetium Tc 99m Sestamibi; D013670:Sodium Pertechnetate Tc 99m; D013974:Thyroxine