Quantitative dual isotope 123iodine/99mTc-MIBI scintigraphy: A new approach to rule out malignancy in thyroid nodules

2021 ◽  
Author(s):  
Hamza Benderradji ◽  
Amandine Beron ◽  
Jean-Louis Wémeau ◽  
Bruno Carnaille ◽  
Laurent Delcroix ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
New Approach ◽  
Dual Isotope ◽  
99Mtc Mibi ◽  
Mibi Scintigraphy ◽  
Rule Out

Percutaneous microwave ablation of benign thyroid nodules

2015 ◽  
Vol 54 (01) ◽  
pp. 13-19 ◽  
Author(s):  
F. Nimsdorf ◽  
C. Happel ◽  
H. Ackermann ◽  
F. Grünwald ◽  
H. Korkusuz
Keyword(s):  
Microwave Ablation ◽  
Thyroid Nodules ◽  
Volume Reduction ◽  
Clinical Issue ◽  
New Approach ◽  
99Mtc Mibi ◽  
The Impact ◽  
Percutaneous Microwave Ablation ◽  
Benign Thyroid Nodules ◽  
Benign Thyroid

SummaryAim: Thyroid nodules represent a common clinical issue. Amongst other minimally invasive procedures, percutaneous microwave ablation (MWA) poses a promising new approach. The goal of this retrospective study is to find out if there is a correlation between volume reduction after 3 months and 99mTcuptake reduction of treated thyroid nodules. Patients, methods: 14 patients with 18 nodules were treated with MWA. Pre-ablative assessment included sonographical and functional imaging of the thyroid with 99mTcpertechnetate and 99mTc-MIBI. Additionally, patients underwent thyroid scintigraphy 24 hours after ablation in order to evaluate the impact of the treatment on a functional level and to ensure sufficient ablation of the targeted area. At a 3-month follow-up, ultrasound examination was performed to assess nodular volume reduction. Results: Mean relative nodular volume reduction after three months was 55.4 ± 17.9% (p < 0.05). 99mTcuptake 24 hours after treatment was 45.2 ± 31.9% (99mTc-MIBI) and 35.7 ± 20.3% (99mTcpertechnetate) lower than prior to ablation (p < 0.05). Correlating reduction of volume and 99mTc-uptake, Pearson's r was 0.41 (p < 0.05) for nodules imaged with 99mTc-MIBI and –0.98 (p < 0.05) for 99mTc-pertechnetate. According to scintigraphy 99.6 ± 22.6% of the determined target area could be successfully ablated. Conclusions: MWA can be considered as an efficient, low-risk and convenient new approach to the treatment of benign thyroid nodules. Furthermore, scintigraphy seems to serve as a potential prognostic tool for the later morphological outcome, allowing rapid evaluation of the targeted area in post-ablative examination.

MIBI scintigraphy in hypofunctioning thyroid nodules

2009 ◽  
Vol 48 (04) ◽  
pp. 144-152 ◽  
Author(s):  
M. Schmidt ◽  
T. Ivanova ◽  
M. Dietlein ◽  
H. Schicha ◽  
P. Theissen
Keyword(s):  
Iodine Deficiency ◽  
Predictive Value ◽  
Selection Criteria ◽  
Thyroid Nodules ◽  
Risk Estimation ◽  
Thyroid Volume ◽  
Needle Aspiration ◽  
99Mtc Mibi ◽  
Thyroid Malignancies ◽  
Mibi Scintigraphy

Summary Aim: Several authors have investigated the value of technetium-MIBI scanning to predict the dignity of hypofunctioning, cold thyroid nodules (HTN) in regions with differing levels of iodine supply. They concluded that an MIBI scan can exclude thyroid malignancy, although comparisons between the studies are of limited value owing to differences in methodology and wide variations in patient selection criteria. The present study investigates whether the above claim is also valid in Germany, a country with a long-standing and persistent, mild iodine deficiency and a high incidence of nodules in large goiters with a low prevalence of malignancy. Patients, methods: The study compares the results of 99mTc-MIBI scintigraphy (incl. SPECT and planar images) in HTN (MIBI) with those of fine-needle aspiration biopsy (FNAB) and histology. Of 154 consecutive patients (121 women, 33 men; mean age 56 ± 12 years), 73 underwent thyroid surgery from which the results of FNAB and MIBI were assessed. Selection criteria were risk estimation or conditions limiting the feasibility of FNAB. The mean thyroid volume was 42 ± 25 ml, with 2.1 ± 1.4 nodules per patient. Results: Histology revealed thyroid malignancies in 8 out of 73 patients (11.0%). The negative predictive value for MIBI was 97%, which is comparable to FNAB (94%). However, in 19.5% of patients FNAB was indeterminate. Lower specificity (54%) and low positive predictive value (19%) showed that MIBI accumulation cannot differentiate between malignant and benign thyroid nodules. However, comparison with cytological and/or histological findings indicated that it could distinguish between lesions with differing rates of mitochondrial metabolism. Conclusion: Even in areas of former or mild iodine deficiency MIBI forms a basis for choosing between wait-and-see and surgical strategies if FNAB is unfeasible or not representative. However, even for pathological MIBI results, the prevalence of malignancy is not very high.

scholarly journals Evaluation of hypofunctioning thyroid nodules with technetium-99m MIBI and ultrasonography

2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Abubakar Farate ◽  
Aadil A. Gutta ◽  
Karien De Graaf ◽  
Trevor Mdaka
Keyword(s):  
Predictive Value ◽  
Thyroid Nodules ◽  
Follicular Adenoma ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Regional Environment ◽  
Technetium 99M ◽  
Significant Difference ◽  
99Mtc Mibi ◽  
Mibi Scintigraphy

Background: Fine needle aspiration cytology (FNAC) cannot reliably differentiate follicular adenoma from follicular carcinoma (FC), which requires histological evidence of capsular or vascular invasion. FC is the most predominant thyroid cancer in our loco-regional environment, indicating the need for improvement in preoperative diagnostic accuracy of thyroid nodules to ensure appropriate and timely interventions.Objective: The purpose of this study was to assess the role of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) scintigraphy and ultrasonography (USG) in the differential diagnosis of thyroid nodules.Methods: Forty-two patients with hypofunctioning thyroid nodules were prospectively studied with 99mTc-MIBI scintigraphy and USG to differentiate benign from malignant nodules. An injection of 740 MBq of 99mTc-MIBI was intravenously administered, followed by semiquantitative analysis of dual-phase scans using a 4-point (0 to 3) scoring system. USG was subsequently performed and interpretation was based on some sonographic criteria for malignancy. In the following days and weeks, patients underwent FNAC followed by surgery and histopathologic examination.Results: All malignant nodules were positive on 99mTc-MIBI and all but two malignant nodules were positive on USG. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy are, respectively, 100%, 70%, 65%, 100%, and 81% for 99mTc-MIBI scintigraphy; 87%, 78%, 68%, 91% and 81% for USG; and 83%, 100%, 100%, 96% and 64% for FNAC. There was no statistically significant difference between 99mTc-MIBI scintigraphy and USG performance for both benign (p = 0.317) and malignant (p = 0.573) nodules.Conclusion: 99mTc-MIBI scintigraphy and USG are important imaging modalities in the evaluation of thyroid nodules, particularly follicular neoplasms which are frequently associated with non-diagnostic cytology.

Preoperative localization of parathyroid glands

2004 ◽  
Vol 43 (03) ◽  
pp. 85-90 ◽  
Author(s):  
E. Lopez Hänninen ◽  
Th. Steinmüller ◽  
T. Rohlfing ◽  
H. Bertram ◽  
M. Gutberlet ◽  
...  
Keyword(s):  
Image Fusion ◽  
Single Photon ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Parathyroid Glands ◽  
Preoperative Localization ◽  
Mri Findings ◽  
99Mtc Mibi ◽  
Weighted Sequences ◽  
Mibi Scintigraphy

Summary Aim: Minimally invasive resection of hyperfunctional parathyroid glands is an alternative to open surgery. However, it requires a precise preoperative localization. This study evaluated the diagnostic use of magnetic resonance (MR) imaging, parathyroid scintigraphy, and consecutive image fusion. Patients, methods: 17 patients (9 women, 8 men; age: 29-72 years; mean: 51.2 years) with primary hyperparathyroidism were included. Examination by MRI used unenhanced T1- and T2-weighted sequences as well as contrast-enhanced T1-weighted sequences. 99mTc-MIBI scintigraphy consisted of planar and SPECT (single photon emission tomography) imaging techniques. In order to improve the anatomical localization of a scintigraphic focus, SPECT-data were fused with the corresponding MR-data using a modified version of the Express 5.0 software (Advanced Visual Systems, Waltham, MA). Results of image fusion were then compared to histopathology. Results: In 14/17 patients, a single parathyroid adenoma was found. There were 3 cases with hyperplastic glands. MRI detected 10 (71%), scintigraphy 12 (86%) adenomas. Both modalities detected 1/3 patients with hyperplasia. Image fusion improved the anatomical assignment of the 13 scintigraphic foci in five patients and was helpful in the interpretation of inconclusive MR-findings in two patients. Conclusions: Both MRI and 99mTc-MIBI scintigraphy sensitively detect parathyroid adenomas but are less reliable in case of hyperplastic glands. In case of a scintigraphic focus, image fusion considerably improves its topographic assignment. Furthermore, it facilitates the evaluation of inconclusive MRI findings.

Utility of 99 Tc-MIBI scintigraphy for the assessment of thyroid nodules with bethesda III cytologies

2018 ◽  
Author(s):  
Marta Sanchez Perez ◽  
Lola Santos Rey ◽  
Ana Gloria Villas Tome ◽  
Ma Jesus Diez Castro ◽  
Teresa Canela Coll ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Mibi Scintigraphy
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