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

Interobserver Agreement of Planar and SPECT Tc99m-MIBI Scintigraphy for the Assessment of Hypofunctioning Thyroid Nodules

2019 ◽  
Vol 58 (03) ◽  
pp. 258-264
Author(s):  
Simone Schenke ◽  
Rigobert Klett ◽  
Peter Acker ◽  
Thomas Rink ◽  
Michael C Kreissl ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Interobserver Agreement ◽  
Thyroid Nodules ◽  
Study Cohort ◽  
Papillary Thyroid ◽  
Planar Images ◽  
Benign Nodules ◽  
Different Levels ◽  
Mibi Scintigraphy ◽  
Spect Images

Abstract Introduction Thyroid scintigraphy with 99mTc-methoxyisobutylisonitrile (MIBI) is a helpful tool for the risk stratification of thyroid nodules (TN). Whereas a nodule with low or hypointense MIBI uptake has a low risk for malignancy, a hyperintense uptake may indicate a malignant nodule, which requires surgical resection. The appropriate diagnostic or therapeutic regimen of an isointense nodule with an uptake similar to the paranodular tissue is discussed controversially. Aim of this study was to assess the interobserver agreement (IA) for the assignment of TN to the three categories: hypo-, iso-or hyperintense. Methods Retrospective analysis of planar and SPECT images of MIBI scintigraphy was performed in 36 randomly selected patients with hypofunctioning TN and histological diagnosis. Four observers with different levels of experience in MIBI-scintigraphy analyzed MIBI uptake and assigned the nodules to the appropriate category. To assess the IA, Fleiss‘ Kappa was calculated. Results The study cohort included 11 patients with papillary thyroid carcinoma (diameter 20.3 mm) and 25 patients with benign nodules (diameter 24.8 mm). The IA for all nodules using planar images was 0.76 compared to 0.80 for SPECT images. The IA was better in the subgroup of malignant nodules for planar images as well as SPECT images (Kappa 0.91 and 0.90, respectively) compared to benign nodules (0.65 and 0.76, respectively). Using SPECT images, only one thyroid carcinoma presented with hypointense uptake, the remainder with hyper- or isointense uptake. In contrast, benign nodules were found in all categories. Conclusion MIBI scintigraphy shows a good IA for the interpretation of thyroid carcinoma. The IA is further improved if MIBI scintigraphy is performed in SPECT technique.

scholarly journals Could Negative Tc-99m-Methoxyisobutylisonitrile (MIBI) Scintigraphy Obviate the Need for Surgery for Bethesda III and IV Thyroid Nodules?

Surgeries ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 260-267
Author(s):  
Stella Armefti ◽  
Jasmin Mettler ◽  
Matthias Schmidt ◽  
Michael Faust ◽  
Marianne Engels ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
University Hospital ◽  
Molecular Testing ◽  
High Negative Predictive Value ◽  
Indeterminate Cytology ◽  
Sensitivity Specificity ◽  
Mibi Scintigraphy

In about 20% of all cases, the fine needle aspiration cytology (FNAC) results are equivocal, delivering the two common categories of indeterminate cytology, Bethesda III and IV. The observed rates of malignancy vary widely among institutions, with the urgent need for a more precise risk stratification. 99mcTc methoxyisobutylisonitrile scintigraphy (MIBI) is less expensive than molecular testing and has been shown to have a high negative predictive value. For this reason, the results of MIBI scintigraphy in adult patients with indeterminate FNAC were collected, and correlated with the final pathology reports of surgical specimens. Patients receiving FNAC, MIBI scintigraphy and surgery for sonographic suspicious hypofunctional thyroid nodules between 2015 and 2019 at the University Hospital of Cologne, Germany were identified. Sensitivity, specificity, positive predictive and negative predictive value of MIBI scintigraphy were calculated. Seventy-eight patients with sonographic suspicious hypofunctional thyroid nodules underwent surgery after interdisciplinary case discussion of both FNAC and MIBI results. In 49 (62.5%) cases, FNAC consisted of Bethesda III and IV results. In 39 (79.6%) of these cases, MIBI scintigraphy resulted in mismatch and intermediary results, but in only 4 (10.2%) of these cases was a carcinoma diagnosed. The negative predictive value of MIBI scintigraphy was 90–100%, respectively. Relying on the negative predictive value of MIBI match results might have obviated the need for surgery in 20.4% cases; one papillary microcarcinoma, however, would have been missed. MIBI scintigraphy has an underused potential for improving the diagnostic precision of hypofunctional thyroid nodules.

MIBI-scintigraphy of thyroid nodules – risk of malignancy

2007 ◽  
Vol 115 (S 1) ◽  
Author(s):  
G Leidig-Bruckner ◽  
G Cichorowski ◽  
B Sattler
Keyword(s):  
Thyroid Nodules ◽  
Risk Of Malignancy ◽  
Mibi Scintigraphy

Importance of MIBI scintigraphy in the detection of thyroidal cancers : a case report

2014 ◽  
Vol 1 (1) ◽  
pp. 38-40
Author(s):  
Adlen Nezzar ◽  
Keyword(s):  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Cytological Study ◽  
Needle Aspiration ◽  
Surgical Removal ◽  
Papillary Thyroid ◽  
Technetium Scan ◽  
Criteria Of Malignancy ◽  
Mibi Scintigraphy ◽  
Cold Nodule

The investigation of thyroidal nodules is intended to select patients who are candidates for surgery, based on a cytological study with a good positive predictive value. Here we report the case of a 30-year-old woman presenting with a thyroid mixed nodule on the whole right lobule, cold on scintigraphy, and with no criteria of malignancy on cervical ultrasound and which cytological study did not reveal any suspicious cells. The 99mTc - methoxyisobutylisonitrile (MIBI) thyroid imaging showed a clear retention of MIBI in the cold nodule as described with technetium scan, motivating the realization of a partial surgery for which extemporaneous study favored papillary thyroid carcinoma, completed afterwards by a surgical removal. Thyroid MIBI imaging is a sensitive test for the detection of thyroid cancers and thus may be useful for improving the diagnostic accuracy of the thyroid nodules approach in the future and optimize invasive gestures from fine-needle aspiration biopsy to surgery.

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.

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
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