Thyroid scintigraphy

Year 2012, Volume: 29 Issue: 4S, 289 - 300, 07.05.2013

Fevziye Canbaz Tosun

https://doi.org/10.5835/jecm.omu.29.s4.016

Abstract

Radionuclide methods in thyroidal diseases were firstly initiated after the Second World War by the use of 131Iodine in therapy. By the early 1950’s, radionuclide thyroid imaging studies have superseded among the diagnostic modalities when gamma scintillation detectors came into the clinical usage. In Nuclear Medicine, since 1980’s, Single Photon Emission Tomography (SPECT) and Positron Emission Tomography (PET) imaging which came into clinical usage in 1990’s, provide three dimensional evaluation of radiotracer distribution in addition to conventional two dimensional planar scan. Hybrid systems which were composed of SPECT and CT or PET and CT scan, produce images with improved attenuation correction and anatomic localization. SPECT/CT and PET/
CT scans are widely performed in benign and malign thyroid diseases in current rutin practice. For many years, thyroid scan has been used in the diagnostic evaluation of several thyroid diseases. The utility of thyroid scintigraphy to characterize thyroid nodules has significantly decreased over the past decade because of the increasing use of thyroid ultrasonography and fine needle aspiration biopsy. Nonetheless, the ability of nuclear medicine to assess physiology and function makes it an indispensable tool in the management of patients with thyroid disease, especially in hyperthyroidism.

Keywords

SPECT/BT, PET/BT, Thyroid scintigraphy, Hyperthyroidism, Thyroid cancer

Tiroit sintigrafisi

Abstract

Tiroit hastalıklarında radyonüklit uygulamalar, ilk olarak İkinci Dünya Savaşı’ndan sonra 131İyot' un tedavide kullanımı ile başlamıştır. Gama sintilasyon dedektörlerinin 1950’lerin erken döneminde kullanıma girmesiyle tiroit görüntüleme çalışmaları da tanısal yöntemler arasında yerini almıştır. Nükleer Tıpta, 1980’lerden beri kullanılan Single Photon Emission Tomography (SPECT) ve 1990’larda klinik kullanıma giren Positron Emission Tomography (PET) inceleme teknikleri daha öncesinde alışılagelmiş 2 boyutlu planar görüntülemeye ek olarak radyotrasör dağılımı ve lokalizasyonunun 3 boyutlu olarak değerlendirilmesine olanak verir. SPECT ve PET kameralarına Bilgisayarlı Tomografi (BT)’nin eklenmesiyle oluşturan hibrit cihazlar, ek olarak atenüasyon düzeltmesi ve lezyonun doğru olarak yerini belirlemeyi sağlarlar. SPECT/BT ve PET/BT günümüz rutininde benign ve malign tiroit hastalıklarının değerlendirilmesinde yaygın olarak uygulanmaktadır. Tiroit sintigrafisi uzun yıllardır çeşitli tiroit hastalıklarının tanısında kullanılmaktadır. Günümüzde tiroit ultrasonografisinin artan kullanımı ve tiroit nodüllerinde tanısal perkütan aspirasyon biyopsisinin yoğun uygulanması ile tiroit sintigrafisi eskiye oranla daha az tercih edilir olmuştur. Tiroit sintigrafisi bezin fizyoloji ve fonksiyonunu göstermesi nedeniyle, hipertiroidi başta olmak üzere hasta yönetiminde hali hazırda önemli role sahiptir

Keywords

Tiroit sintigrafisi, Hipertiroidi, Tiroit kanseri, SPECT/BT, PET/BT

References

• Abraham, T., Schöder, H., 2011. Thyroid cancer-indications and opportunities for positron emission tomography/computed tomography imag- ing. Semin. Nucl. Med. 41, 121-138.
• Becker, D.V., Charkes, N.D., Hurley, J.R., McDougall, I.R., Price, D.C., Royal, H.D., Sarkar, S.D., 1999. Society of Nuclear Medicine Procedure Guideline for ThyroidScintigraphyversion 2.0
• Boelaert, K., Horacek, J., Holder, R.L., Watkinson, J.C., Sheppard, M.C., Franklyn, J.A., 2006. Serum thyrotropin concentration as a novel pre- dictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J. Clin. Endocr. Metab. 91, 4295-4301.
• Brendel, A.J., Guyot, M., Jeandot, R., Lefort, G., Manciet, G., 1988. Thallium-201 imaging in the follow-up of differentiated thyroid carcinoma. J. Nucl. Med. 29, 1515- 1520.
• Cooper, D.S., Doherty, G.M., Haugen, B.R., Kloos, R.T., Lee, S.L., Mandel, S.J., Mazzaferri, E.L., McIver, B., Pacini, F., Schlumberger, M., Sherman, S.I., Steward, D.L., Tuttle, R.M., American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differenti- ated Thyroid Cancer, 2009. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differenti- ated thyroid cancer. Thyroid. 19, 1167-214
• Değer, M., Demir, M., İnce, M., Kıraç, S., Köseoğlu, K., Turan, E., Uysal, B., 2004. Kalite kontrol, enstrumantasyon ve radyasyon güvenliği komitesi yönergesi. Turk J. Nucl. Med.13,151-169.
• Diagnostic accuracy of 18F-FDG PET in restaging patients with medullary thyroid carcinoma and elevated calcitonin levels. J. Nucl. Med. 48, 501-507.
• Diehl, M., Graichen S., Menzel, C., Lindhorst, E., Grünwald, F., 2003. F-18 FDG PET in insular thyroid cancer. Clin. Nucl. Med. 28, 728-731.
• Diehl, M., Risse, J.H., Brandt-Mainz, K., Dietlein, M., Bohuslavizki, K.H., Matheja, P., Lange, H., Bredow, J., Körber, C., Grünwald, F., 2001. Fluorine-18 fluorodeoxyglucose positron emission tomography in medullary thyroid cancer: Results of a multicentre study. Eur. J. Nucl. Med. 28, 1671-1676.
• Haugen, BR., Lin, E.C., 2001. Isotope imaging for metastaic thyroid cancer. Endocrinol. Metab. Clin. North Am. 30, 469-492.
• Joyce, J.M., Swihart, A., 2011. Thyroid: Nuclear medicine update. Radiol. Clin. North. Am. 49, 425-434.
• Ma, C., Kuang, A., Xie, J., Ma, T., 2005. Possible explanations for patients with discordant findings of serum thyroglobulin and 131I whole-body scanning. J. Nucl. Med. 46, 1473-1480.
• Ong, S.C., Schöder, H., Patel, S.G., Tabangay-Lim, I.M., Doddamane, I., Gönen, M., Shaha, A.R., Tuttle, R.M., Shah, J.P., Larson, S.M., 2007. Diagnostic accuracy of 18F-FDG PET in restaging patients with medullary thyroid carcinoma and elevated calcitonin levels. J.Nucl.Med. 48, 501-507.
• Palmedo, H., Bucerius, J., Joe, A., Strunk, H., Hortling, N., Meyka, S., Roedel, R., Wolff, M., Wardelmann, E., Biersack, H.J., Jaeger, U., 2006. Integrated PET/CT in differentiated thyroid cancer: Diagnostic accuracy and impact on patient management. J. Nucl. Med. 47, 616-624.
• Sarkar, S.D., Kalapparambath, T.P., Palestro, C.J., 2002. Comparison of 123I and 131 I for whole-body imaging in thyroid cancer. J. Nucl. Med. 43, 632-634.
• Shankar, L.K., Yamamoto, A.J., Alavi, A., Mandel, S.J., 2002. Comparison of 123I scintigraphy at 5 and 24 hours in patients with differentiated thyroid cancer. J. Nucl Med. 43, 72-76.
• Shiga, T., Tsukamoto, E., Nakada, K., Morita, K., Kato, T., Mabuchi, M., Yoshinaga, K., Katoh, C., Kuge, Y., Tamaki, N., 2001. Comparison of (18)F-FDG, (131)I-Na, and (201)Tl in diagnosis of recurrent or metastatic thyroid carcinoma. J. Nucl. Med. 42, 414-419.
• Töre, G., Karayalçın, B., Esen, B., Türkmen, C., Yüksel, D., Varoğlu, E., Özkılıç, H., Kabasakal, L., Yüksel, M., Kır,. M.K., Özdoğan, Ö., Ata- sever, T., 2003. Tiroid sintigrafisi uygulama kılavuzu. Turk. J. Nucl. Med.12, 178-180.
• Yüksel, D., Argon, M., Atasever, T., Çelen, Y.Z., Kabasakal, L., Karayalçın, B., Kır,. K.M., Özdoğan, Ö., Özkılıç, H., Sarı, O., Türkmen, C., Varoğlu, E., Yapar, A.F. Yüksel, M, 2001. Differensiye Tiroid Kanserlerinde Radyoaktif İyot (I-131) Ablasyonu ve Tedavisi Uygulama Kılavuzu, Turk J. Nucl. Med. 10, 1-27.
• Ziessman, H.A., O’Malley, J.P, Thrall, J.H., 2006. Endocrine System. In The Requisites, Nuclear Medicine, third edition, Mosby Elsevier, Phila- delphia, pp. 71-99.