201Tl in the scintigraphic evaluation of the ?cold? thyroid areas

Palermo, F.; Bruniera, Federico; Caldato, L.; Siega, Maurizio Della; Lazzarini, Mario; Mareso, Antonio

doi:10.1007/bf00257569

Cited by 12 publications

(10 citation statements)

References 4 publications

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“…The magnitude and specificity of 201T1 thyroid uptake was used for thyroid imaging. While the resulting scintigrams yielded an image similar to that obtained after injection of 99rnTc pertechnetate, neither their quality, nor their diagnostic contribution or correlation with various aspects of thyroid pathology justifies the preferential utiliza¬ tion of 201T1 (Palermo et al 1979;Fukuchi et al 1977Fukuchi et al , 1978. 201TI thyroid imaging has been found, however, to be useful in the differentiation of benign vs. malignant tumours, when combined with "mTc or 131I scans (Haradaetal.…”

Section: Discussionmentioning

confidence: 86%

“…201Thallium (201T1) is widely used for the visuali¬ zation of the normal and injured myocardium (Botvinick et al 1978;Dunn et al 1978). As an incidental finding it has been repeatedly observed that the thyroid was also visualized (Atkins et al 1977;Palermo et al 1979), suggesting a high deposition of 201T1 in the gland. This deposition has also been studied in experimental animals (Oster et al 1978).…”

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confidence: 90%

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Thyroid uptake of 201Thallium and its control by TSH

Maayan¹,

Volpert²,

Fine³

et al. 1981

Acta Endocrinologica

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Patients injected with 201Thallium (201Tl) for myocardial scanning present good thyroid visualization. Determinations in mice injected with 201Tl indicated a high thyroid/serum concentration ratio (T/S). The 201Tl biological half life (t\m=1/2\) in serum (30-135 s) was much shorter than in thyroid (53-55 h) for human subjects and experimental animals. The 1 h 201Tl T/S ratio was comparable to that of 131I and 99m Tc, indicating presence of a gradient for 201Tl also. Increase of endogenous TSH induced by propylthiouracil led to a significant rise in T/S for 99mTc, 131I and 201Tl, whereas TSH inhibition by feeding l-thyroxine led to decrease in T/S for 99mTc and 201Tl. In vitro thyroid/medium concentration ratio (T/M) of 99mTc and 201Tl was decreased after 20' incubation with ouabain, an inhibitor of the Na+,K+, activated ATP-ase. However, perchlorate in vitro or in vivo failed to diminish the 201Tl T/M ratios or to affect the t\m=1/2\of 201Tl in human subjects, whereas T/M of 201Tl was depressed by KCl addition to the medium. 201Thallium (201T1) is widely used for the visuali¬ zation of the normal and injured myocardium (Botvinick et al. 1978;Dunn et al. 1978). As an incidental finding it has been repeatedly observed that the thyroid was also visualized (Atkins et al. 1977;Palermo et al. 1979), suggesting a high deposition of 201T1 in the gland. This deposition has also been studied in experimental animals (Oster et al. 1978). The present study further explores the mechanism of action of this selective concentration of 201T1 in the thyroid gland of man and of experimental animals. Materials and MethodsMaterials. All radioisotopes were obtained commercially. 201T1C1 had a specific activity of no less than 1 mCi/ 180 ng, 131I was carrier free. 99mTc pertechnetate was generator-eluted. 42K had a specific activity of 1 mCi/ 13 mg. TSH-NIH-B7 was a generous gift from the NIH pituitary hormone distribution program. Methods I Human studies. Patients referred for myocardial scan¬ ning for diagnosis of cardiac pathology were injected iv with 1.5-2.0 mCi 201T1 and were informed that thyroid (and occasionally serum) radioactivity would be meas¬ ured, not as part of the cardiac study. In such patients, radioactivity over the thyroid region was counted with an uptake probe, at 75 kev ± 14%, 3-4 times for the first 6 h and subsequently up to a week at approximately 24 h intervals. Radioactivity-time distribution was plotted on semi-log paper, and thyroid and serum biological t'/2 were calculated. II Animal studies. Male or female mice of the CF1 strain weighed 20-35 g. They were fed Rat Chow and given tap water freely. Subsequently they were used for in vivo and in vitro procedures.A. In vivo procedures 1) 20lTl deposition in various organs. In a number of experiments, groups of mice were sacrificed at 30, 90, For reprints contact:

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Section: Discussionmentioning

confidence: 86%

mentioning

confidence: 90%

Thyroid uptake of 201Thallium and its control by TSH

Maayan¹,

Volpert²,

Fine³

et al. 1981

Acta Endocrinologica

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“…As previously reported in part (8), this technique of investigation now consists of: i.v. injection of 15-20 jiCi/kg of 2 0 1 Tl-chloride; sequential scintigrams using a gamma-camera (Searle-LFOV, HRC or pinhole collimators) on-line with with a data processing unit (Cine 230 Intertechnique); histo-mode recording 20s frames for the first 20-30 min and zoomdisplayed pictures; eventual simultaneous recording with double tracer ( 2( "T1 + " m Tc-500 (iCi) to pinpoint topographically any equivocal areas (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…summarizes the results in 120 consecutive patients examined according to the procedure and the interpretative criteria described; they were reevaluated in comparison with only qualitative diag-noses expressed in a larger non-selected group of 181 patients in which the former are included. The data of these patients were partly described in earlier reports(7,8).…”

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confidence: 90%

Computerized Study with 201T1 of the Cold Thyroid Node

Palermo¹,

Saitta²,

Coghetto³

et al. 1982

Nuklearmedizin

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Because of its physical and potassium-metabolic characteristics 201T1 is more suitable than 131Cs for radioisotopic studies of the cold thyroid nodule, with the further diagnostic possibility of quantitatively assessing intranodular behaviour for a specific differentiation among different kinds of neoformations. Using a gamma-camera on line with a computer data processing device, sequential scintiscans were recorded for the first 20-30 min after i. v. administration of 15-20 MCi\lkg of radiothallium; delayed sequences were taken at 40-60 min if intranodular uptake appeared. A quantitative appraisal was made of the differential 201Tl uptake-ratio between nodule and healthy thyroid tissue (density-index) and the multiparameter analysis of thyroid time/activity curves generated on the relative regions of interest (ROIs). This computerized study, in 120 out of 293 patients submitted to this radiothallium test, has shown a) diagnostic agreement between clinical-histological and radioisotopic findings in 76 out of 79 colloid-cystic or degenerative neoformations, in all 16 malignant and in 23 out of 25 hyperplastic benign nodules; b) significant statistical difference of the density-index in solid versus cystic but not between benign and malignant nodules; c) different 201T1 kinetics behaviour in different kinds of solid thyroid lesions with a satisfactory statistical difference of the radiothallium nodular dissapearance-index.

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“…In the diagnosis of nodular goiter, many authors have reported the accumulation of this radionuclide in thyroid cancers and their lymphnode metastasis. [1][2][3][4][5][6][7] Meanwhile, since a significant fraction of adenomas or other benign conditions also appear positive in the scintigram, a single radiothallium image could not be a satisfactory test to use in estimating the Received February 4, 1991, revision accepted April 3, 1991. For reprints contact: Takashi Misaki, Department of Radiology, Kyoto City Hospital, Mibuhigashitakada, Nakagyoku, Kyoto 604, JAPAN. histological nature of a given struma nodosa.…”

Section: Introductionmentioning

confidence: 99%

Limited value of delayed radiothallium image in the diagnosis of nodular goiter

et al. 1991

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To test whether delayed thallium image can improve the diagnostic accuracy of thyroid tumor, we have reviewed 35 patients with cold nodules of proven histopathology. Early and delayed images were taken 10-20 min and 3-4 hr postinjection, respectively. In this study, a thyroid nodule was interpreted as malignant if it had normal or increased uptake on early scan and more residual radioactivity than paranodular tissue on delayed scan. In the eighteen patients who had carcinoma, a disappointing 44% false negative rate was observed. No significant difference was seen between retention-positive and negative cases in tumor size or histological type of cancer. Nor could any demographic bias explain the low sensitivity. Of the six false negatives, macroscopic cystic degeneration was seen in two cases, but tumors in the other four were grossly solid. Considering the histological heterogeneity often seen within a thyroid tumor, the portion with increased retention of radiothallium may be too small to be detected in the false negative cases. Furthermore, 3 false positive readings were obtained in 17 patients with benign conditions. We conclude that the contribution of the delayed thallium image was quite limited in predicting or ruling out malignancy in nodular goiters.

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201Tl in the scintigraphic evaluation of the ?cold? thyroid areas

Cited by 12 publications

References 4 publications

Thyroid uptake of 201Thallium and its control by TSH

Thyroid uptake of 201Thallium and its control by TSH

Computerized Study with 201T1 of the Cold Thyroid Node

Limited value of delayed radiothallium image in the diagnosis of nodular goiter

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