Cutoff value of thyroid uptake of &lt;sup&gt;99m&lt;/sup&gt;Tc-pertechnetate to discriminate between Graves&amp;rsquo; disease and painless thyroiditis: a single center retrospective study

Uchida, Toyoyoshi; Suzuki, Ruriko; Kasai, Takatoshi; Onose, Hiroyuki; Komiya, Koji; Goto, Hiromasa; Takeno, Kageumi; Ishii, Shinya; Sato, Junko; Honda, Akira; Kawano, Yasuhiro; Himuro, Miwa; Yamada, Emiko; Yamada, Tetsu; Watada, Hirotaka

doi:10.1507/endocrj.ej15-0441

Cited by 17 publications

(13 citation statements)

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“…In previous studies, the sensitivity and specificity of Tc-99m pertechnetate uptake at these lower reference values were 92–97% and 87-97%, respectively. 15 , 16 Further studies to determine the sensitivity and specificity of these new reference normal values in our population are needed.…”

Section: Discussionmentioning

confidence: 99%

Assessment of normal reference values for thyroid uptake of technetium-99m pertechnetate in a Saudi population

et al. 2021

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BACKGROUND: Thyrotoxicosis is a common medical problem. Thyroid nuclear imaging with either I 123 or technetium-99m (Tc-99m) pertechnetate are used to determine the cause. Although I 123 has been the standard technique, Tc-99m pertechnetate is now commonly used, acceptable and easier to perform. The commonly used normal value of Tc-99m pertechnetate is 1–4%, but lower normal values have been reported in different populations. OBJECTIVE: Determine normal reference range of Tc-99m pertechne-tate thyroid uptake for thyroid scintigraphy in Saudi Arabia. DESIGN: Retrospective, cross-sectional. SETTING: Nuclear medicine service at tertiary care center in Riyadh. PATIENTS AND METHODS: We used data from biochemically euthyroid patients who underwent a thyroid Tc-99m pertechnetate scan while having parathyroid scintigraphy for hyperparathyroidism between April 2009 to April 2019. Medical records and biochemical thyroid function tests were reviewed and Tc-99m pertechnetate thyroid uptake values were determined for each patient. MAIN OUTCOME MEASURES: Thyroid uptake of Tc-99m pertechne-tate in euthyroid patients. SAMPLE SIZE: 167 RESULTS: The mean and median uptake of Tc-99m pertechnetate in euthyroid patients were 0.86% and 1.0%, respectively, and the inter-quartile range was 0.0–1.0%. The normal reference range in the study population was 0.2-2%. Thyroid uptake inversely correlated with age in females (r=−0.37, P <.001), males (r=−0.46, P =.001), and for all patients (r=?0.39, P <.0001). CONCLUSION: The range for normal thyroid Tc-99m pertechnetate was lower than the standard 1-4% range. Moreover, uptake decreased with age. Further studies are needed to establish the normal age-adjusted uptake for the thyroid Tc-99m pertechnetate scan. LIMITATIONS: Single center and retrospective. CONFLICT OF INTEREST: None.

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Section: Discussionmentioning

confidence: 99%

Assessment of normal reference values for thyroid uptake of technetium-99m pertechnetate in a Saudi population

et al. 2021

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“…Numerous studies have shown that thyroid scintigraphy with (99m)Tc-pertechnetate is the most effective way to distinguish Graves' disease from thyroiditis, the two most common causes of thyrotoxicosis. [2][3][4][5] However, the interpretation of thyroid scintigraphy results largely relies on the experience of nuclear medicine (NM) residents, making diagnostic reporting somewhat subjective.…”

Section: Introductionmentioning

confidence: 99%

Deep learning for intelligent diagnosis in thyroid scintigraphy

et al. 2021

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Objective To construct deep learning (DL) models to improve the accuracy and efficiency of thyroid disease diagnosis by thyroid scintigraphy. Methods We constructed DL models with AlexNet, VGGNet, and ResNet. The models were trained separately with transfer learning. We measured each model’s performance with six indicators: recall, precision, negative predictive value (NPV), specificity, accuracy, and F1-score. We also compared the diagnostic performances of first- and third-year nuclear medicine (NM) residents with assistance from the best-performing DL-based model. The Kappa coefficient and average classification time of each model were compared with those of two NM residents. Results The recall, precision, NPV, specificity, accuracy, and F1-score of the three models ranged from 73.33% to 97.00%. The Kappa coefficient of all three models was >0.710. All models performed better than the first-year NM resident but not as well as the third-year NM resident in terms of diagnostic ability. However, the ResNet model provided “diagnostic assistance” to the NM residents. The models provided results at speeds 400 to 600 times faster than the NM residents. Conclusion DL-based models perform well in diagnostic assessment by thyroid scintigraphy. These models may serve as tools for NM residents in the diagnosis of Graves’ disease and subacute thyroiditis.

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“…99m Tc pertechnetate thyroid scintigraphy is one of the most accurate and rapid tests for evaluating patients with thyrotoxicosis, especially when blood tests are insu cient to distinguish Graves' disease from thyroiditis 5,20 . Recently, two studies measured thyroid uptake rate using the camera method, elucidating the cutoff value for differentiating Graves' disease from thyroiditis 11,21 . One study from Turkey demonstrated that the cutoff value for 99m Tc pertechnetate uptake of 1.55% was useful to discriminate between Graves' disease and subacute thyroiditis with a sensitivity of 92%, speci city of 87%, and accuracy of 92.9% 11 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Tc-99m Pertechnetate Thyroid Uptake Rates by Gamma Probe and Gamma Camera Methods for Differentiating Graves’ Disease and Thyroiditis

Jin

Ahn

et al. 2021

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Although technetium-99m (99mTc) pertechnetate thyroid uptake rate can be measured by gamma camera with scintigraphy as well as by gamma probe, the normal reference range known as quite different between them. This study was performed to compare their diagnostic accuracy for evaluating patients with hyperthyroidism. We retrospectively reviewed consecutive 371 patients (euthyroid 89, Graves 167, and thyroiditis 115) who had simultaneously measured data of thyroid uptake rates by both gamma probe and camera methods in our hospital from November 2019 to June 2020. The reference ranges in euthyroid patients were 2.0-4.7% and 0.3–1.9% for probe and camera methods, respectively. For differentiating Graves’ disease and thyroiditis, the area under the curve of the camera method was significantly greater than that of the probe method (0.988 vs 0.975, p = 0.030) on receiver operating characteristic curve analysis. With a cutoff value of 0.7%, the sensitivity and specificity for the camera method were 93.4% and 94.8%, respectively. With a cutoff value of 3.0%, those for the probe method were 92.2% and 91.3%, respectively. In conclusion, 99mTc pertechnetate thyroid uptake rate measured by the camera method with scintigraphy had higher diagnostic accuracy than the probe method for evaluating patients with hyperthyroidism.

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Cutoff value of thyroid uptake of <sup>99m</sup>Tc-pertechnetate to discriminate between Graves’ disease and painless thyroiditis: a single center retrospective study

Cited by 17 publications

References 17 publications

Assessment of normal reference values for thyroid uptake of technetium-99m pertechnetate in a Saudi population

Assessment of normal reference values for thyroid uptake of technetium-99m pertechnetate in a Saudi population

Deep learning for intelligent diagnosis in thyroid scintigraphy

Comparison of Tc-99m Pertechnetate Thyroid Uptake Rates by Gamma Probe and Gamma Camera Methods for Differentiating Graves’ Disease and Thyroiditis

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