Disparate thyroid imaging. Combined studies with sodium pertechnetate Tc 99m and radioactive iodine

Shambaugh, G. E.

doi:10.1001/jama.228.7.866

Cited by 43 publications

(14 citation statements)

References 8 publications

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“…Scintigraphy may be performed with 131 I or 123 I or 99m Tc pertechnetate. The iodine radioisotopes are absorbed and organified by the thyroid and are the preferred isotypes because 3 to 8% of nodules that are hyperfunctioning when mapped with 99m Tc scans are hypofunctioning with iodine (36). Scintigraphy is also indicated for nodules with cytology, which is suggestive of follicular tumor in patients with normal low or low TSH, if it was not performed earlier (37).…”

Section: Isotope Scintigraphymentioning

confidence: 99%

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Rosário

Ward

Carvalho

et al. 2013

Arq Bras Endocrinol Metab

123

147

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Thyroid nodules are frequent findings, especially when sensitive imaging methods are used. Although thyroid cancer is relatively rare, its incidence is increasing, particularly in terms of small tumors, which have an uncertain clinical relevance. Most patients with differentiated thyroid cancer exhibit satisfactory clinical outcomes when treatment is appropriate, and their mortality rate is similar to that of the overall population. However, relapse occurs in a considerable fraction of these patients, and some patients stop responding to conventional treatment and eventually die from their disease. Therefore, the challenge is how to identify the individuals who require more aggressive disease management while sparing the majority of patients from unnecessary treatments and procedures. We have updated the Brazilian Consensus that was published in 2007, emphasizing the diagnostic and therapeutic advances that the participants, representing several Brazilian university centers, consider most relevant in clinical practice. The formulation of the present guidelines was based on the participants' experience and a review of the relevant literature. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Keywords Thyroid nodules; thyroid cancer; Brazilian consensus; update RESUMO Nódulos tireoidianos são muito frequentes, sobretudo quando se empregam métodos sensí-veis de imagem. Embora o câncer seja proporcionalmente raro, sua incidência vem aumentando, especialmente de tumores pequenos, cuja evolução clínica é incerta. A maioria dos pacientes com carcinoma diferenciado de tireoide evolui bem quando adequadamente tratada, com índices de mortalidade similares à população geral. Por outro lado, um percentual não desprezível apresenta recidivas e alguns eventualmente não respondem às terapias convencionais, evoluindo para óbito. Assim, o desafio é distinguir os pacientes merecedores de condutas mais agressivas e, ao mesmo tempo e não menos importante, poupar a maioria de tratamentos e procedimentos desnecessários. Atualizamos o Consenso Brasileiro publicado em 2007, ressaltando os avanços diagnósticos e terapêuticos que os participantes, de diferentes Centros Universitários do Brasil, consideram mais relevantes para prática clínica. A elaboração dessas diretrizes foi baseada na experiência dos participantes e revisão da literatura pertinente. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Descritores

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Section: Isotope Scintigraphymentioning

confidence: 99%

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Rosário

Ward

Carvalho

et al. 2013

Arq Bras Endocrinol Metab

123

147

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“…Although such nodules carry a risk of malignancy, they are usually benign. [108][109][110][111][112][113][114] Therefore, it is recommended by some authors that patients with hot or warm nodules on 99 Tc SC undergo 123 I SC, 110,115 especially if serum TSH is not suppressed. 109 SC has several limitations.…”

Section: Scintigraphy (Sc)mentioning

confidence: 99%

Thyroid nodules - Stepwise diagnosis and management

Polyzos¹,

Kita²,

Avramidis³

2007

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thyroid nodules are common in clinical practice. they may be solitary within a "normal" thyroid gland or dominant within a multinodular goiter. the incidence of thyroid nodules has been on the rise in recent decades, mainly due to the wider use of neck imaging. therefore, the incidental finding of a thyroid nodule in an asymptomatic patient is not rare. the differential diagnosis of a thyroid nodule is crucial, as malignancy necessitates surgery, while strict patient follow-up is necessary in the case of benignity. Fine-Needle Aspiration biopsy is considered to be the "gold standard" in the selection of patients for surgery. Ultrasonography (Us) can be used to determine changes in the size of nodules during follow-up or to detect recurrent lesions in patients suspected for thyroid malignancy, although there are no specific Us findings that suggest malignancy. surgery is mandatory in cytologically malignant nodules or in cases suspicious for malignancy. the definite diagnosis and consequent therapy is based on the histological findings after surgery. In this review we present an approach to thyroid nodules in five distinct steps, from the clinical or incidental finding of a nodule to the suggested treatment baselines.

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“…This might be explained by a dissociation between anion trapping and organification of iodine, which may be seen in a small fraction of thyroid malignancies and therefore appear hyperfunctioning by Tc-99m but hypofunctioning by iodine imaging. 23 The fact that carcinoma was not suspected clinically in this case is not surprising. In a review of 138 thyrotoxic patients reported by Terzioglu et al, 24 thyroid carcinoma was found in eight patients.…”

Section: Discussionmentioning

confidence: 75%

Functioning Thyroid Carcinoma Occurring in Graves' Disease: A Report of One Case and Review of the Literature

Saadeh

Abu-Farsakh

1995

Ann Saudi Med

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Disparate thyroid imaging. Combined studies with sodium pertechnetate Tc 99m and radioactive iodine

Cited by 43 publications

References 8 publications

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Thyroid nodules - Stepwise diagnosis and management

Functioning Thyroid Carcinoma Occurring in Graves' Disease: A Report of One Case and Review of the Literature

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