Technetium 99m pertechnetate thyroid scintigraphy: congenital hypothyroid screening

Wells, Robert G.; Sty, John R.; Duck, Stephen C.

doi:10.1007/bf02386810

Cited by 17 publications

(10 citation statements)

References 14 publications

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“…20 This lack of specificity of technetium Tc 99m pertechnetate may explain the low prevalence of eutopic thyroid (12%) described by Connelly et al 19 as well as other reported results of technetium Tc 99m pertechnetate scintigraphy in patients with CH. [21][22][23] The ratio of ectopic/eutopic thyroid in our series was 0.44:1 as diagnosed using 123 I scans and 1.0:1 using technetium Tc 99m pertechnetate. In the Australian series, 20 which used only technetium Tc 99m pertechnetate, the ratio was 4.4:1, ϳ9 times that of our 123 I findings (P Ͻ .001), and Ͼ4 times that of our scans using technetium Tc 99m pertechnetate (P Ͻ .01).…”

Section: Comparing Radioisotopesmentioning

confidence: 51%

The Key Role of Newborn Thyroid Scintigraphy With Isotopic Iodide (123I) in Defining and Managing Congenital Hypothyroidism

Schoen

Clapp

et al. 2004

Pediatrics

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ABSTRACT. Background. Thyroid imaging with isotopic iodide ( 123 I) or technetium Tc 99m pertechnetate has been available for decades but is not routinely used in newborn infants diagnosed with congenital hypothyroidism (CH). Among clinicians who believe that presence, absence, or abnormal location of a thyroid does not alter management of CH, imaging is not advocated for anatomic diagnosis of CH.Objective. To define the role of thyroid scintigraphy in diagnosing and managing newborn CH.Methods. Results. Of the 210 infants with CH receiving scintigraphy, 90 (43%) had eutopic (normal-appearing) thyroid diagnosed, and 120 (57%) had ectopic or absent gland (25% ectopic, 32% absent) diagnosed. Of these 210 infants, ethnicity was known in 198; of these, 76 (38%) were Latino/Hispanic, and 122 (62%) of the infants were nonLatino/non-Hispanic. Prevalence of CH differed between ethnic groups in our population of >700 000 newborn infants; total prevalence of CH was 1 per 3139. Prevalence of CH in Latino/Hispanic infants was highest at 1 per 1750 infants (1:1357 females, 1:2463 males). Prevalence of CH in non-Latino/non-Hispanic infants was 1 per 4648 infants (1:3500 females, 1:6914 males). Given that the total Kaiser Permanente infant population was ϳ19% Latino/ Hispanic, the percentage of Latino/Hispanic infants with CH was significantly higher than expected. Dysplastic thyroid was more common in Latino/Hispanic females (69%) than in non-Latino/non-Hispanic females (52%). The female-to-male ratio of patients with CH was 1.9:1. Among the 210 infants with CH, normal thyroid was diagnosed more by 123 I scintigraphy (49% of cases) than by scintigraphy using technetium Tc 99m pertechnetate (31% of cases). Use of technetium Tc 99m pertechnetate could have diagnosed dysplastic thyroid in some cases that would be considered eutopic had 123 I been used. Eight familial cases of CH were identified.Comments. CH, a heterogeneous disorder with prevalence influenced by familial, ethnic, and gender factors, is more common in Latino/Hispanic females. When present, a eutopic thyroid is more likely to be detected by 123 I scintigraphy; this method is therefore preferred over scintigraphy using technetium Tc 99m pertechnetate for optimal management of CH. Parents can then be counseled on either the certainty of lifetime therapy (for dysplastic thyroid) or the possibility of later discontinuing therapy (for eutopic thyroid, because CH may be transient in these children). If the dysplastic thyroid gland is absent or ectopic (usually a small sublingual gland), parents can be told that the infant will need lifetime thyroid therapy. If the thyroid gland is present in the normal position (eutopic) and the condition is transient (as shown by controlled withdrawal of thyroid in older children), lifelong treatment may not be needed. Parents rightly expect this maximal clinical and laboratory information in the immediate newborn period. Some clinicians hesitate to recommend neonatal scintigraphy for children with CH because of concern about delaying ...

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Section: Comparing Radioisotopesmentioning

confidence: 51%

The Key Role of Newborn Thyroid Scintigraphy With Isotopic Iodide (123I) in Defining and Managing Congenital Hypothyroidism

Schoen

Clapp

et al. 2004

Pediatrics

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“…Thyroid scintigraphy ( 123 I or 99m Tc) has long been used as the method of choice for diagnostic confirmation and determination of CH aetiology in patients with clinical and laboratory evidence of this disease (Wells et al ., 1986; Verelst et al ., 1991; Sfakianakis et al ., 1999). However, the cost of this exam is relatively high, and it is not always available.…”

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confidence: 99%

Accuracy of ultrasonography to establish the diagnosis and aetiology of permanent primary congenital hypothyroidism

Kreisner

Camargo-Neto

Maia

et al. 2003

Clinical Endocrinology

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“…Scintigraphy is performed rapidly, with a low radiation dose, and does not require patient preparation. Scintigraphy has been con- Fig.2a-c Case 2. a Lateral high-KV film of the neck shows anterior bowing of the trachea and thickening of the retropharyngeal soft tissues, b Noncontrast axial CT scan of the neck shows smooth extrinsic tracheal compression by a bilateral symmetric, high-density neck mass in the region of the thyroid glands, e Technetium99m pertechnetate thyroid scan shows intense uptake of radiotracer by the enlarged, slightly rounded lobes of the thyroid gland, which is in normal position sidered to be the gold standard by which the anatomical diagnosis of neonatal hypothyroidism is made [9]. Scintigraphic examination was requested by the clinical team on patient 2 to confirm that the mass seen on CT was indeed an enlarged thyroid gland (Fig.…”

Section: Discussionmentioning

confidence: 99%

Neonatal goiter: Imaging findings in two children

1996

Pediatr Radiol

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Neonatal goiter is a rare cause of a neck mass and stridor. Often, the diagnosis can be made on clinical grounds exclusively, but there may be times when a neck mass becomes a diagnostic dilemma. There are several different imaging modalities available to the clinician that are useful in the rapid diagnosis of neonatal goiter. Presently, however, there is no definite algorithm for the workup of a neonatal neck mass. The two cases presented here demonstrate the imaging findings of plain film radiography, sonography, scintigraphy, and CT in neonatal goiter.

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Technetium 99m pertechnetate thyroid scintigraphy: congenital hypothyroid screening

Cited by 17 publications

References 14 publications

The Key Role of Newborn Thyroid Scintigraphy With Isotopic Iodide (123I) in Defining and Managing Congenital Hypothyroidism

The Key Role of Newborn Thyroid Scintigraphy With Isotopic Iodide (123I) in Defining and Managing Congenital Hypothyroidism

Accuracy of ultrasonography to establish the diagnosis and aetiology of permanent primary congenital hypothyroidism

Neonatal goiter: Imaging findings in two children

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