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Radioisotopic investigations in endocrinology

Radioisotopic investigations in endocrinology. Indications: thyroid scintigraphy. hyperthyroidia thyroid nodes toxic adenoma thyroid neoplasia hipothyroidia thyroiditis pregnancy. Radiotracers:. 99m Tc , 123 I, 131 I uptake mechanism:

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Radioisotopic investigations in endocrinology

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  1. Radioisotopic investigations in endocrinology

  2. Indications: thyroid scintigraphy • hyperthyroidia • thyroid nodes • toxic adenoma • thyroid neoplasia • hipothyroidia • thyroiditis • pregnancy

  3. Radiotracers: • 99mTc , 123I, 131I • uptake mechanism: • active uptake; iodine = organification, hormones synthesis

  4. Image types: • planars (A, P, profil, oblics…) • tomographic Colimator: - paralel - pin-hole

  5. Interpretation: • Limits, shape • dimensions • intensity(hiperfixation/hipofixation) • uniformity(nodes?) • Quantification: rate node/normaltissue; LD/LS…; thyroid radiotracer uptake (%).

  6. 99mTcO4-scintigram: normal thyroid

  7. scintigraphic images semeiology: • omogen difuse hyperfixation = Basedow d. • difuse hypofixation = hypothyroidia? • Node with no uptake = liquid kyst?/ neoplasia? • Node with hyperfixation = toxic adenom? • Multiple nodes, hiperfixation… =TMNG

  8. 99mTcO4- • Conclusion: Basedow disease

  9. Node with no uptake (LTD)

  10. Node with no uptake (LTD)

  11. 99mTc / 123I (131I) Neoplasia: A - node with hypofixation LTS (99mTc); B - node with no fixation LTS (123I).

  12. 99mTc / 201Tl

  13. 99mTcO4-: multinodular goiter TcO4- uptake: 2,8% (n: 2 - 6%) T4(RIA): 9,4 (n: 6,5-13,5)

  14. Important • Iodine alergy do not c.i. the iodine scintigram • complementar investigations: TSH dosage, T3, T4; radioiodine uptake

  15. 131I whole body scintigram: • Thyroid neoplasia with multiple metastases (cervical, lung)

  16. 131I: • Basedow disease

  17. Precautions: • Different drugs which contain iodine may determine false images (ex. Amiodarone, contrast iodine substances), ATS, thyroid hormones... • 3- 6 weeks.

  18. Alte indica]ii • scintigrafia glandelor suprarenale: • dg.+ al feocromocitomului (MIBG) • d.d. adenom Conn / hiperplazie suprarenal\ • (analog de colesterol marcat cu 131I) • scintigrafia glandelor paratiroide: • dg. de adenom paratiroidian, dg. neoplasm paratiroidian (99mTc MIBI…)

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