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Radioisotopic Investigations in Endocrinology: Thyroid Scintigraphy Indications and Interpretation

Explore the role of radioisotopic investigations in endocrinology, focusing on thyroid scintigraphy for conditions like hyperthyroidism and thyroid neoplasia. Learn about radiotracers, image types, interpretation criteria, and quantification methods in this diagnostic procedure.

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Radioisotopic Investigations in Endocrinology: Thyroid Scintigraphy Indications and Interpretation

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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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