Thallium-201 scan in evaluating thyroid nodules following equivocal fine-needle aspiration cytology

J. K. Lee; R. S. Liu; S. Y. Wu; W. S. Huang; M. C. Chou

doi:10.1055/s-0038-1625220

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2006; 45(05): 201-205
DOI: 10.1055/s-0038-1625220

Original Articles

Schattauer GmbH

Thallium-201 scan in evaluating thyroid nodules following equivocal fine-needle aspiration cytology

Thallium-201-Szintigraphie zur Beurteilung von Schilddrüsenknoten bei unklarer Feinnadelaspirationszytologie

J. K. Lee

¹Department of Nuclear Medicine, Chung-Shan Medical University Hospital, Taichung

,

R. S. Liu

²Taipei Veterans General Hospital, Taipei

,

S. Y. Wu

³Nuclear Medicine Service, Veterans’ Administration-University of California Irvine Healthcare System, Long Beach, CA, USA

,

W. S. Huang

⁴Tri-Service General Hospital, Taipei, Taiwan

,

M. C. Chou

⁵Department of Surgery, Chung-Shan Medical University Hospital, Taichung

› Author Affiliations

Abstract

Summary:

The aim of this prospective study was to evaluate the usefulness of the thallium-201 (²⁰¹Tl) thyroid scan in the detection of malignancy in cold thyroid nodules whose status was equivocal following palpation fine-needle aspiration cytology (FNAC). Patients, methods: Fifty-one patients with clinically palpable solitary cold thyroid nodules classified as non-diagnostic or suspicious following biopsy underwent ²⁰¹Tl thyroid scans. Each scan was performed 15 min (early scan) and 3 h (delayed scan) after an intravenous administration of 74 MBq ²⁰¹Tl. Thallium uptake in the nodules was visually assessed and scored on a three point scale, with a grade of three defining malignancy. All patients underwent surgery and the histopathology of nodule tissues were compared with results of the scans. Results: Fifty-one nodules were examined. Forty were benign and 11 were malignant. For early scans, the diagnostically relevant parameters were: sensitivity (100%), specificity (75%), and accuracy (80%). Corresponding findings for the delayed scan were: 91%, 98%, and 96%. Conclusion: The ²⁰¹Tl scan is useful for detecting malignancy in cold thyroid nodules classified as nondiagnostic or suspicious lesions by FNAC.

Zusammenfassung:

In dieser prospektiven Studie sollte der Nutzen einer Thallium- 201-(²⁰¹Tl)-Schilddrüsenszintigraphie zum Nachweis der Malignität von kalten Schilddrüsenknoten, deren Status nach Palpation und Feinnadelaspirationszytologie (FNAC) unklar war, untersucht werden. Patienten, Methodik: Bei 51 Patienten mit klinisch tastbaren, solitären kalten Schilddrüsenknoten, die einen unklaren oder malignitätsverdächtigen feinnadelzytologischen Befund aufwiesen, erfolgte eine ²⁰¹Tl-Schilddrüsenszintigraphie. Es erfolgten jeweils 15 Minuten (Frühaufnahme) und drei Stunden (Spätaufnahme) nach intravenöser Verabreichung von 74 MBq ²⁰¹Tl planare Szintigraphien. Die Thalliumaufnahme in die Knoten wurde visuell beurteilt und auf einer Dreipunkteskala bewertet; Grad 3 definierte dabei Malignität. Alle Patienten unterzogen sich einer Operation, der histopathologische Befund des Knotengewebes wurde mit den Ergebnissen der Szintigraphie verglichen. Ergebnisse: 51 Knoten wurden untersucht. 40 waren gutartig, 11 waren bösartig. Bei den Frühszintigraphien waren die diagnostisch relevanten Parameter: Sensitivität (100%), Spezifität (75%) und Genauigkeit (80%). Die entsprechenden Ergebnisse für das Spätszintigramm lagen bei 91%, 98% und 96%. Schlussfolgerung: Die ²⁰¹Tl-Szintigraphie eignet sich zum Nachweis der Malignität von kalten Schilddrüsenknoten, die anhand der FNAC als nicht diagnostizierbare oder als verdächtige Läsionen klassifiziert werden.

Key words:

Thallium-201 scan - fine-needle aspiration cytology - cold thyroid nodule - malignancy

Schlüsselwörter:

Thallium-201-Szintigraphie - Feinnadelaspirationszytologie - kalter Schilddrüsenknoten - Malignität

Full Text

References

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