Functional and molecular thyroid imaging

Q J Nucl Med Mol Imaging. 2022 Jun;66(2):86-92. doi: 10.23736/S1824-4785.22.03428-8. Epub 2022 Feb 15.

Abstract

Nuclear medicine methods were introduced in the 1940s for thyroid disease diagnosis and therapy. They is still a crucial part of thyroid nodules work-up. Thyroid imaging with iodine or iodine-analog isotopes is widely employed in patients with thyrotoxicosis and remains the only examination able to prove the presence of autonomously functioning thyroid tissue, which excludes malignancy with a high probability. In addition, technetium-99m-methoxyisobutylisonitrile ([99mTc]Tc-MIBI) scintigraphy and positron emission tomography/computed tomography (PET/CT) with 18F-fluoro-2-deoxy-d-glucose ([18F]FDG) are able to avoid unnecessary surgical procedures for cytologically inconclusive thyroid nodules, as confirmed by meta-analysis and cost-effectiveness studies. All considered thyroid molecular imaging allows functional characterization of different thyroid diseases, even before clinical symptoms become manifest, and remains integral to the management of such conditions. This paper summarizes main concepts of thyroid scintigraphy and its clinical use. In addition, it elaborates development of thyroid scintigraphy, as well as thyroid molecular imaging in patients with thyroid nodules and thyrotoxicosis.

Publication types

  • Meta-Analysis

MeSH terms

  • Fluorodeoxyglucose F18
  • Humans
  • Iodine*
  • Positron Emission Tomography Computed Tomography
  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi
  • Thyroid Neoplasms*
  • Thyroid Nodule* / diagnostic imaging
  • Thyroid Nodule* / pathology
  • Thyroid Nodule* / surgery
  • Thyrotoxicosis* / diagnostic imaging

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Iodine
  • Technetium Tc 99m Sestamibi