Endocrine Abstracts

Introduction: Scintigraphy had long been the only modality for thyroid gland imaging. With the development of other imaging techniques (sonography, CT, MRI), the role of scintigraphy has gradually diminished. However, it cannot be completely ignored, as it is the only technique to image not only the morphological structure, but also the functional status of the thyroid gland. In the current clinical practice, thyroid scintigraphy is performed with ^99mTc pertechnetate, ¹³¹I (¹²³I) at selected facilities and ^99mTc MIBI in some indications.

Possible uses of scintigraphy: i) Toxic goiter, independent adenoma, multinodular goiter (Figs 1–5).

ii) Functional residues of the thyroid gland after surgery (Figs 6–9).

iii) Ectopic thyroid gland.

iv) Thyroid nodules.

^99mTc pertechnetate hypofunctional (scintigraphically ‘cold’) and ^99mTc MIBI functional (scintigrafically ‘hot’) nodules have a relatively significant malignant potential (Figs 10–14).

v) ¹³¹I scintigraphy.

Irreplaceable in patients after thyroid gland surgery due to thyroid cancer for visualization of thyroid gland residues and distant metastases (Figs 14–16).

vi) Differential diagnosis of subacute deQuervain’s thyroiditis with toxic syndrome (blockage of the accumulation of radiopharmaceuticals) and immunogenic hyperthyroidism (increased accumulation). (Figs 17–19)

vii) Parathyroid adenoma (Figs 20–22).

Conclusion: Thyroid scintigraphy has an irreplaceable role in the confirmation of thyroid residues after total thyroidectomy (carcinoma, Graves’ hyperthyroidism with orbitopathy) and localization of parathyroid adenomas. It is an elegant method for differential diagnosis of the thyrotoxic syndrome in patients with subacute thyroiditis and Graves’ disease. It provides a complementary technique for detailed specification of thyroid gland nodules.

Figs 1–22 will be part of the poster.