The thyroid scintigram. II. The cold nodule.

Abstract

The Thyroid scintigram has not been found decisive for the identification of malignancy in thyroid nodules (1–12). Correct delineation of its sphere of usefulness has been delayed by three factors. First, proper attention has not been given to technical aspects of the scanning procedure. Second, many physicians have failed to interpret the scintigram in the light of the total information available from the patient. Third, there has been infrequent correlation of scintigram patterns and autoradiographs of the related tissue. In a previous publication we discussed the scintigram diagnosis of the hot autonomous nodule and offered arguments for its probable benign nature (13). Others have stressed the high incidence of thyroid cancer in cold nodules (1, 3, 5, 6, 14), a statistic heavily weighted by selection. They have called attention to the inverse correlation of function, as judged from the scintigram, and the probability of thyroid cancer. Nodules with little or no autonomous function have been subdivided...