Thyroid Scintigram Research Articles

Occurrence of papillary carcinoma in hyperfunctioning thyroid nodule. Report of a case.

A female patient with a solitary functioning nodule of the thyroid was operated upon. She had clinical symptoms of thyrotoxicosis and the thyroid scintigram showed a “hot” nodule corresponding to the palpable nodule. A cold area was noted in the “hot” nodule. At operation, a 1.6 by 2cm papillary carcinoma was found to be embedded within a functioning follicular adenoma, and metastatic foci were detected histologically in the ipsilateral paratracheal lymph nodes.

Functional cystic parathyroid adenoma

An unusual case of hyperparathyroidism associated with an 85 gm. cystic functioning adenoma is described. The mass had enlarged suddenly and presented as a hemorrhagic thyroid cyst. Thyroid scintigram was compatible with a “cold” nodule of the thyroid gland. The correct diagnosis was made when a high serum calcium level was obtained in the immediate preoperative workup. Clinically palpable parathyroid adenomas occur often enough to justify routine serum calcium and phosphorus determinations in patients who present with masses in the neck, and hypercalcemia should be considered in the differential diagnosis in hypertensive patients.

A Comparison of Thyroid Scintigrams between by Scanner and by Camera

シソチカメラ (Anger type) は構造上RIの量に応じて検査時間を短縮できるので血流動態の形態的検索に利用される。しかしその分解能も従来のスキャンナーと比較して決して劣らない利点も備えている。この点に注目して主としてピンホール・コリメーターの場合に甲状腺シソチグラムの診断能をスキャンナーによるシンチグラムと比較した。線状線源を利用した模型実験とともに実際の臨床例を加えてシソチグラム診断能および検査における両装置の得失について述ぺる。

The thyroid scintigram. II. The cold nodule.

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...

THE THYROID SCINTIGRAM. I. THE HOT NODULE.

The thyroid scintigram is a map of the distribution of radioactive iodine within the thyroid gland. To extract clinically useful information from it, correlation with palpable thyroid abnormalities, pathophysiology, and microscopic anatomy is required. The initial attempt at such correlation was undertaken in cases presenting a problem in preoperative identification of the malignant nodule. As the low level of functional activity of thyroid cancer was well known, it seemed reasonable to attempt to correlate apparent function in terms of scintigram activity and pathological anatomy (1–7). The first classification compared the radioactivity in suspect areas of the scintigram with that in areas presumed to represent the normal portions of the thyroid gland. The basis of this classification was a visual inspection of the concentration of marks recorded or the degree of blackening of a photographic film. The darker a given area on the scintigram the greater the radioactivity (and presumably the function) of the corresponding area of the thyroid as seen by the detector. The descriptive terms “hot nodule,” “warm nodule,” “cool nodule,” and “cold nodule” were introduced into the medical literature to express the above comparisons (8–11). These inexact estimates gained favor, since technical considerations in the production of the scintigram made absolute standards of comparison impractical. Definition A “hot” nodule has usually been defined as one concentrating radioactive iodine to a greater degree than the remaining thyroid tissue (1, 12–14). This diagnosis has carried with it the implication of localized hyperfunction (1, 15). In an attempt to define what should be accepted as a “hot nodule” in a more quantitative fashion, Perlmutter and Slater suggested that the count rate should be 125 per cent or more of the symmetrical contralateral portion of the gland (11). The emphasis on the physical appearance of the scan and relative count rates has delayed recognition of the fact that the scintigram pattern described above may be associated with diverse pathophysiology. All the following conditions would qualify as “hot nodules” as currently defined: (a) The autonomous hyperfunctioning thyroid lesion. (b) Tissue of relatively normal function with surrounding areas of degeneration or thyroiditis. (c) A normal, hyperplastic, or nodular lobe with congenital or acquired absence of the other lobe. “Acquired” includes total or subtotal surgical resection. (d) A prominently lobulated gland with sufficient asymmetry that by virtue of greater mass alone one lobe or one area contains significantly more radioactive iodine than the other. (Toxic dependent goiter [Graves' disease] may present in such a fashion.) Perlmutter and Slater even made reference to a functioning cervical node metastasis following total thyroidectomy for thyroid carcinoma as an example of a “hot nodule.”

ReviewSavoir Interpréter la Scintigraphie du corps thyroide. By SavoieJ. C. and ValleeG., pp. 102, 1964 (Brussels. Albert de Visscher), Frs. b. 150.

In an increasing number of types of diagnostic investigation, the clinician needs to have a substantial understanding of the scope and limitations of the techniques used if he is to make the fullest use of the results or reports that he receives. The “Savoir Interpréter” series is designed to meet this need, and the present small handbook goes much of the way towards explaining the use of thyroid scintigrams in clinical problems, in a manner that will be clear to the man who is a specialist neither in thyroid diseases nor in counting methods.

An Attempt of Getting Standard Technique for the Thyroid Scintigram

An Attempt of Getting Standard Technique for the Thyroid Scintigram

Thyroid gland weight determination from thyroid scintigrams with postmortem verification.

The determination of the weight of the human thyroid gland has become extremely important since the introduction of I131 in the treatment of hyperthyroidism. In most clinics estimates of the weight of the gland are obtained by palpation, which at best is a crude procedure. Allen and Goodwin (1) have recently described a more accurate method. The point-by-point technic of plotting the frontal area occupied by the thyroid gland used by Allen, Libby, and Cassen (2) has been simplified by the introduction of the “scintiscanner” (3, 4) for obtaining an actual size scintigram of the gland. The formula presented by Allen and Goodwin can be readily applied to measurements obtained from a scintigram. In the Wads-worth General Hospital (Los Angeles) this procedure has become routine in the determination of dosages of I131 for the treatment of hyperthyroidism and intractable heart disease (5). As the constant in the formula of Allen and Goodwin was obtained from a very limited series of autopsy and surgical material...