Abstract
To test whether delayed thallium image can improve the diagnostic accuracy of thyroid tumor, we have reviewed 35 patients with cold nodules of proven histopathology. Early and delayed images were taken 10–20 min and 3–4 hr postinjection, respectively. In this study, a thyroid nodule was interpreted as malignant if it had normal or increased uptake on early scan and more residual radioactivity than paranodular tissue on delayed scan. In the eighteen patients who had carcinoma, a disappointing 44% false negative rate was observed. No significant difference was seen between retention-positive and negative cases in tumor size or histological type of cancer. Nor could any demographic bias explain the low sensitivity. Of the six false negatives, macroscopic cystic degeneration was seen in two cases, but tumors in the other four were grossly solid. Considering the histological heterogeneity often seen within a thyroid tumor, the portion with increased retention of radiothallium may be too small to be detected in the false negative cases. Furthermore, 3 false positive readings were obtained in 17 patients with benign conditions. We conclude that the contribution of the delayed thallium image was quite limited in predicting or ruling out malignancy in nodular goiters.
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Fukuchi M, Tachibana K, Kuwata K, et al: Thallium-201 imaging in thyroid carcinoma—appearance of a lymph node metastasis.J Nucl Med 19: 195–196, 1978
Tonami N, Bunko H, Michigishi T, et al: Clinical application of201Tl scintigraphy in patients with cold thyroid nodules.Clin Nucl Med 3: 217–221, 1978
Palermo F, Bruniera F, Caldato L, et al:201Tl in the scintigraphic evaluation of the “cold” thyroid areas.Eur J Nucl Med 4: 43–48, 1979
Harada T, Ito Y, Shimaoka K, et al: Clinical evaluation of201Thallium chloride scan for thyroid nodule.Eur J Nucl Med 5: 125–130, 1980
Höschl R, Murray IPC, McLean RG, et al: Radio-thallium scintigraphy in solitary nonfunctioning thyroid nodules.World J Surg 8: 956–962, 1984
Makimoto K, Ohmura M, Tamada A, et al: Combined scintiscans in the diagnosis of thyroid carcinomas.Acta Otolaryngol Suppl 419: 189–194, 1985
Ikekubo K, Higa T, Hirasa M, et al: Evaluation of radionuclide imaging and echography in the diagnosis of thyroid nodules.Clin Nucl Med 11: 145–149, 1986
Ochi H, Sawa H, Fukuda T, et al: Thallium-201-chloride thyroid scintigraphy to evaluate benign and/ or malignant nodules: Usefulness of the delayed scan.Cancer 50: 236–240, 1982
Henze E, Roth J, Boerer H, et al: Diagnostic value of early and delayed201T1 thyroid scintigraphy in the evaluation of cold nodules for malignancy.Eur J Nucl Med 11:413–416, 1986
Bleichrodt RP, Vermey A, Piers DA, et al: Early and delayed thallium 201 imaging: Diagnosis of patients with cold thyroid nodules.Cancer 60: 2621–2623, 1987
The Japan Society of Thyroid Surgery: General rules for the description of thyroid cancer, Tokyo, Kanehara & Co., 1983
LiVolsi VA: Pathology of thyroid disease. In Thyroid disease: Endocrinology, surgery, nuclear medicine, and radiotherapy, Falk SA, (ed.), New York,Raven Press, pp. 127–175, 1990
Tennvall J, Palmer J, Cederquist E, et al: Scintigraphic evaluation and dynamic studies with thallium-201 in thyroid lesions with suspected cancer.Eur J Nucl Med 6: 295–300, 1981
Palermo F, Saitta B, Coghetto F, et al: Computerized study with201Tl of the cold thyroid node.Nucl Med 21: 23–29, 1982
Hamburger JI: Getting the most out of fine needle biopsy. In Thyroid disease: Endocrinology, surgery, nuclear medicine, and radiotherapy, Falk SA, (ed.), New York,Raven Press, pp. 361–368, 1990
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Misaki, T., Yagi, K., Dokoh, S. et al. Limited value of delayed radiothallium image in the diagnosis of nodular goiter. Ann Nucl Med 5, 65–68 (1991). https://doi.org/10.1007/BF03164616
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DOI: https://doi.org/10.1007/BF03164616