EANM practice guideline/SNMMI procedure standard for RAIU and thyroid scintigraphy



Scintigraphic evaluation of the thyroid gland enables determination of the iodine-123 iodide or the 99mTc-pertechnetate uptake and distribution and remains the most accurate method for the diagnosis and quantification of thyroid autonomy and the detection of ectopic thyroid tissue. In addition, thyroid scintigraphy and radioiodine uptake test are useful to discriminate hyperthyroidism from destructive thyrotoxicosis and iodine-induced hyperthyroidism, respectively.


Several radiopharmaceuticals are available to help in differentiating benign from malignant cytologically indeterminate thyroid nodules and for supporting clinical decision-making. This joint practice guideline/procedure standard from the European Association of Nuclear Medicine (EANM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) provides recommendations based on the available evidence in the literature.


The purpose of this practice guideline/procedure standard is to assist imaging specialists and clinicians in recommending, performing, and interpreting the results of thyroid scintigraphy (including positron emission tomography) with various radiopharmaceuticals and radioiodine uptake test in patients with different thyroid diseases.

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The authors thank the EANM and SNMMI committees and national delegates for their critical review of the manuscript. Also, we appreciate the great support of Sonja Niederkofler from the EANM office in Vienna and Julie Kauffman from the SNMMI office in Reston during the development of this guideline.

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Correspondence to Luca Giovanella.

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Conflict of interest

L.G. is member of Roche Diagnostics’ advisory board and has received research grants and speaker honoraria from Roche Diagnostics, IBSA, and Sanofi-Genzyme. F.A.V. has received research grants from Sanofi-Genzyme and speaker honoraria from Sanofi-Genzyme, Diasorin, and Jubilant Draximage. M.L. has received research grants and speaker honoraria from Sanofi-Genzyme, Bayer, and Astra Zeneca. Other authors declare that they have no conflicts of interest. E.W. states that the opinions and assertions expressed herein are his own opinions and do not necessarily reflect the official policy or position of the Department of Defense or the Department of Air Force of the USA.

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Giovanella, L., Avram, A.M., Iakovou, I. et al. EANM practice guideline/SNMMI procedure standard for RAIU and thyroid scintigraphy. Eur J Nucl Med Mol Imaging 46, 2514–2525 (2019). https://doi.org/10.1007/s00259-019-04472-8

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  • Thyroid
  • Scintigraphy
  • Radioiodine uptake test
  • 99mTc-sestaMIBI, 18F-fluorodeoxyglucose