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Radionuclide Therapy in Benign Thyroid Diseases: Nodular Goiter Disease

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Abstract

Thyroid nodules are very common and their prevalence is increased in older patients. Thyroid nodules can be palpated in about 5% of the population, and can be detected in up to 70% of people on ultrasound examination [1]. The majority of thyroid nodules derive from thyroid follicular cells. Benign follicular nodules, the most common mass lesions, can be single or part of a multinodular goiter. Benign thyroid nodules may tend to increase in size over time [2]. Therefore, the thyroid and cervical lymph nodes should be palpated for characterizing size, location, and texture during the routine physical examination. An ultrasonographic evaluation provides detailed information about the size and morphological structure of the gland and, if present, the thyroid nodules. In all patients with a thyroid nodule, serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) and/or free triiodothyronine (fT3) levels should be measured to determine thyroid gland function. A suppressed TSH level may be the biochemical sign of the presence of a hyperfunctioning nodule. In this case, information about the function of a thyroid nodule(s) can be detected from a technetium-99 thyroid scan. Correlating the thyroid ultrasonography and radionuclide scan can help to diagnose a toxic nodular goiter (TNG) or a toxic multinodular goiter (TMG). In cases with multinodular goiter, there may be tracheal compression and related respiratory distress symptoms. In this case, tracheal compression and tracheal deviation and, if any, retrosternal extension of the thyroid gland can be evaluated by non-contrast neck and upper mediastinal computed tomography [3].

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Correspondence to Özgür Karaçalıoğlu .

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Karaçalıoğlu, Ö. (2022). Radionuclide Therapy in Benign Thyroid Diseases: Nodular Goiter Disease. In: Bekiş, R., Polack, B., Bozkurt, M.F. (eds) Radionuclide Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-97220-2_4

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