The usefulness of [99mTc]MIBI scintigraphy in the diagnostic algorithm of ultrasonographical suspected thyroid nodules by using EU-TIRADS criteria.

Pub Date : 2023-01-01 DOI:10.5603/NMR.a2023.0002
Nevena Manevska, Tanja Makazlieva, Bojana Stoilovska Rizova, Sinisa Stojanoski
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Abstract

Background: Although not yet involved in the algorithm of thyroid nodules, 99mTc-methoxy-isobutyl-isonitrile ([99mTc]MIBI) scintigraphy may help in the individual diagnostic workup of a thyroid patient, especially where indeterminate fine needle aspiration biopsy (FNAB) is present. The aim of this study was to evaluate the usefulness of [99mTc]MIBI thyroid scintigraphy in the diagnostic algorithm of thyroid nodules, particularly in ultrasound EU-TIRADS 4 or 5 lesions, that cytologically were either indeterminate or benign.

Material and m: ETHODS: A retrospective randomized study, including 42 thyroid patients, with mean age 47 ± 17 years, was conducted. [99mTc]MIBI scan was compared with ultrasound (US) EU-TIRADS criteria, pertechnetate scan, FNAB and histopathological findings for the differentiation of malignant thyroid nodules from benign lesions.

Results: The US mainly detected hypoechoic inhomogeneous presentation of the thyroid nodules (35/42, 83.33%), 4 cases with isoechoic nodules and 2 cases presented with hyperechoic thyroid nodules. Histopathology revealed malignancy in 15/42 (35.71%), while all other patients 27/42 (64.29%) were benign. Visual analysis score showed that patients scored with 1+ and 2+ were statistically significant to be benign, while 13 vs. 10 pts that were visual score 3+ were malignant vs. benign (p > 0.05). Sensitivity was 100%, while specificity was very low 22.22%, PPV was 41.67%.

Conclusions: Even [99mTc]MIBI scan is not routinely used as a daily practice diagnostic tool of thyroid nodules, we will further apply it on a larger group of patients and try to quantify the uptake of the radiotracer to see whether it will help in the diagnostic algorithm of thyroid nodules.

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[99mTc]MIBI闪烁成像在EU-TIRADS标准超声诊断甲状腺结节中的应用
背景:99m锝-甲氧基-异丁基-异腈([99m锝]MIBI)闪烁扫描虽然尚未被纳入甲状腺结节的诊断算法,但它可能有助于甲状腺患者的个体诊断工作,尤其是在细针穿刺活检(FNAB)存在不确定性的情况下。本研究旨在评估[99m锝]MIBI甲状腺闪烁扫描在甲状腺结节诊断算法中的作用,特别是在超声EU-TIRADS 4或5病变中,细胞学上为不确定或良性。将[99m锝]MIBI扫描与超声(US)EU-TIRADS标准、过硫酸盐扫描、FNAB和组织病理学结果进行比较,以区分恶性甲状腺结节和良性病变:超声检查主要发现甲状腺结节呈低回声不均匀表现(35/42,83.33%),4 例为等回声结节,2 例为高回声甲状腺结节。组织病理学显示,15/42(35.71%)的患者为恶性,而其他 27/42(64.29%)的患者均为良性。肉眼分析评分显示,评分为1+和2+的患者良性的统计学意义显著,而肉眼评分为3+的患者中,恶性的有13例,良性的有10例(P > 0.05)。敏感性为100%,特异性仅为22.22%,PPV为41.67%:即使[99m锝]MIBI扫描并未被常规用作甲状腺结节的日常诊断工具,我们也将在更大的患者群体中进一步应用,并尝试量化放射性示踪剂的摄取量,以确定它是否有助于甲状腺结节的诊断算法。
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