Technetium-99m (99mTc) and Iodine-123 (123I) in comparison with thyroid ultrasonography in the differential diagnosis of Saudi patients with Graves, disease

In thyroid autoimmune diseases diagnosis, there is growing evidence that thyroid ultrasonography (US) can be helpful without accurate differentiation of Graves’ disease GD from other autoimmune diseases. Using histopathological findings as a reference standard, this study aimed to determine the diagnostic accuracy of ^99mTc and ¹²³I in comparison with US for the differential diagnosis of GD in Saudi patients. Results demonstrated that thyroid scintigraphy using ^99mTc (sensitivity = 96.1 vs. 23.5%) and ¹²³I (sensitivity = 83.33 vs. 25%) was superior to US in detection of GD in Saudi patients. All GD patients detected by US were detected by both ^99mTc and ¹²³I scans, whereas, ^99mTc (37/39) and ¹²³I (14/18) scans detected many patients from GD cases that US failed to detect. This superiority was found regardless of gender and age particularly in ^99mTc scan. In the same group of patients, both ^99mTc and ¹²³I scans had the same sensitivity (80%) (P = 0.151). In conclusion, the conducting study findings proved that ^99mTc and ¹²³I thyroid scintigraphy scans could be used in the differential diagnosis of GD from other thyroiditis disorders with a higher degree of diagnostic accuracy.