Nuclear Medicine in the Assessment of Thyrotoxicosis Associated with Increased Thyroid Function and Radioiodine 131 Ablative Therapies

Abstract

Nuclear medicine is directly involved in both the diagnosis and treatment of benign thyroid disease. Thyroid scintigraphy (most commonly with technetium-99 m pertechnetate) should be used as the imaging modality of choice for assessment of thyrotoxicosis, since it demonstrates the functional state of the thyroid gland. An adequate understanding of the pathophysiological mechanisms and characteristics of the patient is essential, as well as the different treatments of thyroid disorders that present with hyperthyroidism (Graves' disease, toxic multinodular goiter, and toxic adenoma-Plummer's disease). Therapeutic modalities include antithyroid drugs, radioiodine and surgery. Antithyroid drugs are the first line of therapy and regarding the use of radioiodine, current recommendations consider it a safe and effective therapeutic alternative in hyperthyroidism. Finally, we highlight the existence of some special situations (children, pregnancy, thyroid eye disease, chronic renal failure and dialysis patients) and the importance of radiation protection measures to the patient, the public and professionals.

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“…Statistical significance was defined as Pvalue <0.05. The sensitivity determination and reliability of scintigraphy in the early identification of hyperthyroidism has been achieved through the use of sensitivity test, specificity, positive predictive value, and negative predictive value using the relevant formulas (Table 1) [13]:…”