Update 2019 zur MIBI-Szintigrafie bei hypofunktionellen Schilddrüsenknoten

Schmidt, Matthias; Schenke, Simone

doi:10.1055/a-0916-6238

Cited by 8 publications

(10 citation statements)

References 50 publications

(53 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Pathophysiologie und Indikationen MIBI ist ein lipophiler kationischer Komplex, der über passive Diffusion in Abhängigkeit von der Durchblutung und der Zellzusammensetzung in das Nebenschilddrüsengewebe aufgenommen wird und durch Bindung an die negativ geladene Zellmembran der mitochondrienreichen, überwiegend onkozytären (oxyphilen) Zellen in der Zelle akkumuliert. Der Washout von MIBI aus dem umgebenden, gesunden Nebenschilddrüsen-und Schilddrüsengewebe ist typischerweise schneller als aus Nebenschilddrüsenadenomen oder hyperplastischem Nebenschilddrüsengewebe [6], [11], [12], [13], [14], [15], [16]. Diesen Effekt macht man sich bei der Bildgebung mit der planaren Zweiphasentechnik zunutze.…”

Section: Mibi)unclassified

See 1 more Smart Citation

Konventionelle nuklearmedizinische Bildgebung bei Hyperparathyreoidismus

Schenke¹,

Zimny²,

Kreißl³

2021

Radiopraxis

Self Cite

View full text Add to dashboard Cite

Section: Mibi)unclassified

“…Es kommt zu einer Akkumulation in mitochondrienreichen bzw. hypervaskulären Schilddrüsenknoten, was zu falsch-positiven Befunden führen kann [13], [15]. Zusätzlich können je nach Verfügbarkeit tomografische Aufnahmen (SPECT, SPECT/CT)typischerweise nach den planaren Spätaufnahmenangefertigt werden [14], [20] (s. a. Fallbeispiel 2).…”

Section: Mibi)unclassified

Konventionelle nuklearmedizinische Bildgebung bei Hyperparathyreoidismus

Schenke¹,

Zimny²,

Kreißl³

2021

Radiopraxis

Self Cite

View full text Add to dashboard Cite

“…below the thoracic aperture), and should not be performed on patients on anticoagulant therapy [6]. Molecular imaging with 99m Tc-methoxy-isobutyl-isonitrile ( 99m Tc-MIBI, MIBI) has been used in the assessment of TNs for more than two decades [7][8][9]. MIBI is a lipophilic cation and member of the isonitrile family.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies showed that a MIBI negative TN has a high probability of being a benign lesion [10,[13][14][15], thus, making MIBI imaging a suitable tool to ruleout malignancy. On the other hand, relatively low specificity and accuracy have been described [6][7][8]. Selecting hypofunctioning nodules for MIBI imaging increases the overall accuracy, as hyperfunctioning nodules are commonly benign but MIBI positive due to an increased vascularization and higher proliferation rate of hyperfunctioning follicular cells.…”

Section: Introductionmentioning

confidence: 99%

“…Selecting hypofunctioning nodules for MIBI imaging increases the overall accuracy, as hyperfunctioning nodules are commonly benign but MIBI positive due to an increased vascularization and higher proliferation rate of hyperfunctioning follicular cells. Even in hypofunctioning nodules, however, different technologies (i.e., planar and SPECT images), injected activities, protocols, and image interpretation criteria account for heterogeneous results reported in the literature [7]. Therefore, the present study was undertaken to assess the clinical use and methodology of MIBI imaging in patients with nodular thyroid disease in Europe.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A multicenter survey of current practices of 99mTc-methoxy-isobutyl-isonitrile (MIBI) imaging for the diagnosis of thyroid nodules: more standardization is essential

Schenke

Campennì

Tuncel

et al. 2021

Clin Transl Imaging

View full text Add to dashboard Cite

Purpose Molecular imaging with 99mTc-methoxy-isobutyl-isonitrile (99mTc-MIBI, MIBI) has been used in the assessment of thyroid nodules (TNs) for more than two decades. Many studies showed that MIBI imaging is a suitable tool to rule-out malignancy when negative. However, relatively low specificity and accuracy have been described, thus, limiting its acceptance in clinical practice. Additionally, different technologies, protocols, and interpretation criteria are adopted accounting for heterogeneous data reported in the literature. Therefore, the present study was undertaken to assess the clinical use and methodology of MIBI imaging in patients with nodular thyroid disease in Europe. Methods A questionnaire was sent to 12 European centers of Nuclear Medicine. The questionnaire encompassed ultrasound (US) and fine-needle aspiration cytology (FNAC) procedures and their evaluation as well scintigraphy imaging indications, technical procedures, and interpretation criteria of MIBI imaging. Results The survey showed a good agreement of different centers in approaching TNs by TSH measurement, US evaluation and 99mTc-pertechnetate thyroid scintigraphy. MIBI imaging is mainly used to assess TNs with inconclusive/indeterminate cytological findings and selection of target nodule(s) for FNAC in patients with multi-nodular goiter. Technical procedures adopted in different centers are globally comparable and the recorded differences are unlikely to impact clinical results. However, as the main result of the present study, substantial differences were found in interpretation criteria adopted in different centers. Conclusions Our survey supports the urgent need of standardized interpretation criteria of thyroid MIBI imaging in order to improve its diagnostic performance and make results comparable in clinical practice.

show abstract

Integrated Thyroid Imaging: Ultrasound and Scintigraphy

Schenke

Groener

Grunert³

et al. 2023

Integrated Diagnostics and Theranostics of Thyroid Diseases

View full text Add to dashboard Cite

Thyroid sonography has made substantial progress over the last decades in terms of spatial resolution and additional parameters including vascularity, perfusion, and elasticity of lesions. The improved depictability of thyroid nodules has led to a more detailed sonographic characterization of malignant thyroid nodules considering features like microcalcification, capsular invasion, and reduced elasticity. Thus, ultrasound (US) has become the most important single tool for risk assessment of thyroid nodules. Predominantly cystic and spongiform nodules as well as many nodules with a mixed composition of solid and cystic components can safely be identified as benign on ultrasound and need no further work-up for risk assessment. Predominantly solid nodules, however, require a structured and consistent sonographic assessment including the evaluation of nodule composition, echogenicity, calcifications, shape, margins, and additional sonographic parameters. One should adhere to one of the TIRADS when reporting ultrasound findings on thyroid nodules categorizing each nodule to a certain risk class. However, the risk of malignancy reported in studies for each class may not be readily transferrable to daily routine, since the prevalence of malignant nodules in tertiary care centers is as high as 20% whereas in primary care units the prevalence may be as low as 1 per mille, thus lowering positive predictive values by one to two orders of magnitude. In addition, some suspicious features found in those studies may not be directly transferable to daily practice: microcalcifications are often difficult to discern from benign colloidal spots, even after having run through learning sessions; a taller-than-wide shape of nodules with contact to the dorsal parts of the thyroid gland does not imply malignancy according to a pole concept which has been recently developed.Thyroid scintigraphy (TS) has long been an indispensable modality for functional characterization of thyroid nodules. It should be applied to rule out malignancy in a substantial proportion of predominantly solid nodules by showing a hyperfunctioning (“hot”) nodule. Such nodules are almost always benign with few exceptions (e.g., “trapping only” nodules). If laboratory findings and scintigraphic appearance of a hot nodule do not match, further diagnostic work-up is warranted including 123I− scintigraphy with late imaging at 24 h and fine-needle aspiration cytology (FNAC). In settings with a rather low prevalence of malignant thyroid nodules such as in primary or secondary care units, a combined use of US and TS may be adopted to rule in suspicious nodules for further work-up by FNAC, including predominantly solid hypofunctioning (“cold”) nodules. MIBI scintigraphy can be used in hypofunctioning nodules with indeterminate cytology and if contraindications preclude patients from FNAC.TS is a valuable tool to detect functional abnormalities not only in nodules but also in the thyroid gland as a whole by assessing the overall radionuclide uptake. As such, it has long been used to confirm the diagnosis of Graves’ disease and thyroid autonomy. For disseminated autonomy, it is the only tool to definitely verify the diagnosis. In destructive thyroiditis, TS reliably shows a reduced overall radionuclide uptake justifying its application in selected cases with doubtful sonographic or laboratory findings. The user of TS is encouraged to calculate a site-specific normal range for the uptake value normalized to TSH in addition to the raw uptake. Thus, even subtle functional disorders of the thyroid can be detected and graded.Functional or metabolic imaging is increasingly combined with morphological imaging and is acquired and displayed as volume data rather than planar images including SPECT/CT, PET/CT, and PET/MRI. These combined modalities increase the restricted morphological field of view from ultrasound enabling to reliably image substernal, ectopic, or dystopic localizations of thyroid tissue. Combined modalities also benefit from the increasing spectrum of functional or metabolic tracers including MIBI, iodine isotopes (e.g., 124I-) and newer PET tracers.

show abstract

Update 2019 zur MIBI-Szintigrafie bei hypofunktionellen Schilddrüsenknoten

Cited by 8 publications

References 50 publications

Konventionelle nuklearmedizinische Bildgebung bei Hyperparathyreoidismus

Konventionelle nuklearmedizinische Bildgebung bei Hyperparathyreoidismus

A multicenter survey of current practices of 99mTc-methoxy-isobutyl-isonitrile (MIBI) imaging for the diagnosis of thyroid nodules: more standardization is essential

Integrated Thyroid Imaging: Ultrasound and Scintigraphy

Contact Info

Product

Resources

About