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General Clinical Specialties: EndocrinologyEndocrinology Posters |
1 Div Nucl Med; 2 Div Endo, Washington Hospital Ctr, Washington, District of Columbia
1040
Objectives: The utility of thyroid scintigraphy (TS) prior to radioiodine (RAI) ablation in patients with Graves' disease (GD) is controversial. The objective of this study was to assess how frequently TS showed abnormal findings that could alter the management of the patient with GD.
Methods: A retrospective review was performed of all patients who 1) had a TS performed between Sept 2005 and Oct 2007, 2) were referred for thyrotoxicosis, 3) elevated RAI uptake, and 4) had one or more of the following: a diagnosis of GD from their endocrinologist, clinical presentation classical for GD, and/or findings on their TS strongly suggestive of GD (e.g. large size, visually increased uptake, and/or globular configuration). Any patients known to have multinodular goiter, a solitary nodule, Plummer's Disease, or subacute thyroiditis prior to the TS were excluded. One reader (DVN) blindly reviewed all TSs and characterized them as having either diffuse homogeneity, significant heterogeneity, focal area(s) of decreased activity, or focal area(s) of increased activity.
Results: Of 257 patients examined, 195 met the above criteria. The mean age (range) of these patients was 49.7 y.o. (21-92), and 80% were female. A total of 19% (36) had an abnormal scan, with 11% (21) who had heterogenous uptake and 11% (21) who had distinct cold areas. Also, 2 cases had areas of focally increased activity.
Conclusions: 1) Thyroid scintigraphy is useful in the detection of significant heterogeneity and hypofunctioning areas in patients with GD prior to RAI. 2) These findings could warrant either an increase in prescribe RAI activity or further evaluation for possible malignancy in as many as 1 in 5 patients.
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