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Thyroid scintigraphy: establishing a clinically useful normal range for 99mTc pertechnetate uptake.

Michael Grunert1,2, Simone Agnes Schenke3,4, Andrea Konrad1

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|July 31, 2024
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This study establishes a normal range for thyroid uptake using 99mTc pertechnetate scans, normalizing for TSH stimulation. This provides a clinically useful parameter for distinguishing thyroid disorders from raw uptake values.

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Area of Science:

  • Nuclear Medicine
  • Endocrinology
  • Radiopharmacology

Background:

  • Thyroid uptake scans using 99mTc pertechnetate are crucial for evaluating thyroid function.
  • Establishing a precise normal range for thyroid uptake is essential for accurate diagnosis of thyroid disorders.
  • Variations in uptake can be influenced by factors like TSH levels and iodine concentration.

Purpose of the Study:

  • To establish a normal range for thyroid uptake derived from 99mTc pertechnetate scans.
  • To investigate the influence of TSH stimulation and urinary iodine concentration on thyroid uptake values.
  • To compare normalized uptake values with raw uptake calculations for improved diagnostic accuracy.

Main Methods:

  • A prospective, multicentric study involving 125 healthy patients undergoing thyroid scans.
  • Patients were selected based on normal TSH, thyroid size, absence of antibodies, and no thyroid disorder symptoms.
  • Calculated raw Tc-uptake and normalized values (uptakeTSH1, uptakeTSH1&uic) considering TSH, iodine, gland volume, age, smoking, weight, and tissue thickness.

Main Results:

  • A positive correlation between thyroid uptake and TSH was observed, enabling calculation of a normalized uptake value (uptakeTSH1).
  • The normalized uptakeTSH1 range showed a clearer distinction from thyroid functional disorders compared to raw uptake.
  • Further normalization for urinary iodine concentration (uptakeTSH1&uic) potentially enhanced diagnostic power, while other factors were not significant.

Conclusions:

  • A normal range for thyroid uptake, normalized for TSH stimulation (uptakeTSH1), can be reliably established.
  • This normalized parameter offers a clinically useful alternative to raw uptake, with superior ability to differentiate thyroid functional disorders.
  • Normalization for TSH is effective, with potential additional benefit from urinary iodine concentration adjustment.