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Reverse discordant scintigraphy in diffuse goiter

A W Huiskes1, J M De Klerk, P M Zelissen

  • 1Department of Nuclear Medicine, University Hospital Utrecht, The Netherlands.

Clinical Nuclear Medicine
|September 15, 1998
PubMed
Summary
This summary is machine-generated.

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Technetium-99m pertechnetate and radioactive iodine provide similar thyroid imaging information. A rare case of "reverse discordant" behavior, with decreased Tc-99m uptake and normal iodine uptake, was observed in subclinical hyperthyroidism.

Area of Science:

  • Nuclear medicine
  • Radiopharmaceutical imaging
  • Thyroid diagnostics

Background:

  • Technetium-99m pertechnetate and radioactive iodine (I-123 NaI, I-131 NaI) are standard radiopharmaceuticals for thyroid scintigraphy.
  • These agents typically provide comparable functional information about the thyroid gland.

Observation:

  • Discordant thyroid scintigraphy findings (e.g., hot on pertechnetate, cold on iodide) are occasionally reported, primarily in solitary thyroid nodules.
  • This report details a unique case exhibiting diffusely decreased Tc-99m pertechnetate uptake concurrent with normal radioactive iodine (I-131 NaI) uptake.

Findings:

  • The observed pattern represents a rare "reverse discordant" behavior in thyroid scintigraphy.
  • This phenomenon occurred in a patient diagnosed with diffuse goiter and subclinical hyperthyroidism.

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Implications:

  • Highlights the potential for discordant results beyond solitary nodules, emphasizing the need for careful interpretation.
  • Suggests that "reverse discordant" patterns may be associated with specific thyroid conditions like subclinical hyperthyroidism.
  • Underscores the complementary roles of different radiopharmaceuticals in comprehensive thyroid evaluation.