Scintigraphy of the thyroid gland with iodine. What is thyroid scintigraphy - indications, preparation and conduct of the study, side effects. Cost of thyroid and parathyroid scintigraphy

Radioisotope examination of the thyroid gland - scintigraphy - is not a new and well-proven diagnostic method.

The principle of scintigraphy is to register the process of accumulation of a radiopharmaceutical (RP) by the tissues of the thyroid gland and visualize the response radiation using special equipment (gamma camera). The analysis of the obtained images of the thyroid gland makes it possible to study in detail the functionality of the organ as a whole and each of its lobes separately, to identify the pathological changes occurring in the gland and to assess the degree of their severity.

Based on the conclusion of the scintigraphy, the doctor plans a scheme for further treatment and / or rehabilitation of the patient.

Indications

The endocrinologist prescribes thyroid scintigraphy only if there are certain indications:

anatomically incorrect location of the gland;
congenital anomalies in the structure or development of the thyroid gland;
thyrotoxicosis (differential diagnosis);
"Hot" (hyperfunctioning) and "cold" (non-functioning) nodes in the gland;
suspicion of tumor formations.

On a note: Thyrotoxicosis is a condition in which the thyroid gland intensively produces hormones, this is a symptom complex with

diffuse toxic goiter,
thyrotoxic adenoma of the thyroid gland (Plummer's disease),
subacute thyroiditis (de Quervain's disease),
autoimmune thyroiditis,
autoimmune ophthalmopathy,
vegetative-vascular dystonia, etc.

Therefore, if thyrotoxicosis is suspected, it is necessary to carry out differential (comparative) diagnostics by scintigraphy.

Contraindications

Direct (absolute) contraindications for scintigraphy are pregnancy at any time and individual intolerance to the substances that make up the RFP. Of the relative contraindications, experts distinguish the period of lactation (breastfeeding) and recommend that women refuse to feed their baby with breast milk only for the time the RFP is removed from the body (1-2 days).

Preparation for thyroid scintigraphy

No special preparations are required for thyroid scintigraphy. But in order to obtain more accurate results, it is recommended to stop taking medications a month before the planned procedure, leaving only vital drugs. Also, within 3 months before the examination, it is not advisable to undergo X-ray, computer and magnetic resonance diagnostics.

Methodology

Depending on the RFP used, one or two clinic visits may be required. The duration of the scan itself is 30 minutes.

Radioisotopes of iodine. They accumulate in the tissues of the thyroid gland during the day. Therefore, in the morning of one day, the patient comes to the clinic, take an oral (drink) RFP, and the next day, in the morning, a scan is performed.

Technetium radioisotopes. The substance is administered intravenously and accumulates in the gland within half an hour. After that, scintigraphy is performed.

Important! The use of technetium allows you to undergo an examination and get results in one day. Also, technetium is eliminated from the body much faster than radioactive iodine, and practically does not give side effects in the form of allergies.

Where is scintigraphy done?

Thyroid scintigraphy can only be done in the direction of an endocrinologist. Usually this procedure is paid, regardless of the institution in which it is carried out (in a private medical center or a public hospital). Therefore, you should opt for the clinic where the examination is carried out by qualified specialists using modern high-tech equipment.

Procedure safety

Scintigraphy is a safe procedure, contrary to popular belief. Radioactive substances are removed from the body within 24 hours without causing any harm to healthy tissues and organs. After the examination, it is recommended to drink more fluids in order to increase urination and speed up the process of RFP elimination. It is also advisable to immediately take a hygienic shower, wash your hair with shampoo, and wash the clothes in which the examination was carried out.

Scintigraphy is a painless procedure, does not cause any particular discomfort to the patient, and is usually easily tolerated by patients. Examination with technetium is allowed even for young children and babies.

On a note: re-scintigraphy may be required to monitor the effectiveness of the prescribed treatment. Usually, the procedure is performed 2 months after the initial examination.

Thyroid scintigraphy results

In conclusion, the radiologist gives a detailed description of the anatomical position, shape and size, structure of the gland and the "hot" and "cold" nodes present in it.

"Hot" nodules accumulate more RP, which means they also produce more hormones. Such hyperactivity can be a symptom of nodular toxic goiter or toxic adenoma.

Cold nodes are clumps of non-working cells. The tissue does not absorb RFP and does not synthesize hormones. Such formations are characteristic of nodular colloid goiter or tumor diseases and require further diagnosis by fine-needle biopsy (tissue sampling for examination).

To assess the functionality of the thyroid gland as a whole, the general picture of absorption by tissues of the radioisotope allows. If the level of saturation is increased evenly, then this is one of the signs of diffuse toxic goiter. A decrease in absorbing activity indicates

Scintigraphy is one of the highly informative non-invasive diagnostic methods related to the branch of clinical medicine that deals with the use of radionuclide pharmaceuticals.

Carrying out an examination with its help gives the opportunity to visualize organ - systems and tissue structures. In the process of diagnostics using a radioisotope pharmaceutical agent and a device that helps to register the propagation of gamma rays, simultaneously with imaging, an assessment is made of the work and the extent of the thyroid gland lesion.

Nuances of thyroid scintigraphy

Examination of the thyroid gland by this method does not pose a danger to the body of the patient under study. As an isotope, technetium is used, which is characterized by a short half-life and the lowest radiotoxicity. The dose of the radioactive agent used will be enough to obtain the necessary indicators, but it cannot negatively affect the body.

To detect changes and disorders, a radioactive drug is administered to the patient in combination with drugs so that they reach the problem organ through the bloodstream. The radiopharmic agent used includes compounds that are rapidly absorbed by the organ or tissue structures under investigation, as well as radioactive isotopes embedded in the carrier agent.

The clinical picture is visualized using a particle scanner and gamma camera. For reliable diagnostics and obtaining information with high accuracy, both installations are often used. During the examination period, the installation registers and analyzes the obtained indicators and creates a picture of the tissues in the examination area. Using specially developed programs, the work of the organ is recorded, graphs are displayed in the form of curves on the screen and on paper. The graph shows the functionality of the gland with high precision.

How the examination is carried out

Thyroid scintigraphy is performed in two stages - the introduction of a radiopharmaceutical agent and scanning in a gamma camera. Before conducting the study, the doctor talks with the patient, explains to him what a scintigraphic study is and how it is carried out.

The patient is given or given to drink a radioactive isotope. The radiopharmaceutical is injected through a catheter placed in the cubital vein. The different agents used reach the problem area at different times. In most cases, preliminary stenography is performed about 5 minutes after the introduction of the radiopharmaceutical. With the help of these images, the blood flow is monitored and the extent of the damaged area is approximately determined.

During the period of scintigraphy, the patient should take a horizontal position on the working table of the gamma camera and not move during the entire procedure. His breathing rhythm should be even, not too deep. In order to increase blood volume, activate blood flow in the vascular canal and better transport the diagnostic agent, the patient is advised to drink plenty of clean water.

Subsequent images give the opportunity to register the distribution of the drug in tissue structures, to fix the zones of active accumulation (if any), or vice versa, the areas in which the marker is accumulated in an unexpressed way. Stenography is carried out after 3 - 4, if necessary, 6 - 8 hours after the introduction of the radiopharm drug.

Sometimes situations arise when a specialist re-scans every other day from the beginning of the examination to observe the dynamics of the withdrawal of the used marker from the problem area.

Scintigraphy can also be performed 24 hours after the introduction of a radioactive agent. In this case, the isotope under study is administered on the eve of the procedure on an empty stomach, the diagnosis is carried out the next day. Scanning time is about 30 minutes.

Drugs used

Thyroid scintigraphy is performed using certain radioactive drugs:

Iodine 131. The agent enters the body by oral route;
Iodine 123. This type of drug is rarely used because of its high cost. The route of administration is intravenous;
Technetium-99. The technetium treatment is performed more frequently than with other markers. The substance is administered intravenously, it is removed from the body relatively faster and is less hazardous to health.

Types of procedures

For accurate diagnosis, certain types of procedures are used:

static - scintigraphy of the thyroid gland is performed half an hour after the ingestion of the radiopharm agent. The method is designed to observe the accumulation of an isotope in the tissues of a problem organ, accompanied by the production of a series of images.
dynamic - the duration is up to 3 hours, after admission to the manipulation itself. A radioisotope study of the thyroid gland of this type helps to monitor the placement of the marker in the problem area.
tomographic - performed using single-photon emission CT, which makes it possible to construct a three-dimensional image of the area being examined.
planar - this type of diagnosis allows you to get a picture of the problem area in 2 mutually vertical images.

Preparatory activities

Scintigraphic examination requires preparation, but these activities do not affect the usual life rhythm. Preparation for thyroid scintigraphy, taking into account all the doctor's instructions, allows you to get clearer and more informative indicators:

3 months before the scintigraphy, it is not allowed to conduct X-ray studies with contrast elements, as well as MRI, urography and angiography;
within a month before manipulation, it is important to refuse to include certain foods in food, like seafood, which contain a large amount of iodine;
in 3 to 6 months it is required to stop using Amiodarone;
for 1 - 2 months, you should stop taking medications containing iodine. It is necessary to stop taking thyroid hormones for 3 weeks;
It is not recommended to use certain medications 7 days before the procedure.

Before starting the diagnosis, it is imperative to get rid of metal jewelry, dentures with metal structures, and other items containing or made from metal.

After the end of the procedure, it is advised to drink plenty of fluids to accelerate the removal of radioactive elements from the body.

When is scanning done and when is it prohibited?

The procedure is prescribed in order to clarify the nature of the nodal formations. Thyroid scintigraphy gives the opportunity to find out the reason for the decrease or increase in the activity of the organ. The method is also used to control the treatment course, to identify the dynamics of recovery and determine the further strategy of the therapeutic course.

Scintigraphy is also performed when:

abnormal location of the lobes;
the need for clear visualization and identification of auxiliary lobes;
malfunction of the gland;
differentiation of thyrotoxicosis;
the need to calculate the dose for the correct organization of the procedure using iodine with increased radioactivity;
increased parathyroid hormone.

Thyroid scintigraphy is performed with the introduction of a radiopharmaceutical, but stenography of the picture is not performed.

There are certain contraindications for the procedure.

Scintigraphy on pregnant women and during lactation is not allowed. It is forbidden to carry out radiodiagnostics if X-ray or CT has already been performed on the day intended for scanning. A radioisotope study of the thyroid gland of this type is not carried out if the patient's weight is 150 kg or more.

Side effects

Radiation manipulation is not hazardous to health. Side effects in most cases are recorded as a result of individual intolerance and hypersensitivity of the examined person.

The examinee may temporarily register an increase or decrease in blood pressure, and there may be frequent urges to urinate. Uncommon, but there is a risk of fever, dizziness, redness, itching, and weakness.

In case of hypersensitivity to iodine, thyroid scintigraphy with technetium is performed, which practically does not cause negative findings.

The likelihood of exposure of subjects in contact with the patient after the procedure is practically non-existent. To avoid re-entry of the radiation dose into the body, strict adherence to hygiene standards is required. You need to often wash your hands, take a bath, shower, often change linen and bedding, a towel.

After completion of the materials used in radioactive manipulation, they must be left in the clinic, where they will be placed in specially designed containers for substances in contact with radiopharmaceutical agents.

To prevent side effects and harmful effects on the body, it is required to adhere to precautionary measures:

women (of reproductive age) should have a scan 12 days after their last menstrual period to avoid possible pregnancy;
when carrying out scanning in children, a prerequisite is to adjust the dose of the radiopharmaceutical in accordance with the weight of the child;
breastfeeding mothers need to stop breastfeeding;
the person undergoing this examination must exclude contact with children, with women expecting the birth of a child, and nursing mothers for a specific period of time, the duration of which depends on the markers used.

How and why is the parathyroid gland examined?

The parathyroid glands are located behind, on either side of the thyroid gland. They produce parathyroid hormone, which stimulates an increase in the percentage of Ca and calcitonin, which promotes the elimination of Ca from the body.

When the ability to synthesize these glands is impaired, heart and kidney failure occurs, blood clotting increases, there are malfunctions of the nervous system, food absorption, problems with the gastrointestinal tract, deformations of bone formations, and abnormal fractures. Scintigraphy allows you to determine the cause of the violation of Ca metabolism in the body.

For the examination, technetium-99 is used, it is injected 20 minutes before scanning, re-introduction is performed three hours later.

Method evaluation

Thyroid scintigraphy is performed taking into account the advantages and disadvantages of the procedure. Before carrying out radionuclide diagnostics, the doctor explains to the patient all possible consequences, introduces the procedure for conducting, and how he will need to behave after the study.

The advantages of the method include:

non-invasiveness of the method and minimal harm of the procedure to the organism of the investigated person. The amount of isotope used is selected to provide a clear picture of the problem area. The risk of negative effects on the body at such doses is extremely small;
the possibility of a one-time examination of the specifics of the structure of the organ and its activity;
fixing the degree of damage;
the ability to repeat the procedure several times for accurate diagnosis without harm to health;
lack of discomfort and pain during the procedure;
the ability to conduct a radioisotope study of the thyroid gland of patients of any age. However, when scanning children, it must be taken into account that they cannot remain motionless throughout the entire procedure, and even the slightest movement can distort the actual picture of the disease and serve as the basis for an incorrect diagnosis.

The disadvantages of this method include:

the duration of the study. Sometimes it takes about 7 hours to get accurate information;
clarity and contrast of the picture. The image may be blurry;
the possibility of carrying out diagnostics by this method only in specific clinics;
preparatory measures, which include refusal to take certain drugs, disinfectants.

How is the diagnosis made?

The results of the study of scintigraphic images, recommendations and extracts are received by the examinee after the end of the procedure. The results can also be presented over several days.

The method gives the opportunity to discover<<горячие>> or<<холодные>> areas in the fabric. Normally, the iron scintigram has a uniformly dark color. The appearance of dark areas (hot - have an orange and red color) indicate the formation of a site of increased activity with toxic goiter, as well as nodular thyroiditis. The lightest zones (cold - have a color from blue to purple) indicate the presence of an area with reduced function, which is detected in cystic formations and other neoplasms, in cancer.

When the marker gradually or progressively accumulates in the thyroid gland, the presence of diffuse toxic goiter is recorded. Intense absorption of radiopharmaceuticals by tissue structures is a signal of the presence of hypothyroidism.

With various painful detections associated with the functionality of the thyroid gland, scintigraphy is an accurate and reliable diagnostic method. The information obtained using this method allows timely detection of the problem and the organization of appropriate treatment.

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Thyroid scintigraphy

The essence of the method: scintigraphy of the thyroid gland - a method of radioisotope study of the functional activity of the tissue of the thyroid gland and nodules. Scintigraphy allows you to judge the morphology, topography and size of the thyroid gland, identify its focal and diffuse changes, identify and differentiate "hot" (hormonally active) and "cold" (functionally inactive) nodes of the gland.

The advantage of thyroid scintigraphy is the ability to visually assess the level of hormonal activity in normal thyroid tissue and foci of compaction.

Thyroid scintigraphy has a low radiation dose: the dose of radiation is lower compared to other methods (in particular, X-ray), and the used radioisotopes are quickly washed out of the body.

Thyroid scintigraphy helps detect ectopia or possible fragments of thyroid tissue after the gland is removed. Thyroid scintigraphy cannot accurately diagnose a benign or malignant node, although it suggests the presence of oncological alertness. Thyroid scintigraphy reveals metastatic lesions of regional (submandibular, cervical) lymph nodes.

Disadvantage: thyroid scintigraphy serves as a method of clarifying diagnostics and, unlike computed tomography and magnetic resonance imaging, ultrasound examination, has a lower resolution and gives a less clear image of the organ.

Indications for research:

Adenoma of the parathyroid glands;

Thyroid adenoma;

Autoimmune thyroiditis;

Hyperthyroidism;

Hypothyroidism;

Diffuse toxic goiter;

Thyroid cancer;

Thyroiditis;

Thyroid nodules and cysts.

Conducting research: 20-30 minutes before thyroid scintigraphy, the patient is injected intravenously with a microdose of a radiopharmaceutical (isotope of iodine 131I, 123I or technetium 99mTc), which can accumulate in the thyroid tissue and in the nodes, and then its distribution is assessed using a series of scintigrams performed over 15 -20 minutes.

Contraindications, consequences and complications: an absolute contraindication is an allergy to the substances that make up the used radiopharmaceutical. Relative contraindications - pregnancy, breastfeeding, general serious condition of the patient.

Preparation for research: before scintigraphy of the thyroid gland, it is required to stop taking any iodine-containing drugs: L-thyroxine 3 weeks before the study, mercaptisol and propylthiuracil - 5 days.

Thyroid scintigraphy should not be performed earlier than three weeks after the CT scan using a contrast medium containing iodine.

Decoding of research results must be carried out by a qualified radiologist, the final conclusion on the basis of all data on the patient's condition is made by the clinician who sent the patient for examination - an endocrinologist, gastroenterologist, surgeon, oncologist and other specialists.

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Thyroid scintigraphy is a functional method for examining thyroid activity. In addition, thanks to this method, the abnormal location of the gland and the state of the nodules present in it are determined, and cancer metastases are detected.

For the vital activity of the thyroid gland and the production of the required amount of thyroid hormones, it is necessary to enter the body with a sufficient amount of iodine. This research technique is based on this - the thyroid gland will actively capture any iodine offered to it from the outside.

A radiopharmaceutical (RP) containing isotopes of iodine-123 (123I), iodine-131 (131I) or technetium pertechnetate-99 (99mTc) is injected into the patient's body. The rate of iodine absorption by the thyroid tissue is 100 times higher than that of other tissues of the body. The radioactive iodine or technetium accumulated in the thyroid gland begins to decay into isotopes, the signals of which are recorded by a scanner in a gamma camera.

The shape and position of the gland, the presence of a “cold” (weak accumulation) or “hot” (high accumulation) node are determined by the intensity of RP accumulation. The amount of RFP is such that it is easily fixed with special equipment without harming the body.

Thyroid scintigraphy is performed at the second stage of diagnosing thyroid diseases, it is considered an additional method that completes routine examinations (ultrasound, hormonal profile, puncture biopsy), therefore it has few indications for conducting:

Lack of a thyroid gland in a typical location;
Retrosternal goiter;
Goiter of the root of the tongue;
Toxic adenoma of the thyroid gland;
Thyrotoxicosis;
Metastases of highly differentiated thyroid cancer to other parts of the body, lymph nodes;
Confirmation of the complete absence of thyroid tissue after total strumectomy.

Thyroid scintigraphy is an absolutely painless and harmless procedure for the body. Radionuclides for research are selected in such a way that their effect on the body does not differ from the effect of the natural radiation background. The drugs will differ only in the ability to emit rays, which make it possible to determine the location, quantity and distribution. Each RFP undergoes a long cycle of studies that determine the effect on the body, and is approved by the commission of the Ministry of Health only after testing. The dosage of the radiation received is so small that a repeated scintigraphic examination can be carried out after 14 days.

It is not recommended to conduct other studies associated with the introduction of a contrast medium 90 days before scanning (MRI or CT with contrast, angiography, urography). It is recommended to stop taking iodine preparations 30 days before the study (cough syrup, Lugol's solution, multivitamins). Thyroid and antithyroid drugs are discontinued 3 weeks before the study. Glucocorticoids, anticoagulants, phenothiazines, salicylates are canceled 1 week before the study.

The preparation of the patient and the timing of the procedure depend on which drug is used for the study:

Thyroid scintigraphy is performed after complete absorption of the drug. For this, the patient is placed in a gamma camera, special sensors begin to receive signals from the thyroid gland, which has accumulated RFP. The information is transmitted directly to a computer, where a color image of the gland is created. The intensity of the staining depends on the degree of accumulation of the isotope. Normally, the thyroid gland looks like a butterfly, the lobes are presented in the form of two dark ovals, colored evenly and having clear contours. The duration of the study is 30 minutes.

The choice of radiopharmaceutical depends on the diagnosis and the planned further treatment. If an oncological lesion, adenoma and nodular goiter is suspected, 99mTc is injected. If a toxic goiter is suspected and 131I therapy is planned, iodine isotopes are used for the study, according to the capture of which the required therapeutic activity of 131I is calculated. But for scanning in this case, 123I is used, which reduces the radiation load on the patient and allows starting therapy earlier, since there is no residual beta radiation.

Decoding the results

Thyroid scintigraphy shows the degree of absorption of RP by the gland and its distribution. Each pathology has a characteristic picture: (the picture is clickable)

Diseases of the endocrine system are the scourge of modern society. And the most common among them are thyroid pathologies. To recognize what exactly caused a particular pathology, various diagnostic studies help, one of which is thyroid scintigraphy.

What is the principle of this study, how is it carried out, in which cases it is prescribed, and are there any contraindications for its conduct?

Scintigraphy is one of the methods of functional diagnostics that allows you to visualize the organ under study. The principle of this method is the use of radioactive isotopes, which are injected into the patient's body either orally or intravenously. When interacting with isotopes, organs begin to emit radiation, which is determined by a gamma scintillation camera, displaying an image on a monitor. Considering that when carrying out diagnostics, radiopharmaceuticals labeled with gamma-emitting radionuclides are used, this method has the definition of "radionuclide research".

The more familiar method of ultrasound diagnostics allows to consider the anatomy of the organ. However, it turns out to be powerless when the thyroid gland changes its location. With scintigraphy, you can easily identify the thyroid gland, even if it is located in the retrosternal space, and detect a violation of its functions.

Thyroid scintigraphy is performed if it is necessary to determine the state of hormonal activity of its lobes. With a decrease in activity, the areas are defined as cold, and with an increase in activity, they are defined as hot.

Despite the fact that this research method appeared a long time ago, no more than two hundred gamma cameras are located on the territory of Russia. At the same time, scintigraphy is the prerogative of large medical centers. Therefore, residents of the regions most often have to look for where to do a thyroid scintigraphy. Most of the gamma scintillation cameras are located in the Russian capital. But in European countries, this procedure is carried out in every outpatient clinic. For example, Estonia is one of these countries.

Thyroid scintigraphy involves the use of radioisotopes 123 and 131, or technetium 99. Despite the fact that the procedure itself does not harm the human body, it is not indicated for all thyroid pathologies.

Normally, the thyroid gland consists of two lobes, which, in turn, are composed of follicles. In the cells of the follicles, iodine is accumulated and stored, which by means of biochemical processes is converted by them into thyroid hormones.

Scintigraphic examination is based precisely on the property of the thyroid gland to accumulate and assimilate iodine. During normal functioning, the thyroid gland is able to assimilate only a certain amount of iodine, from which thyroid hormones are produced. If, after the administration of a dose of a radiopharmaceutical, the thyroid gland has absorbed too much of it, this indicates the development of thyrotoxicosis. If, on the contrary, any part of the thyroid gland remains inactive and does not absorb iodine, hypothyroidism is diagnosed.

In most cases, a study of the thyroid gland shows focal uptake of iodine isotopes, when different parts of the organ react differently to the radiopharmaceutical. This may indicate the presence of diffuse nodules or a tumor. Thyroid scintigraphy is also prescribed for malignant neoplasms. In this case, this method allows you to determine not only the location of the malignant tumor, but also the location of the spread of metastases.

It should be noted that the introduction of radioactive iodine is not contraindicated in thyrotoxicosis, since this substance does not participate in the formation of thyroid hormones. Isotopes are very quickly excreted from the body in feces and urine.

Scintigraphy is considered the most informative examination of the thyroid gland for good reason. This procedure is very simple and does not require any special training. The patient who is shown this research method does not have to change the daily routine. Only the following conditions must be met.

If the patient is taking iodine-containing drugs, they must be discontinued one month before the planned study. The only exceptions are drugs used to treat diseases. However, it is necessary to warn the doctor about their use, as they can distort the results of the study.
3 months before the scintigraphy, it is not recommended to undergo other studies that involve the use of contrast drugs, for example, renal urography.

To undergo the procedure, the patient will have to visit the medical center twice. First, he needs to report on an empty stomach in order to take the radiopharmaceutical. Then he goes home and returns exactly 24 hours later to undergo the procedure directly. Moreover, breakfast is no longer a contraindication.

After preliminary preparation associated with the introduction of isotopes, the patient is directed to a gamma camera, which perceives their radiation. The scintigraphy takes no more than half an hour.

This procedure is not recommended for all patients with thyroid disease. It is prescribed only in exceptional cases.

If the thyroid gland is incorrectly positioned, and the ultrasound scan did not allow it to be visualized.
In the presence of any congenital anomalies in the development of the endocrine organ.
To determine the number and functions of nodules.
In the differential diagnosis of hyperthyroidism.
If a tumor is suspected. In this case, scintigraphy allows you to determine the nature of their development.

Most often, a radionuclide study is used to identify and assess the activity of nodules. What is a thyroid scintigram? A scintigram is a three-dimensional image showing areas of color that are classified according to their ability to store iodine and produce hormones.

Cold areas. Their presence is the most common pathology. Such nodes do not accumulate radioisotopes, which indicates a nodular goiter. Most often, this pathology is benign.
Warm areas are rare. And in most cases, such formations are also benign. In this case, one can assume diffuse changes in the thyroid gland, when its tissue captures iodine and produces a normal amount of hormones.
Hot spots indicate increased activity of thyroid cells, which uncontrollably produce hormones, not obeying the pituitary gland. This pathology is detected in 5% of patients, and most often requires surgical intervention.

Scintigraphy does not cause side effects or adverse effects. Therefore, if necessary, it is carried out even for infants, provided that radioactive iodine is replaced with technetium 99.

Contraindications for its implementation are the following conditions.

Pregnancy regardless of the term.
If a woman is breastfeeding a baby, breastfeeding should be avoided during the procedure. It can be resumed only a day after its end.
A contraindication is an allergic reaction to any of the components that make up radiopharmaceuticals. The main signs of allergies are dizziness, general weakness, and itchy skin.

Very often, this procedure is prescribed after surgery to remove the thyroid gland. Scintigraphic examination allows you to determine with high accuracy whether the patient has metastases, and in which organs they are located.

A feature of the procedure for thyroid cancer is that after taking radioactive iodine, it is necessary to wait several days so that iodine can be distributed throughout all organs. To detect metastases, the patient is scanned not only the thyroid gland, but also the rest of the organs, so the time for the procedure is increased to 1.5 hours.

Thyroid pathologies are the most common among all diseases of the endocrine system. Diagnostics is carried out by various methods, with ultrasound being the main one. If its results are insufficient for an accurate diagnosis, a thyroid scintigraphy is performed. The method involves irradiation, and they resort to it only in controversial cases.

The thyroid gland affects the function of almost every system in the body. Violations in her work negatively affect the human condition and worsen the quality of life, so you should not postpone the diagnosis. It is carried out including through scintigraphy. This is a radionuclide method that evaluates the ability of glandular tissue to accumulate, absorb and excrete radioactive substances.

The study is carried out by introducing technetium 99, iodine 123 or iodine 131 into the body. These substances create radiation, which the gamma camera captures and converts into electrical signals. They are displayed on the monitor in the form of a picture, or a scintigram. Based on these data, the diagnosis is clarified.

To understand what scintigraphy is for examining the thyroid gland, its diagnostic capabilities will help. The following is revealed:

the exact location of the gland;
its size and shape;
working capacity;
the presence of foci of inflammation;
destructive phenomena.

Usually scintigraphy is performed after ultrasound, so its main purpose is to evaluate pathological changes.

The method is important for the diagnosis of malignant tumors, it helps to clarify whether there are metastases. "Cold" zones - an indication of colloid cysts, and in 7% of cases - on tumors, "hot" - on the functional autonomy of the gland.

Scintigraphy is performed strictly as directed by an endocrinologist. Indications:

hormonal disorders in the absence of the effect of medications;
education in the gland (to clarify the location and size);
severe functional impairment;
thyrotoxicosis;
anomalies in the development and position of the thyroid gland;
suspicion of cancerous tumors;
diagnostics of "active" and "inactive" formations;
inflammation in the glandular tissues;
undergoing chemotherapy;
monitoring the state of the thyroid gland after surgery.

Although radiation is expected, the doses are small, making scintigraphy relatively safe. It is prohibited for infants and pregnant women - because of the risk of the penetration of a radioactive substance to the fetus through the placenta, which is fraught with malformations.

The procedure is prescribed with caution when allergies are susceptible. It is difficult to predict the body's response to a radioactive drug.

The particulars of the procedure depend on whether the scintigraphy is performed with technetium or radioactive iodine. The results are delivered to the patient together with the captured image disk.

The whole process, together with preparation for it, takes 20-40 minutes. The patient must remove all metal objects. Further actions:

The drug is injected into a vein and waited 15 minutes until technetium is distributed in the body.
The patient lies down on the table. A gamma camera is installed at a distance of 20 cm from his neck and an image is captured.
The results are sent for decryption.

Preparing for a technetium thyroid scintigraphy does not involve diet.

do not use iodine-containing medicines;
Do not undergo other studies for 3 months;
follow a diet with the rejection of foods rich in iodine;
8 hours before the procedure do not eat or drink anything, the bladder must be empty.

Technique of the procedure:

On the morning of the examination, the patient takes a capsule of iodine 131 or a substance dissolved in water.
Wait 2 hours, all this time you can't eat anything.
The patient lies down on a couch, a gamma camera is installed at a distance of 20 cm from his neck and an image is captured.
The procedure is repeated after 6 hours, after a day and after 2 days (depending on the decision of a specialist).

Radioiodine therapy is used both for the treatment of a tumor that cannot be completely removed, and for prevention - so that the oncological process does not spread further after removal of the neoplasm. The method is often a concern, but it is safe even for children. The patient receives a radioisotope of iodine I-131 in an individually adjusted dosage. The substance irradiates the cells of the gland from the inside, but does not cause damage. Cancer cells die. Most of the drug is excreted in 2 days, and after 8 days it does not remain in the body at all.

Iodine 131 emits beta particles that act within 2 mm. Scintigraphy with it is painless, does not cause complications, does not provoke other pathologies, does not pose a danger to nearby organs.

In decoding scintigraphy indicate:

the location of the thyroid gland;
its size and shape;
the presence of nodes with an excessive content of the radiopharmaceutical.

The third point indicates the presence of "cold" and "hot" points in the gland. "Hot" speaks of an increased accumulation of a radioisotope, which means that the production of hormones in these zones is increased. Possible nodular toxic goiter or toxic adenoma. There are practically no radioisotopes in the "cold" spots, which indicates that the cells are inert. A colloid or cancer formation is likely; a biopsy is needed to confirm the diagnosis.

If the substance is evenly distributed, and the thyroid gland intensively absorbs it, a diffuse toxic goiter is possible. At a reduced level, hypothyroidism, a deficiency of hormones due to the reduced functionality of the thyroid gland, is detected.

The radiation doses that the patient receives are safe. They are so small that scintigraphy can be performed twice a month. 99% of side effects are caused by drug hypersensitivity. Possible:

allergic reactions to radioactive substances;
temporary pressure change;
frequent urge to urinate, nausea, vomiting (pass quickly);
blush and fever (rare).

If, after the injection of a substance for scintigraphy, your head is spinning, your skin itches, you feel weak, you need to immediately inform the medical staff about this.

In a public hospital, you can do a scintigraphy free of charge under the compulsory medical insurance policy. If you need to get tested faster, there is the option of contacting one of the private medical centers. Prices in them vary between 3,000 - 8,000 rubles.

Specialists regarding scintigraphy note that this is such a study of the thyroid gland, which is used only in controversial situations. The method allows you to make an accurate diagnosis if it was not possible to do it according to the results of ultrasound. The body is exposed to insignificant radiation, so with careful preparation and adherence to all recommendations, the procedure is safe and gives a 100% result.

Endocrinological specialists practice non-invasive techniques for examining the thyroid gland. Modern technologies in radiation diagnostics make it possible to assess the topographic anatomy and functional activity of internal organs.

Imaging with radioisotope solutions includes a number of techniques for obtaining images that display the distribution of radiolabeled substances in the body. Scintigraphy is considered one of the most informative and safe examinations. The main task of scintigraphy is to visualize and study the kinetics of radiopharmaceutical drugs in the internal organs of a person.

Thyroid scintigraphy is a radioisotope study of the functional state of thyroid tissue and nodules, based on an assessment of the accumulation of a radio indicator in the required amount.

The study provides an opportunity to identify and obtain information about the following parameters of the thyroid gland:

organ location;
the structure of the building;
performed functional activity;
differentiate the state of hormonal activity of the lobes;
detect focal changes;
changes in the vascular pattern;
metastatic lesion of the lymph nodes;
possible oncological alertness.

In the world medical practice, radioisotope scanning of the thyroid gland is used in the following cases:

Diagnosing pathological changes in the gland.
The presence of nodules found on palpation.
Differential diagnosis of thyrotoxicosis.
Evaluation of the effectiveness of the performed surgical intervention.
Ectopies of thyroid tissue.
Monitoring the medical treatment of thyroid dysfunctions.
Diagnosis of possible residual tumor tissues and distant sites of the pathological process.

The study has contraindications for conducting:

pregnancy;
claustrophobia;
individual intolerance to the used radioisotope substances;
lactation period.

The option of conducting a scintigraphic examination during lactation still exists. Gland scintigraphy is performed using technetium (99 mTc-pertechnetate).

Technetium is a short-lived isotope that appears in the body like iodine. These radionuclides are used in medicines with high specific activity. The trace element has been used in nuclear medicine since 1980. Among modern diagnostic procedures using radionuclides, technetium scintigraphy is the most commonly performed.

Pertechnetate is not involved in hormone synthesis. The half-life is six hours, and complete disintegration occurs within 60 hours. Technetium has a higher excretion rate than iodine-based radiopharmaceuticals. Technetium has a low dose load on the patient's body, thanks to which the isotope is used for research in children and lactating women.

The considered radioisotope study on the distribution of a radioactive drug in the tissues of the thyroid gland has a number of advantages and disadvantages.

Scintigraphic examination of the thyroid gland has a number of fairly significant advantages over other methods of radiation diagnostics, namely:

Low radiation activity is the minimum dose of radiation for the body.
High excretion of the used radiopharmaceuticals - rapid elimination of radio substances from the body.
Absence of pain syndrome.
The possibility of conducting research without limitation on the age group of the patient.
Characterization of the hormonal activity of normal thyroid tissue.
The absence of secondary complications associated with the negative impact of radiopharmaceuticals on the body.
Survey using technetium.
The planned nature of the conduct.

Thyroid scintigraphy is a specialized and safe examination. However, this radiation technique has several disadvantages:

The high cost of the survey.
Possible allergic reactions arising from the use of iodinated drugs.
Variability of blood pressure indicators after scintigraphy.
Low resolution and blurry organ image.
Specific preparation for the study.
Failure to establish whether the node is benign or malignant.

Among the endocrinological examinations of the thyroid gland, scintigraphy takes the leading place.

Thyroid scintigraphy requires specific preparation for its conduct. First of all, it is more expedient to create conditions for iodine and thyroid hormone deficiency. To achieve this goal, it is necessary:

Exclude foods containing a trace element from the diet.
Stop taking medications that may contain iodine or bromine.
Do not use hormonal preparations containing thyroxin for 30 days.
If it is necessary to use antiseptic drugs, preference is given to antiseptics that do not contain iodine.
Do not use contrast media.

A survey involving the use of pertechnetate does not require special preparatory measures. This is due to the fact that the trace element is not involved in the production of hormones by the gland.

Before the procedure, a consultation with an endocrinologist is required. Re-discussion of the need for the procedure and the possibility of taking medications regularly used by the patient.

Thyroid scintigraphy is performed in laboratories for radioisotope diagnostics. A gamma camera is required in a special room. This installation has a complex mechanical structure, and includes:

radiation detectors;
photomultiplier tube;
lead devices for obtaining parallel beams of light rays;
device necessary to fix the resulting image.

A gamma camera is a scanners needed to register the concentration of a substance in the thyroid gland. The installation is irreplaceable when carrying out radionuclide diagnostics. Modern devices make it possible to obtain scintograms in an arbitrarily oriented plane, while changing the position of the patient is not required.

Scintigraphy procedure:

Introduction into the bloodstream of an isotopic substance (minimum doses of pertechnetate or iodine isotopes).
The patient takes a horizontal position.
Placement of the patient in a gamma camera.
Registration of radiation emitted by radiopharmaceutical drugs absorbed by the tissues of the gland.
A three-dimensional image of the gland is displayed on the monitor screen and fixed on the hard disk of the computer.
Taking pictures.
End of the procedure.

The duration of the procedure is 20-80 minutes. However, due to possible obstructive changes in the gland, the time of the procedure may vary.

During the procedure, in parallel with radioisotopes, a fixed dose of radiation is injected into the body.

Complications after scintigraphy of the gland, based on the damaging effect on the body, were not noted.

This fact testifies to the safety of the study.

Radionuclide research allows you to get results within 30 minutes after the procedure. During normal functioning and structure of the gland, the segments of the organ accumulate the introduced isotopes evenly. The visual picture in the photographs is presented in the form of two dark symmetrical oval areas.

Segments of the thyroid gland, which are not sufficiently saturated with a radio indicator, are reflected in the images as light areas. This fact indicates that hormones are not being produced, and are called "cold" foci. Such foci may indicate an inflammatory lesion of the gland, cysts, involution and proliferation of connective tissue with the presence of cicatricial changes.

Dark areas in the images are considered hormone-active and are called "hot" areas. This picture is possible with nodular thyroid goiter.

Visualization of an increase in all segments of the organ, accompanied by a uniform cumulation of the radiotracer, means the presence of diffuse toxic goiter. This pathological change is characterized by an increased storage function.

It is more expedient not to carry out an independent decoding of scintograms. The description of the obtained indicators is carried out by endocrinologists.

Today, endocrine pathologies are a medical and social problem. The study of the morphology and functional state of the endocrine secretion glands, the hormones they produce, the characteristics of their synthesis and effects on the body is extremely important. Radioisotope studies are widely used in endocrinology to diagnose pathological processes in the body.

According to medical statistics, thyroid scintigraphy in extremely rare cases causes secondary complications.

Yakutina Svetlana

Expert of the ProSosudi.ru project

The development and expansion of the diagnostic capabilities of modern medicine made it possible to leave in the past many techniques that do not meet the growing requirements for the quality of visualization, the degree of safety and the amount of information received. Thyroid scintigraphy, being a pioneer among the methods of radionuclide diagnostics, has managed to retain its position as a highly informative examination with potential for further development.

Emerging new and promising techniques that can provide a similar or greater amount of information, one way or another, are based on the principles of performing scintigraphy. A significant role is played by radionuclide diagnostics not only in clarifying the nature of the disease, but also in the treatment of malignant neoplasms of the thyroid gland.

Method essence

Thyroid scintigraphy is a radionuclide method for assessing the functional activity of the lobes of the thyroid gland (TG), based on the properties of its tissues to absorb iodine and use it to produce hormones. The use of radiopharmaceuticals (RFP) in the diagnostic process - chemical compounds perceived by the tissues of the organ as a necessary participant in metabolism and containing radioactive isotopes in the structure - makes it possible to record the intensity and uniformity of absorption, accumulation and distribution of a substance in the thyroid gland.

In the absence of alternative imaging techniques currently available in diagnostic medicine, such as ultrasound, MRI or CT, scintigraphy was the only way to obtain an image of an internal organ. Today, with the help of all of the above methods, it is possible to obtain a maximum of useful information about the shape, structure and location of the thyroid gland, however, none of them is able to assess its functional state.

The mechanism for obtaining information is the introduction into the body of RFP (for example, radioactive iodine), which is actively absorbed or not absorbed by the endocrine organ. With the subsequent registration of the radiation intensity, it is possible to obtain a flat or three-dimensional image (in the case of using an emission computer tomograph), reflecting the zones of normal, increased or decreased concentration of radioactive substances.

Areas with increased radiation, highlighted in color or shading, indicate tissue hyperactivity, and areas with low or absent radiation, indicate their partial or complete functional failure. The use of scintigraphy is advisable only to determine the activity of hormone production in one of the parts of the thyroid gland (node or lobe), the pathological state of which has already been identified using laboratory or instrumental research methods.

In color images, inactive thyroid tissues are shown in blue, and active ones - in red.

Important! Scintigraphy cannot be considered an independent research method, based on the results of which any diagnostic decision can be made. Its use is justified only if it is necessary to obtain additional information.

Choice of radiopharmaceutical

Since radionuclide diagnostics are based on the ability to register the intensity and amount of ionizing radiation emanating from radiopharmaceuticals, there are 3 main requirements, compliance with which makes scintigraphy the most informative and safe diagnostic method:

The behavior of the drug in the human body should be identical to the behavior of natural organic substances.
The drug must contain a radioactive nuclide or a radioactive label, which makes it possible to determine its location using recording equipment.
The radiation dose during diagnostics should be minimal.

An important aspect when choosing an RFP is the half-life, the duration of which should not exceed the permissible levels of exposure, but at the same time, it allowed performing the necessary diagnostic manipulations. The use of iodine isotopes (123Ι and 131Ι) in nuclear medicine can be considered a classic, since the first studies carried out with their help were described as early as 1951.

Thanks to the ability of the thyroid gland to capture iodine, it became possible to fix the rate of its accumulation and distribution in tissues. However, to date, the use of 123Ι and 131Ι isotopes is limited by the need for a subsequent course of therapy for cancer or toxic thyroid adenoma.

Due to the fact that the half-life of the 123Ι isotope is 13 hours, and the 131Ι isotope is 8 days, the latter, as the most traumatic, is used to destroy malignant cells, and the use of the 123Ι isotope for diagnostic purposes makes it possible to estimate the rate of uptake of molecules and calculate optimal therapeutic dose.

Modern RFPs are isotopes that, as a result of decay lasting about 7 days, form a new unstable element called a radionuclide tag. A feature of such a label is the ability to create symbiosis with any chemical element involved in the metabolic processes of this or that organ. The most common drug in medical practice is technetium (99mTc).

The advantages of technetium can be considered an extremely short half-life (6 hours) and the absence of the need to introduce iodine into the body, which makes it possible to obtain a "cleaner" picture from a diagnostic point of view. Another advantage of technetium, which makes it possible to minimize the risks of negative effects of radiation, is the possibility of obtaining it from the parent isotope stored in a container immediately before the diagnostic procedure, as well as the possibility of adjusting its optimal activity.

Container for storage and generation of technetium 99mТс

Indications and results

Radioisotope examination of the thyroid gland is carried out according to strictly defined indications. For example, a thyroid disease such as hyperthyroidism (hyperfunction) can be caused by diffuse or nodular changes in the tissues of the gland. The main purpose of the examination, in this case, is to determine the magnitude of hyperfunction, which in diffuse goiter can be done using ultrasound and in laboratory blood tests.

At the same time, an ultrasound scan shows the size, structure and blood supply of the thyroid gland, and a blood test shows the level of hormones, which is quite enough for a diagnosis. Scintigraphy is not required even if a small number of nodes up to 3 cm in size are found, because regardless of the test results, excess (hyperthyroidism) or lack of hormones (hypothyroidism) cannot be caused by such nodes.

Thus, thyroid scintigraphy should be prescribed for the following indications:

the presence of one or more nodes more than 5 cm in diameter with a simultaneous increase in hormone levels due to hyperfunction of the gland. In this case, using scintigraphy, it is possible to assess the intensity of absorption by the tissues of the RFP node and, according to the results obtained, to judge the source of the increased production of hormones. After identifying the node that caused the hyperthyroidism, the optimal way to remove it is selected;
the presence of a large node occupying at least half of one lobe of the thyroid gland (adenoma). The examination is carried out in order to determine the hormonal activity of adenomatous tissue, which can fully fulfill the functions of a hormone-producing organ, or it can be completely inactive. When determining further treatment tactics, they rely on the results of scintigraphy and the anatomical features of the location of the node (the presence of compression of adjacent organs). If the node is actively growing, but does not produce hormones, it is removed;
the likelihood of the formation of thyroid tissue in uncharacteristic places. An atypical location of the thyroid gland is a rather rare occurrence, much more often the appearance of thyroid tissue in various places is characteristic of the spread of metastases in thyroid cancer. Scintigraphic examination helps with high accuracy to identify the localization of pathological foci in lingual, retrosternal and other locations. In the future, as a rule, iodine isotope therapy is performed.

Important! When evaluating the results of scintigraphy, terms are used that reflect the degree of activity of thyroid tissues. The site or site that actively accumulates isotopes is called "hot", and the passive site is called "cold".

Scintigraphic images of pathological changes in the thyroid gland

Preparation

It is believed that preparation for scintigraphy includes a list of limitations, the main goal of which is to achieve the most reliable results. So, in order to avoid possible distortions, a month before the intended examination, you should refuse to use products containing iodine (for example, seaweed), and iodine-containing medicines should be abandoned much earlier - approximately 2-3 months before the procedure.

For 2-3 weeks it is necessary to stop taking medications prescribed as part of hormone replacement therapy (L-thyroxin, Thyrodin, Eutirox), as well as thyreostatics (Tyrozol, Mercazolil, Propicil). However, taking into account the specificity of diagnostic scintigraphy, which is carried out in order to differentiate an existing diagnosis, it is usually not necessary to carry out such a long preparation.

In practice, taking iodine-containing drugs is stopped 1-2 days before the procedure, while the doctor must know exactly the amount and dosage of drugs taken by the patient and take these data into account when reading the results. The use of technetium 99mTc as a radiopharmaceutical makes it possible not to carry out long preparation for the examination, since this radionuclide does not participate in iodine and hormonal metabolism, but reflects the natural processes occurring in the body.

Carrying out

Diagnostics includes 2 stages:

reception of RFP;
scanning.

If iodine isotopes are used during a scintigraphic examination, then the patient drinks the drug in the form of a liquid or in the form of a capsule. Depending on the RFP used, the scan may take 2-24 hours. When using technetium, the radionuclide is injected directly into a vein, and a scan is started after a few hours.

For scanning, the patient lies down on a couch located in a special room in front of the gamma camera. Modern gamma cameras register the radiation emanating from the patient using a crystal (detector) that reacts to isotopes with flashes, which, in turn, interacting with a cathode-ray tube, form an image on photographic paper.

The use of computer technologies makes it possible to carry out not only stationary images, but also serial ones, and, keeping the previous result in memory, determine the nature and speed of isotope movement. Scanning with an emission computed tomography scanner, the detector of which rotates around the patient's couch, is extremely informative.

This approach allows several frames to be taken at different angles, which, with the help of computer processing, take the form of a three-dimensional image. The most modern achievement of nuclear diagnostics can be considered a positron emission tomograph (PET). The sensitivity of this detector is so high that examinations can be done using significantly lower doses of RFP or using RFP with a very short half-life.

PET scan is a commonly used diagnostic method

Contraindications

It is permissible to carry out scintigraphy during breastfeeding, however, from the moment the radioactive drug is taken (introduced) and until its final decay, breastfeeding should be replaced with artificial, and your own milk should be expressed and poured out. In some cases, when using "hard" isotopes of iodine, close contact with the child should be minimized.

Among the side effects that arise in patients with the introduction of RP, a reaction to iodine-containing drugs is noted:

allergy;
increased body temperature;
hyperemia of the face, neck or hands;
dizziness;
nausea;
change in blood pressure.

If the patient has a history of gastrointestinal diseases, antacids can be taken after taking an iodine-containing RP. Adequate drinking regimen will also help to minimize negative feelings after taking the RFP.

Important! When using technetium as an RFP, the likelihood of an allergic reaction is excluded.

Scintigraphy for thyroid cancer

Despite the fact that scintigraphy remains one of the main methods of differential diagnosis of thyroid diseases, in the diagnosis of cancer, the method is considered to be of little information. The main reason can be considered the difference in the forms of malignant neoplasms, some of which are capable of absorbing RP, and some remain inactive. However, according to statistics, the number of malignant neoplasms among "cold" nodes is significantly higher than among "hot" ones.

Scintigraphy for infants is done exclusively using technetium

Another point of support in the diagnosis of malignant neoplasms of the thyroid gland using scintigraphy is the high rate of metabolic processes in the tumor tissue, and, accordingly, increased consumption of glucose. Using the 18FDG radionuclide label, which is perceived by tissues similarly to glucose, and an emission-positron tomograph, it is possible to determine thyroid cancer with 85% accuracy.

The main criterion that determines the choice of a clinic where to do scintigraphy is the availability of the latest generation equipment, which allows not only to increase the diagnostic accuracy, but also to significantly reduce the dose of the RFP used.

Thyroid scintigraphy is a diagnostic method that uses radioisotopes. This method aims at obtaining a two-dimensional image using radiation emitted by an organ. The study allows you to determine the functional activity of the gland, to find foci of the disease, as well as a change in the pattern created by the interlacing of the vessels on the surface of the organ.

This method is based on the property of the thyroid gland to absorb, accumulate, and also remove iodine, even radioactive. For scintigraphic studies, radioisotopes of iodine 131 and 123, isotopes of technetium 99 are used. It is possible to use other isotopes that are suitable for this diagnosis.

Question: what is thyroid scintigraphy? Do I need to carry it out? Does it pose another health hazard? There are many questions, the answer to them is short - this diagnosis on the apparatus using radioisotopes is necessary and safe. To understand this, you should carefully study the principle of operation.

The gland intensively absorbs iodine, and the intensity is much greater than that of other organs. Technetium is also very well absorbed by the thyroid gland. But technetium is not used by the body to produce hormones, so it is excreted from the body naturally rather quickly. The introduced radioisotopes of iodine and technetium are rapidly absorbed by the thyroid gland, then they are distributed through the tissues.

The next step is to scan the organ using a specialized counter in a gamma camera. Information is visible on the monitor screen and recorded on the computer.

On the monitor screen, a mathematical version of the thyroid gland is viewed in a three-dimensional image. Such an image is called a scintigram.

Gamma - the camera assumes the presence of:

detector;
photomultiplier tube;
replaceable lead collimators;
a device that captures the resulting image.

With this method, it is easy to determine not only the location of the thyroid gland, scintigraphy shows its activity. With thyroid cancer, lesions are revealed, the nature of their changes, a clear image of metastases is visible. It is possible to visually see both lobes and assess the state of their hormonal activity, defined as "cold" or "warm".

A cold state is considered when the thyroid gland is low, warm when there is increased activity. Both states of active activity of the organ are deviations from the norm, and only the scintigraphy method allows one to reveal this effect in just 20 minutes, in addition, to obtain an accurate picture of all zones of the thyroid gland, which have warm and cold anomalies.

Organ scintigraphy is carried out mainly after ultrasound, therefore, the purpose of the study is to assess the detected pathological changes. The definition of "cold" zones usually indicates the formation of a colloid cyst, but perhaps in about 7% that it is a tumor. Hot spots indicate functional autonomy of the organ.

Preparation for thyroid scintigraphy

The technique itself is quite simple and no special preparation is required for it.

The preparatory process will not disrupt the patient's usual rhythm of life:

Usually, to obtain reliable information, it is recommended to stop using medicinal iodine-containing drugs.
Doctors do not recommend doing other studies for three months, for example, renal urography, magnetic resonance imaging.

Before leaving for the procedure, two conditions must be met:

to keep the bladder empty;
do not eat anything, do not even drink tea.

The preparation procedure is as follows: in the morning, the patient is offered to drink a capsule of iodine radioisotope on an empty stomach. During the day, iodine will actively accumulate in the organ.

After 24 hours after taking the drug, the patient can have a scan.

Since the cumulation of the radiopharmaceutical on the thyroid gland will be in sufficient quantity to carry out the diagnostic procedure itself. The procedure takes no more than half an hour

Scintigraphy is performed for those patients who:

the wrong location of the gland is found;
there is an innate unusual development of it;
nodes, neoplasms;
in the differential diagnosis of thyrotoxicosis;
to study the detected neoplasm of the organ in order to determine the nature of the process.

Thyroid scintigraphy is a simple manipulation and has no negative consequences. Even babies can do it.

The image enables the oncologist to diagnose:

the presence of malignant or benign neoplasms;
determine swelling or inflammation;
organ hyperactivity;
consider a goiter;
the presence of cancerous infections.

Thyroid scintigraphy makes it possible to study the visually obtained data immediately after the end of the scan with a gamma camera. This radionuclide examination of the thyroid gland allows doctors to compare the readings of the color picture.

These indications facilitate the diagnosis of the disease.

The hot spot is a zone where the content of the radionuclide preparation is overestimated. In the picture, any of the shades of color: orange, yellow or red, which designates this area. Too much accumulation indicates thyrotoxicosis or the formation of malignant nodes from hormone-producing cells.
A cold hearth indicates an underestimated content of radioactive iodine. The picture shows areas of tissue accumulation. This picture is observed with cancerous lesions or cystic growths.

This study is used in order to assess the functional activity of nodal neoplasms. These nodes can contribute to the production of excess hormones, or, conversely, contribute to a decrease in the synthesis of hormones.

This method is indispensable in cases where it is not always possible to carry out diagnostics by other methods, therefore, a radionuclide diagnostic method is used. This method allows you to get a clear image of a cancerous infection or precancerous state of an organ.

Introduced iodine-131 spontaneously decomposes rather quickly. Usually the dosage is calculated individually for each patient. For example, in Estonia, research is carried out using the Discovery NM / CT 670 equipment. The patient receives the examination results in Russian along with a disk, which allows doctors to carefully study all indications at home, to see even the slightest organ changes.

Radioiodine therapy is treated with caution, but this method is relatively safe for both adult patients and children. It provides for the patient to receive the radioactive isotope of iodine I-131. Since radioactive iodine I-13 is used only for the treatment of various diseases of the thyroid gland.

In this case, the ability of the thyroid organ to accumulate iodine, radioactive iodine is used. It irradiates an organ cell from the inside, damaging it. Cancer-infected cells die. The treatment is painless, there are no complications and the risk of developing other pathologies.

This method of treatment does not pose any danger to other organs. Since the beta particles emitted by I-131 are only valid within 2 mm.

Radioiodine therapy is performed for the treatment and prevention of:

It is used for treatment if it is completely impossible to remove the tumor.
Prevention with radioiodine therapy is performed when the tumor has already been removed, but so that the spreading process does not go further.

During the treatment period, it is not recommended:

Take medications containing iodine.
Do not apply iodine solution to the skin.
Do not eat products containing iodine.
Preparation is required to begin one month before the start of the procedures.

In preparation for the procedure, it is imperative to adhere to a certain diet in order to prepare the thyroid gland. That is, the thyroid gland must experience iodine hunger. This will make it possible to actively absorb radioiodine. Usually, the diet is prescribed 2 weeks before admission, it must be adhered to for the entire course when diagnostics or treatment is carried out.

How long is iodine I-131 retained in the body?

Most of it is excreted naturally during the first 2 days, the rest decreases sharply, and after the eighth day it does not remain at all.