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A nuclear medicine parathyroid scan demonstrates a parathyroid adenoma adjacent to the left inferior pole of the thyroid gland. The above study was performed with Technetium-Sestamibi (1st column) and Iodine-123 (2nd column) simultaneous imaging and the subtraction technique (3rd column).
The RAIU test is a reliable measurement when using a dedicated probe with a reproducibility of 1 percent and a 95%-least-significant-change of 3 percent. [3] The normal uptake is between 15 and 25 percent, but this may be forced down if, in the meantime, the patient has eaten foods high in iodine, such as dairy products and seafood. [4]
Technetium (99m Tc) sestamibi (commonly sestamibi; USP: technetium Tc 99m sestamibi; trade name Cardiolite) is a pharmaceutical agent used in nuclear medicine imaging.The drug is a coordination complex consisting of the radioisotope technetium-99m bound to six (sesta=6) methoxyisobutylisonitrile (MIBI) ligands.
Thyroid hormone uptake (T uptake or T 3 uptake) is a measure of the unbound thyroxine binding globulins in the blood, that is, the TBG that is unsaturated with thyroid hormone. [2] Unsaturated TBG increases with decreased levels of thyroid hormones. It is not directly related to triiodothyronine, despite the name T 3 uptake. [2] Reference ranges:
The nominal injection activity is 185 MBq [7] and a scan should not be performed with less than 111 MBq. Thyroid blocking via oral administration of 120 mg potassium iodide is recommended to minimize unnecessary excessive uptake of radioiodine. [8] This is typically given 1–4 hours before the injection. [7] [9]
Iodine-123 (123 I) is a radioactive isotope of iodine used in nuclear medicine imaging, including single-photon emission computed tomography (SPECT) or SPECT/CT exams. The isotope's half-life is 13.2232 hours; [1] the decay by electron capture to tellurium-123 emits gamma radiation with a predominant energy of 159 keV (this is the gamma primarily used for imaging).
Thyroid scan. A thyroid scan using a radioactive iodine uptake test can be used in viewing the thyroid. [20] A scan using iodine-123 showing a hot nodule, accompanied by a lower than normal TSH, is strong evidence that the nodule is not cancerous, as most hot nodules are benign. [21]
Thyroid blockade with (nonradioactive) potassium iodide is indicated for nuclear medicine scintigraphy with iobenguane/mIBG. This competitively inhibits radioiodine uptake, preventing excessive radioiodine levels in the thyroid and minimizing risk of thyroid ablation (in treatment with 131 I).