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Use of Ultrasound and Digital Scintiphoto Analysis in the Evaluation of Solitary Thyroid Nodules

Academisch Ziekenhuis der V.U., Amsterdam, The Netherlands

Correspondence: For reprints contact: L. G. Thijs, Dept. of Internal Medicine, Academisch Ziekenhuis der V.U., 1117 de Boelelaan, Amsterdam 1011, The Netherlands.

ABSTRACT

Thyroid scintigraphy is widely accepted as the only means to study thyroid nodules detected by palpation. Accordingly these nodules are classified as "hot", "warm", "cool", or "cold". Cool and cold nodules are often malignant, hot nodules nearly always benign. In this paper digital scintiphoto analysis with a multichannel system is combined with ultrasonic tomography, which adds a third dimension (depth) to the two-dimensional scintigraphic picture. In this way nodules can be shown to be hypo- or nonfunctioning which appear as warm areas on the scintiphoto. This proved to be the case in 13 of 102 patients with clinically single thyroid nodules. Similarly, an increase in radioactivity per unit surface (hot area) may prove to be due to a local thickening of normally functioning thyroid tissue. The addition of ultrasonic tomography as a diagnostic tool may thus help avoid misclassification of thyroid nodules which is not uncommon if performed on the basis of palpation and scintigraphy alone.