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Thallium-201 Scintigraphy of the Suppressed Thyroid: An Alternative for Iodine-123 Scanning After TSH Stimulation

Departments of Nuclear Medicine and Endocrinology, University Hospital Nijmegen, Nijmegen, The Netherlands

Correspondence: For reprints contact: Frans Corstens, MD, Dept. of Nuclear Medicien, University Hospital Nijmegen, Box 9101, 6500 HB Nijmegen, The Netherlands

ABSTRACT

Thallium-201 scintigraphy of the thyroid gland suppressed by autonomous nodule was compared with ¹²³I scintigraphy after TSH stimulation. In all patients, similar images were obtained by both methods. In 20 patients, the contralateral lobe was visualized on both scans and in 14 of these, the upper pole of the ipsilateral lobe was also visualized. In one patient, neither ¹²³I scanning after TSH nor ²⁰¹Tl scintigraphy showed any extranodular tissue. This study suggests that ²⁰¹Tl scintigraphy is a reliable alternative for scanning after TSH. It is a relatively simple method, not inducing any TSH-related allergic reactions. Iodine uptake in extranodular tissue is not stimulated and therefore, ²⁰¹Tl scintigraphy and radioiodine therapy can be combined on one day, without increasing the risk of radiation damage to the normal thyroid tissue with a resultant post-treatment hypothyroidism.