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Technetium-99m-Sestamibi Scintigraphy Compared with Thallium-201 in Evaluation of Thyroid Tumors

Noguchi Thyroid Clinic and Hospital Foundation, Beppu, Oita
Department of Radiology, Miyazaki Medical College, Miyazaki, Japan

Correspondence: For correspondence or reprints contact: Hiroshi Nakahara, MD, Miyazaki Medical College, 5200 Ohaza Kihara, Kiyotake, Miyazaki, Japan 889-16.

ABSTRACT

Technetium-99m methoxyisobutylisonitrile (MIBI) is a myocardial perfusion imaging agent that has been reported to effectively localize in various tumors (e.g., lung and thyroid carcinomas and osteogenic sarcoma). To determine its usefulness in thyroid tumors, we compared ^99mTc-MIBI with ²⁰¹TI imaging. Method: We evaluated 25 patients with thyroid tumors (papillary carcinoma in 11, follicular carcinoma in 2, follicular adenoma in 7, adenomatous goiter in 5). Fifteen metastatic lesions from differentiated thyroid carcinomas were also evaluated. Early (10 min after injection) and delayed images (120 min after injection) were obtained for both ^99mTc-MIBI and ²⁰¹Tl scintigraphy. Results: The early images showed very similar findings for both ^99mTc-MIBI and ²⁰¹TI. However, the delayed images showed that malignant tumors tended to retain more tracer agent than benign nodules. Marked retention was in 61.5% (8 of 13) of ²⁰¹TI images and 53.8% (7 of 13) of ^99mTc-MIBI images. For metastatic lesions from thyroid carcinomas, the findings for ^99mTc-MIBI imaging were nearly identical to those for ²⁰¹TI imaging. A slight difference in clarity was seen that may have been due to the effect of the ^99mTc. Conclusion: Although ^99mTc-MIBI scintigraphy does not have particularly good results in differentiating malignant from benign thyroid tumors, it may be useful in evaluating metastases or predicting recurrence because of its better imaging characteristics.

Key Words: technetium-99m-sestamibi • thallium-201 • thyroid tumors

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