Die (99m)Technetium-Methoxy-Isobutyl-Isonitril (MIBI)-Szintigraphie als präoperatives diagnostisches Verfahren zur Beurteilung der Dignität von Schilddrüsenknoten
InstitutionsUKU. Klinik für Nuklearmedizin
UKU. Klinik für Allgemein- und Viszeralchirurgie
Is (99m)Tc–sestamibi scintigraphy able to predict malignancy of thyroid nodules? Objective: A differentiation between benign and malignant thyroid nodules is a common issue for preoperative decision making in patients subjected to thyroid surgery. The aim of this study was to determine whether (99m)Tc-sestamibi scintigraphy was able to identifiy differentiated thyroid carcinoma. Methods: A prospective database was reviewed to identify 57 patients (72 % female, 28 % male, mean age 57.6 years) with thyroid nodules and preoperative (99m)Tc-sestamibi scintigraphy for primary hyperparathyroidism (32 %) and/or suspicious thyroid nodules. Results: In 39 patients a thyroid lobectomy was performed. In 1 patient a nodule enucleation was done. 17 patients underwent near-total or total thyroidectomy, 6 of them an additional prophylactic central lymph node dissection. In 82,5 % benign thyroid disease was detected, in 17,5 % histopathology described thyroid malignancies (9 PTC, 1 FTC). The mean tumor size was 1.5 cm. The sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of (99m)Tc-sestamibi scintigraphy for the diagnosis of thyroid malignancy were 90.0 %, 36.2 %, 23.1 % and, 94.4 %. False-negative results were only noticed for 1 papillary microcarcinoma of 0.4 cm diameter. Conclusions: (99m)Tc-sestamibi scintigraphy has a high negative predictive value and may therefore lead to a higher rate of thyroid nodules that can be followed. Sestamibi positive lesions should be strongly considered for thyroid surgery.
Subject HeadingsSchilddrüse [GND]
Thyroid gland [MeSH]
Thyroid nodule [MeSH]
Technetium Tc 99m sestamibi [MeSH]