Molecular imaging of thyroid and parathyroid diseases

Figures & data

Table 1. Gamma camera radionuclides.

Radionuclide	Half Life	Production	Energy
^99mTc	6.02 hours	Generator	140 keV (89%)
^123I	13.22 hours	Cyclotron	159 keV (83%)
^131I	8.02 days	Nuclear reactor	364 keV (81%)

Table 2. positron emission tomography radionuclides.

Radionuclide	Half Life	Production	Positron energy (Max/mean)	Positron range (Mean/Max)
^18F	109.8 min	Cyclotron	0.65/0.28 MeV	2.5/0.7 mm
^68Ga	67.7 min	Generator	1.90/0.84 MeV	9.0/2.9 mm
^11C	20.04 min	Cyclotron	0.96/0.39 MeV	4.2/1.2 mm
^124I	4.2 days	Cyclotron	2.14/1.53 MeV	3.0/1.0 mm

Figure 1. ^99mTc-pertechnetate scan presentation of Graves’ disease (a), autonomously functioning thyroid nodules (b) and destructive thyroiditis (c).

Figure 2. ^99mTc-pertechnetate (a) and ^99mTc-MIBI (b) scans: cold and MIBI active nodules in both lobes (arrows). Histopathology: multifocal invasive follicular variant of papillary thyroid carcinoma.

Figure 3. ¹⁸FDG PET/CT (axial image): FDG-avid thyroid nodule (i.e. risk of malignancy about 30%).

Figure 4. Post-ablation¹³¹I SPECT/CT (B) in a young female affected by papillary thyroid carcinoma (pT2 Nx) showing a central neck lymph-node metastasis.

Figure 5. Post-therapy¹³¹I WBS (a, anterior; b, posterior views) and SPECT/CT (C) in a 50 years old female affected by papillary thyroid carcinoma (pT2 N1b) showing multiple visceral and skeletal radioiodine-avid metastases.

Figure 6. ¹⁸F-FDG PET maximum intensity projection image of a patient with poorly differentiated thyroid carcinoma showing increasing radiopharmaceutical uptake within the thyroid, corresponding to the primary tumor site and multiple lymph node, lung, liver, bone and renal metastases.

Figure 7. Parathyroid ultrasound: ovoidal hypoechoic nodule with vascular basket-pole, consistent with enlarged and hyperfunctioning parathyroid gland.

Figure 8. ^99mTc-MIBI dual phase scintigraphy: tracer uptake and late retention in a parathyroid adenoma (red arrow).

Figure 9. ^99mTc-MIBI SPECT/CT (coronal a-c, axial d-f): ectopic mediastinal parathyroid adenoma (red arrows).

Figure 10. ¹⁸F-fluorocholine PET/CT (axial a, coronal b): parathyroid adenoma (red arrows).