Role of Tc-99m pertechnetate thyroid scintigraphy in evaluation of lingual and midline neck swellings

Authors

  • Bhairavi Mohit Bhatt Department of Nuclear Medicine, T. N. Medical College, Mumbai, Maharashtra, India
  • Shwetal Uday Pawar Department of Nuclear Medicine, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Anuja Anand Department of Nuclear Medicine, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Mangala Kedar Ghorpade Department of Nuclear Medicine, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
  • Suruchi Suresh Shetye Department of Nuclear Medicine, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20180601

Keywords:

Midline neck swelling, Thyroid scan, Ultrasound

Abstract

Background: The ectopic thyroid tissue in thyroglossal cyst or suprahyoid swelling is one of most important differential to be diagnosed. The purpose of this study was to find out role of Technetium-99m Pertechnetate Thyroid Scintigraphy (TS) to detect functioning thyroid tissue in ectopic locations presenting as midline neck swelling.

Methods: A retrospective observational study was done where 26 subjects presenting with midline neck swelling were included. These subjects were injected with 1-5MBq/kg of Technetium-99m Pertechnetate to perform the TS. The uptake of tracer in the midline neck swelling and in other ectopic location was assessed. The comparison with Ultrasound (USG) was also done.

Results: 12 (46.15%) subjects presented with infra hyoid swelling and rest 14 (53.85%) presented with supra hyoid and submental swelling. 33.3% subjects presenting with thyroglossal duct cyst showed functioning thyroid tissue. Also 4 subjects showed dual functioning ectopic tissue. USG an TS showed concordant results for detecting thyroid tissue in ectopic location (p=0.68). However, TS performed better to detect ectopically located thyroid tissue (p=0.0086).

Conclusions: USG and TS showed similar results to detect thyroid tissue in normal location. However, TS is better to detect topically located thyroid tissue. TS adds information of functioning thyroid tissue during workup of midline neck swelling. 

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References

Som PM, Smoker WR, Curtin HD, Reidenberg JS, Laitman J. Congenital lesions of the neck. In: Som PM, Curtin HD, eds. Head and neck imaging. 5th ed. St Louis, Mo: Mosby;2011:2235-86.

Allard RH. The thyroglossal cyst. Head Neck Surg. 1982;5(2):134-46.

Zander DA, Smoker WR. Imaging of ectopic thyroid tissue and thyroglossal duct cysts. Radiographics. 2014;34(1):37-50.

Ahuja AT, Wong KT, King AD, Yuen EH. Imaging for thyroglossal duct cyst: the bare essentials. Clin Radiol. 2005;60(2):141-8.

Koeller KK, Alamo L, Adair CF, Smirniotopoulos JG. Congenital cystic masses of the neck: radiologic-pathologic correlation. Radiographics. 1999;19(1):121-46.

Subramanyam P, Palaniswamy SS. Pictorial essay of developmental thyroid anomalies identi ed by Technetium thyroid scintigraphy. Indian J Nucl Med. 2015;30:323-7.

Ruchała M, Szczepanek E, Sowiński J. Diagnostic value of radionuclide scanning and ultrasonography in thyroid developmental anomaly imaging. Nucl Med Rev Cent East Eur. 2011;14(1):21-8.

Ziessman H, O’Malley J. Nuclear Medicine: The Requisites 4th Edition, Endocrinology. Boston: Saunders;2014:66-97.

Kreisner E, Camargo-Neto E, Maia CR, Gross JL. Accuracy of ultrasonography to establish the diagnosis and aetiology of permanent primary congenital hypothyroidism. Clin Endocrinol (Oxf). 2003;59:361-5.

Perry J, Maroo S, Maclennan AC, Jones JH, Donaldson MDC. Combined ultrasound and isotope scanning is more informative in the diagnosis of congenital hypothyroidism than single scanning. Arch Dis Child. 2006;91:972-6.

Jain A, Pathak S. Rare developmental abnormalities of thyroid gland, especially multiple ectopia: A review and our experience. Indian J Nucl Med. 2010;25(4):143-6.

Kurt A, Ortug C, Aydar Y, Ortug G. An incidence study on thyroglossal duct cysts in adults. Saudi Med J. 2007;28:593-7.

Hirshoren N, Neuman T, Udassin R, Elidan J, Weinberger JM. The imperative of the Sistrunk operation: review of 160 thyroglossal tract remnant operations. Otolaryngol Head Neck Surg. 2009;140: 338-42.

Katz AD, Hachigian M. Thyroglossal duct cysts. A thirty-year experience with emphasis on occurrence in older patients. Am J Surg. 1988;155:741-4.

Ozer C, Demir Apaydin F, Yildiz, Duce MN, Kinaci NC, Azizoglu F, et al. Thyroid hemiagenesis: two case reports. Eur J Radiol. 2003;48:23-6.

Gursoy A, Anil C, Unal AD, Demirer AN, Tutuncu NB, Erdogan MF. Clinical and epidemiological characteristics of thyroid hemiagenesis: ultrasound screening in patients with thyroid disease and normal population. Endocrine. 2008;33:338-41.

Korpal-Szczyrska M, Kosiak W, Swieton D. Prevalence of thyroid hemiagenesis in an asymptomatic schoolchildren population. Thyroid. 2008;18:637-9.

McCoul ED, De Vries EJ. Concurrent lingual thyroid and undescended thyroglossal duct thyroid without orthotopic thyroid gland. Laryngoscope. 2009;119:1937-40.

Müller J, Ritzén EM, Ivarsson SA, Rajpert-De Meyts E, Norjavaara E, Skakkebæk NE, et al. Revised guidelines for neonatal screening programmes for primary congenital hypothyroidism. Hormone Research in Paediatrics. 1999;52(1):49-52.

American Academy of Pediatrics, Rose SR; Section on Endocrinology and Committee on Genetics, American Thyroid Association, Brown RS; Public Health Committee, Lawson Wilkins Pediatric Endocrine Society, Foley T, Kaplowitz PB, Kaye CI, Sundararajan S, Varma SK. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006;117(6):2290-303.

Fugazzola L, Persani L, Mannavola D, Reschini E, Vannucchi G, Weber G, et al. Recombinant human TSH testing is a valuable tool for differential diagnosis of congenital hypothyroidism during l‐thyroxine replacement. Clinical endocrinology. 2003;59(2):230-6.

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Published

2018-02-22

How to Cite

Bhatt, B. M., Pawar, S. U., Anand, A., Ghorpade, M. K., & Shetye, S. S. (2018). Role of Tc-99m pertechnetate thyroid scintigraphy in evaluation of lingual and midline neck swellings. International Journal of Research in Medical Sciences, 6(3), 842–847. https://doi.org/10.18203/2320-6012.ijrms20180601

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Original Research Articles