Is the technetium 99M scan useful in screening for nontoxic solitary thyroid nodules?

ABSTRACT

The proposed benefits of the technetium [99[m] Tc] scan in the screening of patients with clinically solitary thyroid nodules were assessed. One hundred seventy-eight patients with such lesions underwent 99[m]Tc scanning followed by surgical resection. The solitary nature of the lesion was confirmed by Tc scanning in 153 [86%] patients. In the remaining 25 [14%], the scan showed patchy uptake by the thyroid gland, suggesting subclinical multinodularity. Of these 25 patients with conflicting clinical and scan findings, the lesion was confirmed to be sol-these 25 patients with conflicting clinical and scan findings, the lesion was confirmed to be solitary by operative and pathological findings in ten [40%] patients, of whom two patients had thyroid malignancies that might have been misdiagnosed as multinodular goiter. In the other 15 [60%] patients, the scan was accurate in detecting subclinical multinodularity, but again, two patients in this group had thyroid malignancies that might have been misdiagnosed as multinodular gointer. These findings indicate that the 99[m]Tc scan is useless in screening patients with nontoxic solitary thyroid nodules, and even more so in patients from geographical areas where there is a high incidence of malignancy in multinodular thyroid disorders