Determinación de la certeza diagnóstica de la gammagrafía tiroidea con tecnecio 99 sestamibi en pacientes con nódulo tiroideo y resultado histopatológico definitivo / Determination of the diagnostic accuracy of 99mTc sestamibi scanning in patients with thyroid nodule and a definitive histopathological report

Antecedentes La gammagrafía con tecnecio 99 (Tc99) sestamibi y la biopsia por aspiración permiten predecir de forma relativamente segura el resultado histopatológico de un nódulo tiroideo. Objetivo Determinar la utilidad diagnóstica de la gammagrafía tiroidea con tecnecio 99 sestamibi para detección de malignidad en pacientes con nódulo tiroideo, confirmado por resultado histopatológico definitivo posterior a tiroidectomía. Material y métodos Se estudió un total de 69 pacientes con diagnóstico de nódulo tiroideo solitario que contaban con punción por aspiración con aguja fina y que fueron sometidos a tiroidectomía total ante sospecha de cáncer con análisis patológico posterior en todos. Cincuenta y cuatro pacientes con gammagrafía tiroidea positiva para malignidad; 25 pacientes con un histopatológico final de cáncer y 29 con un histopatológico negativo al mismo. Quince pacientes con gammagrafía tiroidea negativa para neoplasia tiroidea, con 3 presentando un diagnóstico de cáncer confirmado por patología y 12 confirmados con ausencia de malignidad. Resultados En el presente estudio se realizó un análisis estadístico para determinar la certeza diagnostica del Tc99 sestamibi para detectar malignidad en los nódulos tiroideos. El estudio con gammagrafía tiroidea con Tc99 sestamibi para cáncer de tiroides, tuvo una sensibilidad de 89,28%, con una especificidad de 29,25%. El Tc99 sestamibi mostró un valor predictor positivo de 46,29% y un valor predictor negativo de 80%.ConclusionesConsideramos que la práctica de la gammagrafía tiroidea con Tc99 sestamibi debe ser una técnica diagnóstica que se utilice de forma rutinaria en todo aquel paciente con un nódulo tiroideo que presente una punción aspiración con citología tiroidea indeterminada; siendo su mayor utilidad para descartar malignidad en aquellos que presentan captación baja en el estudio de medicina nuclear (AU)

Background 99m Tc sestamibi scanning and aspiration biopsy can predict the histopathological result of a thyroid nodule fairly accurately. Objective To determine the accuracy of 99mTc sestamibi scanning in detecting malignancy in patients with thyroid nodule confirmed by definitive histopathological report after thyroidectomy. Material and methods A total of 69 patients with a solitary thyroid nodule were studied. In all patients, fine needle aspiration, total thyroidectomy for suspected thyroid cancer, and histological analysis of the surgical specimen were performed. There were 54 patients with a positive 99mTc sestamibi scan; of these, malignancy was confirmed by histological analysis in 25 and excluded in 29. There were 15 patients with a negative 99mTc sestamibi scan; of these, three had a final diagnosis of cancer and 12 were confirmed as cancer-free. Results The diagnostic accuracy of 99mTc sestamibi scanning in detecting malignancy in thyroid nodules was determined through a statistical analysis. 99mTc sestamibi scan for thyroid cancer had a sensitivity of 89.28% and a specificity of 29.25%. The positive predictive value was 46.29% and the negative predictive value was 80%.ConclusionsWe believe that 99mTc sestamibi scan should be routinely used in all patients with a thyroid nodule and an indeterminate result on fine needle aspiration. This procedure is most useful in excluding malignancy in patients with a negative 99mTc sestamibi scan (AU)

[Determination of the diagnostic accuracy of 99mTc sestamibi scanning in patients with thyroid nodule and a definitive histopathological report]. / Determinación de la certeza diagnóstica de la gammagrafía tiroidea con tecnecio 99 sestamibi en pacientes con nódulo tiroideo y resultado histopatológico definitivo.

BACKGROUND: 99mTc sestamibi scanning and aspiration biopsy can predict the histopathological result of a thyroid nodule fairly accurately. OBJECTIVE: To determine the accuracy of 99mTc sestamibi scanning in detecting malignancy in patients with thyroid nodule confirmed by definitive histopathological report after thyroidectomy. MATERIAL AND METHODS: A total of 69 patients with a solitary thyroid nodule were studied. In all patients, fine needle aspiration, total thyroidectomy for suspected thyroid cancer, and histological analysis of the surgical specimen were performed. There were 54 patients with a positive 99mTc sestamibi scan; of these, malignancy was confirmed by histological analysis in 25 and excluded in 29. There were 15 patients with a negative 99mTc sestamibi scan; of these, three had a final diagnosis of cancer and 12 were confirmed as cancer-free. RESULTS: The diagnostic accuracy of 99mTc sestamibi scanning in detecting malignancy in thyroid nodules was determined through a statistical analysis. 99mTc sestamibi scan for thyroid cancer had a sensitivity of 89.28% and a specificity of 29.25%. The positive predictive value was 46.29% and the negative predictive value was 80%. CONCLUSIONS: We believe that 99mTc sestamibi scan should be routinely used in all patients with a thyroid nodule and an indeterminate result on fine needle aspiration. This procedure is most useful in excluding malignancy in patients with a negative 99mTc sestamibi scan.