Abstract
Eighty-eight patients referred consecutively for thyroid imaging were studied. Each patient was scanned with a 3″ rectilinear scanner using both 125I and 99mTc. The paired scans were evaluated independently by two physicians experienced in thyroid evaluation and image analysis. The images were ranked on a scale from 1 to 5 as follows:
1) 125I scan much better than the 99mTc scan, 2)..., 3) 125I scan and 99mTc scan the same, 4) h., 5) 99mTc scan much better than 125I scan.
The scores were statistically analyzed by the sign test and transformed normal score methods. Categories analyzed were: A. Hypothyroid, B. Euthyroid, C. Hyperthroid, (A-C based upon RAIU measurements), D. Cold Nodules, E. Graves Disease, F. Hot-Nodules, G. Multinodular Nontoxic Goiter, H. Miscellaneous and I. Normal. The significance of this study is that regardless of the classification we used, in no category was the 99mTc scan considered better than the 125I scan. This finding is at variance with the observations of some others comparing 99mTc with other iodine radioisotopes. 99mTc may have some procedural advantages and does deliver a lower radiation dose to the thyroid.
Similar content being viewed by others
References
Andros, G., Harper, P.V., Lathrop, K., McCardle, R.D.: Pertechnetate-99m localization in man with applications to thyroid scanning and the study of thyroid physiology. J. Clin. Endocrin. 25, 1067–1076 (1965)
Arnold J.E., Pinsky, S.: Comparison of 99mTc and 123I for thyroid imaging. J. Nucl. Med. 17, 261–267 (1976)
Atkins, H.L.: Technetium-99m pertechnetate uptake and scanning in the evaluation of thyroid function. Sem. Nucl. Med. 1, 345–355 (1971)
Atkins, H.L., Klopper, J.F., Lambrecht, R.M., Wolf, A.P.: A comparison of technetium-99m and iodine-123 for thyroid imaging. Am. J. Roentgenol. 117, 195–201 (1975)
Atkins, H.L., Richards, P.: Assessment of thyroid function and anatomy with technetium-99m as pertechnetate. J. Nucl. Med. 9, 7–15 (1968)
Charkes, N.D.: Scintigraphic evaluation of nodular goiter. Sem. Nucl. Med. 1, 316–333 (1971)
Charkes, N.D., Sklaroff, D.M.: The use of iodine-125 in thyroid scintiscanning. Am. J. Roentgenol. 90, 1052–1058 (1963)
Dixon, W.J., Massey, F.J.: Introduction to statistical methods, pp 335–342. New York: McGraw-Hill 1969
Dodds W.J., Powell, M.R.: Thyroid scanning with technetium-99m pertechnetate. Radiology 91, 27–31 (1968)
DosRemedios, L., Weber, P.M., Jasko, I.A.: Thyroid scintigraphy in 1,000 patients: Rational use of 99mTc and 131I compounds. J. Nucl. Med. 12, 673–677 (1971)
Endlich, H., Harper, P., Beck, R., Siemens, W., Lathrop, K.: The use of 125I to increase isotope scanning resolution. Am. J. Roentgenol. 87, 148–155 (1962)
Goolden, A.W.G., Glass, H.I., Williams, E.D.: Use of 99mTc for the routine assessment of thyroid function. Brit. Med. J. 4, 396–399 (1971)
Greig, W.R.: Radionuclide evaluation of thyroid diseases in children. Sem. Nucl. Med. 2, 85–107 (1972)
Hirabayashi, S., Koga, Y., Kitahara, T., Hishida, T., Kiga, M., Lindo, S.: Inconsistent images of thyroid nodule scintigrams made with iodine and pertechnetate: Case report. J. Nucl. Med. 16, 1918 (1975)
Hurley, P.J., Strauss, H.W., Pavoni, P., Langen, J.K., Wagner, H.N.: The scintillation camera with pinhole collimator in thyroid imaging. Radiology 101, 133–138 (1971)
Kim, E., Kumar, B.: Discrepant imaging of nodular hyperplasia with pertechnetate and radioiodine. Clin. Nucl. Med. 1, 204–205 (1976)
Krishnamurthy, G.T., Shoop, L., Walsh, C.F., Blahd, W.H.: Comparison of 99m-technetium pertechnetate and radioiodine (I-131) as thyroid scanning agents. Nuclear-Medizin. 12, 97–106 (1973)
Li, J.C.R.: Introduction to statistical inference, pp. 87–94. An Arbor: Edwards Bros. Inc. 1957
Libby, R.L.: Statistical evaluation of I-125 vs I-131 for scanning cold lesions. J. Nucl. Med. 5, 887–894 (1964)
Marion, M.A., Ronai, P.M., Pain, R.W., Wise, P.H.: Simultaneous assessment of thyroid structure and function with the gamma camera using pertechnetate: A comparison with radioiodine and biochemical diagnosis. Aust. N.Z.J. Med. 4, 379–384 (1974)
McDougal, I.R., Kriss, J.P.: Which radioisotope for diagnosis of thyroid disorders? Clin. Nucl. Med. 1, 217–218 (1976)
Miller, J.M., Kasenter, A.G., Marks, D.S.: Disparate imaging of the autonomous functioning thyroid nodule with 99mTc pertechnetate and radioiodine. Radiology 119, 737–739 (1976)
Nishiyama, H., Ashare, A.B., Shabie, A., Saenger, E.L., Sodd, V.J.: A comparison of 123I and 131I for thyroid imaging using various collimators. Int. J. Nucl. Med. Biol. 1, 201–204 (1974a)
Nishiyama, H., Sodd, V.J., Berke, R.A., Saenger, E.L.: Evaluation of clinical value of 123I and 131I in thyroid disease. J. Nucl. Med. 15, 261–265 (1974b)
Quinn, J.L., Henkin, R.E.: Scanning techniques to assess thyroid nodules. Ann. Rev. Med. 26, 193–201 (1975)
Rall, J.E.: The need for iodine-123 in Nuclear Medicine: Endocrinologic viewpoint. In: Applications of Iodine-123 in Nuclear Medicine, pp. 26–29. Proceeding of a conference held in Rockville, Maryland: Bureau of Radiological Health 1976
Riceabond, G.: I125 in the clinical evaluation of thyroid disease. New Eng. J. Med. 273, 126 (1965)
Robinson, T., Collica, C.J., Chang, S.: Clinical comparison of scans and scintiphotos of the thyroid gland. Am. J. Roentgenol. 103, 738–745 (1961)
Rollo, F.D., Schultz, A.G.: Effect of pulse-height selection on lesion detection performance. J. Nucl. Med. 12, 690–696 (1971)
Russell, C.D., Webber, M., Waisman, J.: The 125I thyroid scan: Clinicopathological correlation. Int. J. Nucl. Med. Biol. 2, 129–134 (1975)
Ryo, U.Y., Arnold, J., Colman, M., Arnold, M., Farus, M., Frohman, L., Schneider, A., Stachura, M., Pinsky, S.: Thyroid scintigram: Sensitivity with sodium pertechnetate Tc99m and gamma camera with pinhole collimator. JAMA 235, 1235–1238 (1976)
Sanders, T.P., Kuhl, D.E.: Technetium pertechnetate as thyroid scanning agent. Radiology 91, 23–26 (1968)
Schall, G.L., Roth, J.A., Temple, R.: Differential uptake of 125I and 99mTcO −4 in a histologically unusual metastatic thyroid carcinoma. J. Surg. Onocl. 5, 235–242 (1973)
Schultz, J., Hanner, T.C., Witcofski, R.L., Maynard, C.D.: Comparison of 99mTc and 125I thyroid scans. J. Nucl. Med. 7, 797 (1966)
Shambaugh, G.E., Quinn, J.L., Oyasu, R., Freinkel, N.: Disparate thyroid imaging. Combined studies with sodium pertechnetate Tc-99m and radioactive iodine. JAMA 228, 866–869 (1974)
Sodee, D.B.: The study of thyroid physiology utilizing intravenous sodium pertechnetate. J. Nucl. Med. 7, 564–567 (1966)
Steinberg, M., Cavalieri, R.R., Choy, S.H.: Uptake of technetium 99-pertechnetate in a primary thyroid carcinoma: Need for caution in evaluation nodules. J. Clin. Endocrinol. Met. 31, 81–84 (1970)
Strauss, H.W., Hurley, P.F., Wagner, H.N.: Advantages of 99mTc pertechnetate for thyroid scanning in patients with decreased radioiodine uptake. Radiology 97, 307–310 (1970)
Usher, M.S., Arzoumanian, A.Y.: Thyroid nodule scans made with pertechneteate and iodine may give inconsistent results. J. Nucl. Med. 12, 136–137 (1971)
Turner, J.W., Spencer, R.P.: Thyroid carcinoma presenting in a pertechnetate “hot” nodule, but without 131I uptake: Case report. J. Nucl. Med. 17, 22–23 (1976)
Weber, P.M., DosRemedios, L., Fish, M., Pollycove, M.: Thyroid imaging: 131I or 99mTc, a clinical comparison. J. Nucl. Med. 10, 451 (1969)
Wellman, H.N., Anger, R.T.: Radioiodine dosimetry and the use of radioiodine other than 131I in thyroid diagnosis. Sem. Nucl. Med. 1, 356–378 (1971)
Wellman, H.N., Mach, J.F.: Study of preliminary experience with the use of 123I for thyroid function and scanning compared to 131I. J. Nucl. Med. 9, 359 (1968)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Prince, J.R., Zu'bi, S.M. & Haag, B.L. Thyroid imaging with iodine-125 and technetium-99m. Eur J Nucl Med 4, 37–41 (1979). https://doi.org/10.1007/BF00257568
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00257568