Toxic Adenoma other imaging findings

Jump to navigation Jump to search

Toxic Adenoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Toxic Adenoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Template:T On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Toxic Adenoma other imaging findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Toxic Adenoma other imaging findings

CDC on Toxic Adenoma other imaging findings

Toxic Adenoma other imaging findings in the news

Blogs on Toxic Adenoma other imaging findings

Directions to Hospitals Treating Psoriasis

Risk calculators and risk factors for Toxic Adenoma other imaging findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Radionuclide imaging and quantitative radioisotopic uptake studies are always required to establish the diagnosis of toxic adenoma or toxic nodular goiter

Other Imaging Findings

  • Radionuclide imaging and quantitative radioisotopic uptake studies are always required to establish the diagnosis of toxic adenoma or toxic nodular goiter.[1]
  • Radionuclide imaging can be performed with radioactive iodine-123 ( 123 I) or with technetium-99m ( 99m Tc).[2][3]
  • Radionuclide imaging performed with 123 I or 99m Tc-technetium pertechnetate, are trapped by the sodium-iodide symporter in functioning thyroid tissue, although only radioiodine is subsequently organified.
  • In patients with hyperthyroidism caused by a toxic adenoma, there is a characteristic restriction of radionuclide uptake to the responsible hyper functioning nodule with suppression of radionuclide uptake in the remainder of the gland.
  • In a patient with a low serum TSH concentration, not only does the scan appearance support the diagnosis of toxic adenoma, but in almost all cases it also excludes malignancy in the nodule.
  • If some thyroid nodules are hypo functioning, it is necessary to rule out cancer by fine-needle aspiration cytology.
Differential for thyrotoxicosis Fractional Uptake

of Radioactive Iodine in

24 hrs (%)

Radioactive iodine

Distrubution

Graves’ disease 40-95 Diffuse

(Homogeneous within thyroid)

Toxic adenoma 20-60 Restricted to autonomous regions in thyroid
Subacute thyroiditis <2 minimal uptake
Silent thyroiditis <2 minimal uptake
Iodine-induced thyrotoxicosis <2 minimal uptake
Factitious or

iatrogenic thyrotoxicosis

<2 minimal uptake
Struma ovarii <2 Uptake in ovary
Follicular carcinoma <2 Uptake in cancer metastasis
Thyroid-stimulating hormone–induced thyrotoxicosis 30-80 Diffuse

(Homogeneous within thyroid)

References

  1. Hurley PJ, Maisey MN, Natarajan TK, Wagner HN (1972). "A computerized system for rapid evaluation of thyroid function". J. Clin. Endocrinol. Metab. 34 (2): 354–60. doi:10.1210/jcem-34-2-354. PMID 4110446.
  2. Smith JR, Oates E (2004). "Radionuclide imaging of the thyroid gland: patterns, pearls, and pitfalls". Clin Nucl Med. 29 (3): 181–93. PMID 15162989.
  3. Bianco AC, Anderson G, Forrest D, Galton VA, Gereben B, Kim BW, Kopp PA, Liao XH, Obregon MJ, Peeters RP, Refetoff S, Sharlin DS, Simonides WS, Weiss RE, Williams GR (2014). "American Thyroid Association Guide to investigating thyroid hormone economy and action in rodent and cell models". Thyroid. 24 (1): 88–168. doi:10.1089/thy.2013.0109. PMC 3887458. PMID 24001133.