What is the Thyroid Scintigraphy test?.The thyroid Scintigraphy test involves the use of short-lived nuclear medicine called Isotope to differentiate between different types of thyroid abnormalities. It defines various functional abnormalities as against an ultrasound of the thyroid gland which helps to visualise the structure of the gland. So, in the absence of functional abnormality of thyroid gland, if a patient has only structural abnormality, then perhaps an ultrasound is a superior test after the hormone assay to determine what is the nature of the enlarged thyroid gland. However, where there is functional abnormality of the thyroid gland which means the thyroid hormones are manufactured in excessive quantity, then it is necessary to choose a functional test. All the nuclear medical procedures target the function of various organs and choice of radiotracer decides its destination.As far as the thyroid is concerned, there are two different types of thyroid disorders accounting for the same clinical presentation. One is called Graves' disease, where the manufacture of the thyroid hormones in the thyroid gland is increased (i.e. the turnover of T3 and T4 hormones is high). In the second entity where there isn't any excessive production but there is excessive release of the thyroid hormones in the circulation. The second entity occurs because of “thyroiditis.” Nuclear thyroid scan accurately differentiates these two entities..How is Nuclear Scan performed?.It involves administration of a small amount of short- lived radiotracer intravenously followed by a waiting period of about 20 minutes. Thereafter the patient is scanned under a gamma camera which lasts for about two to three minutes. There are no side effects of the administered radiotracer. The result is released within an hour of performing a test or by evening. The advantage of these tests is very objective and it has zero side effects, it can be safely performed in all age groups and there is no contraindication. However, we don't perform any nuclear procedures either in pregnancy or during lactation. These are the two contraindications for any nuclear medicine procedure..What is a thyroid Scan and How it is performed?.Thyroid scan helps in differentiating between various causes of thyrotoxicosis ie Graves' disease versus thyroiditis. It is an objective way to differentiate the two. Based on this the endocrinologist and the physicians make the decision about the treatment strategy. Patients with Graves' disease or those in whom there is excessive production of T3 T4 hormones, require long-term strategic treatment either with medication or with the radioactive substance called radioactive iodine therapy. Whereas in patients who have subacute thyroiditis where the thyroids hormones are just released in circulation without excessive production there is no place either for radioactive iodine therapy or surgery or long-term medication for that matter. It's a self-limiting entity..How are results interpreted?.The beauty of nuclear medicine is its objectivity and it can be very easily understood by a layman. When it comes to ultrasound that is highly operator dependent, you have to depend on the interpreter's verdict..And any other advice you want to give to people who are undergoing this test?.Tips I can give to patients who come for thyroid scans include:. first and foremost, the patient doesn't have to fear the test because it's a very simple test that does not involve any side effects. It's not performed in a closed Gantry. The gantry is open so there is no claustrophobia.. It takes only about one hour from the point of registration to the point of releasing the patient after documentation of medical reports. It is mandatory for patients to carry their blood test i.e. T3 T4 TSH if they are suffering from thyrotoxicosis.. One important practical tip is for those who have hypo-functioning thyroid gland i.e. those in whom the TSH is elevated. These patients are not candidates for a nuclear thyroid scan. Because, the thyroid gland is not adequately producing the hormones and for which your doctors will prescribe required medicine.The nuclear scan is indicated for thyrotoxicosis and not for hypothyroidism. There is an exception here. In Infants who have been detected with hypothyroidism, the paediatrician may desire to know if there is agenesis of the gland (i.e. congenital absence of development of thyroid gland) or dyshormonogenesis which means that even though the gland has developed, it is incapable of producing adequate level of thyroid hormones. Thyroid scan helps differentiate between thyroid agenesis and hypo functioning thyroid gland. .Any advice you want to give to people with foot problems?.In people with diabetes foot problems, a nuclear scan is primarily to look for abnormalities of circulation and destruction of the joints which are caused because of diabetic neuropathy. So, as I said, athree-phase bone scans involve administration of the tracer followed by immediate imaging for about five minutes and then there is an interval of about three hours in which patients can return home or choose to stay at the hospital. At about 3 hours, a whole- body scan is done which takes about forty minutes. It is a very objective way to document inflammation in the various joints of the foot. It also helps to localise the extent of abnormalities so that the managing physician can accordingly decide the strategy of treatment. It's also useful for determining if the infection in the foot has reached the bone or not. In patients who have undergone any kind of intervention such as nailing, metallic fixation etc. sometimes there could be a need to add up an FDG PET scan to increase the level of confidence for diagnosis of the infection of bones and joints. .What does the test involve?.The bone scan result is interpreted by a physician and validated by another. If required, we add an MRI to the procedure without an extra cost so as to better define the structure of various bones of the foot in greater detail..How is the result interpreted?.It is a gamma camera scan and it determines based on the osteoblastic activity of the skeleton. Normally, a healthy skeleton shows uniform distribution of the radiotracer throughout the skeleton. In patients with injury or inflammation, the regional bone undergoes remodelling and shows abnormal increase in tracer uptake. This appears as a “hot spot” on the scan..Dr Shrikant V Solav did his MD in medicine from Bhopal university and diploma in Nuclear medicine from Mumbai university. He started private clinic of Nuclear medicine called as “Spectlab” in the year 2001.
What is the Thyroid Scintigraphy test?.The thyroid Scintigraphy test involves the use of short-lived nuclear medicine called Isotope to differentiate between different types of thyroid abnormalities. It defines various functional abnormalities as against an ultrasound of the thyroid gland which helps to visualise the structure of the gland. So, in the absence of functional abnormality of thyroid gland, if a patient has only structural abnormality, then perhaps an ultrasound is a superior test after the hormone assay to determine what is the nature of the enlarged thyroid gland. However, where there is functional abnormality of the thyroid gland which means the thyroid hormones are manufactured in excessive quantity, then it is necessary to choose a functional test. All the nuclear medical procedures target the function of various organs and choice of radiotracer decides its destination.As far as the thyroid is concerned, there are two different types of thyroid disorders accounting for the same clinical presentation. One is called Graves' disease, where the manufacture of the thyroid hormones in the thyroid gland is increased (i.e. the turnover of T3 and T4 hormones is high). In the second entity where there isn't any excessive production but there is excessive release of the thyroid hormones in the circulation. The second entity occurs because of “thyroiditis.” Nuclear thyroid scan accurately differentiates these two entities..How is Nuclear Scan performed?.It involves administration of a small amount of short- lived radiotracer intravenously followed by a waiting period of about 20 minutes. Thereafter the patient is scanned under a gamma camera which lasts for about two to three minutes. There are no side effects of the administered radiotracer. The result is released within an hour of performing a test or by evening. The advantage of these tests is very objective and it has zero side effects, it can be safely performed in all age groups and there is no contraindication. However, we don't perform any nuclear procedures either in pregnancy or during lactation. These are the two contraindications for any nuclear medicine procedure..What is a thyroid Scan and How it is performed?.Thyroid scan helps in differentiating between various causes of thyrotoxicosis ie Graves' disease versus thyroiditis. It is an objective way to differentiate the two. Based on this the endocrinologist and the physicians make the decision about the treatment strategy. Patients with Graves' disease or those in whom there is excessive production of T3 T4 hormones, require long-term strategic treatment either with medication or with the radioactive substance called radioactive iodine therapy. Whereas in patients who have subacute thyroiditis where the thyroids hormones are just released in circulation without excessive production there is no place either for radioactive iodine therapy or surgery or long-term medication for that matter. It's a self-limiting entity..How are results interpreted?.The beauty of nuclear medicine is its objectivity and it can be very easily understood by a layman. When it comes to ultrasound that is highly operator dependent, you have to depend on the interpreter's verdict..And any other advice you want to give to people who are undergoing this test?.Tips I can give to patients who come for thyroid scans include:. first and foremost, the patient doesn't have to fear the test because it's a very simple test that does not involve any side effects. It's not performed in a closed Gantry. The gantry is open so there is no claustrophobia.. It takes only about one hour from the point of registration to the point of releasing the patient after documentation of medical reports. It is mandatory for patients to carry their blood test i.e. T3 T4 TSH if they are suffering from thyrotoxicosis.. One important practical tip is for those who have hypo-functioning thyroid gland i.e. those in whom the TSH is elevated. These patients are not candidates for a nuclear thyroid scan. Because, the thyroid gland is not adequately producing the hormones and for which your doctors will prescribe required medicine.The nuclear scan is indicated for thyrotoxicosis and not for hypothyroidism. There is an exception here. In Infants who have been detected with hypothyroidism, the paediatrician may desire to know if there is agenesis of the gland (i.e. congenital absence of development of thyroid gland) or dyshormonogenesis which means that even though the gland has developed, it is incapable of producing adequate level of thyroid hormones. Thyroid scan helps differentiate between thyroid agenesis and hypo functioning thyroid gland. .Any advice you want to give to people with foot problems?.In people with diabetes foot problems, a nuclear scan is primarily to look for abnormalities of circulation and destruction of the joints which are caused because of diabetic neuropathy. So, as I said, athree-phase bone scans involve administration of the tracer followed by immediate imaging for about five minutes and then there is an interval of about three hours in which patients can return home or choose to stay at the hospital. At about 3 hours, a whole- body scan is done which takes about forty minutes. It is a very objective way to document inflammation in the various joints of the foot. It also helps to localise the extent of abnormalities so that the managing physician can accordingly decide the strategy of treatment. It's also useful for determining if the infection in the foot has reached the bone or not. In patients who have undergone any kind of intervention such as nailing, metallic fixation etc. sometimes there could be a need to add up an FDG PET scan to increase the level of confidence for diagnosis of the infection of bones and joints. .What does the test involve?.The bone scan result is interpreted by a physician and validated by another. If required, we add an MRI to the procedure without an extra cost so as to better define the structure of various bones of the foot in greater detail..How is the result interpreted?.It is a gamma camera scan and it determines based on the osteoblastic activity of the skeleton. Normally, a healthy skeleton shows uniform distribution of the radiotracer throughout the skeleton. In patients with injury or inflammation, the regional bone undergoes remodelling and shows abnormal increase in tracer uptake. This appears as a “hot spot” on the scan..Dr Shrikant V Solav did his MD in medicine from Bhopal university and diploma in Nuclear medicine from Mumbai university. He started private clinic of Nuclear medicine called as “Spectlab” in the year 2001.
