Radionuclide imaging with both Tc-99m sodium pertechnetate and TI-201 chloride was studied in 152 patients with thyroid nodules. Ultrasonography also was performed in 81 of those patients. Tc-99m sodium pertechnetate scans demonstrated nodules in 69.7percnt; of 78 differentiated thyroid carcinomas (DC) and 72.2percnt; of 54 thyroid adenomas (Ad). TI-201 chloride was accumulated in 73.7percnt; of DC and 53.6percnt; of Ad. By combining the Tc-99m sodium pertechnetate and TI-201 chloride scans, the detectability of the nodules was increased to 90.8percnt; for DC and 88.9percnt; for Ad, respectively. The Tc-99m sodium pertechnetate scans showed better visualization of cystic lesions than did the TI-201 chloride imaging. The TI-201 chloride images clearly demonstrated intrathoracic tumor invasions in six cases of carcinoma and two cases of Ad. The TI-201 chloride scan was also of value in detecting regional lymph node involvement and the recurrence and metastasis after thyroidectomy. The detectability of space-occupying lesions by ultrasonography was 96.3percnt; in 81 patients with thyroid nodules. Ultrasonography differentiated well between solid and cystic lesions. The presence and extent of nodular lesions were detected with radionuclide imaging and ultrasonography in 98.8percnt; of patients. Radionuclide imaging combined with ultrasonography provides a rapid, convenient, and useful method for the localization and visualization of thyroid tumors.
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