Eur J Endocrinol
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Accepted Preprint first posted online on 4 July 2008

European Journal of Endocrinology 2008;159:423.

DOI: 10.1530/EJE-08-0348
Copyright © 2008 by European Society of Endocrinology
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CLINICAL STUDY

The usefulness of 99mTc-sestaMIBI thyroid scan in the differential diagnosis and management of Amiodarone-induced thyrotoxicosis

Mario Piga, Maria Chiara Cocco, Alessandra Serra, Maurizio Loy, Francesco Boi and Stefano Mariotti

M Piga, Scienze mediche -Nuclear medicine, Azienda ospedaliero-universitaria, Monserrato, Italy
M Cocco, Scienze mediche- Endocrinology, Azienda ospedaliero-universitaria, Monserrato, Italy
A Serra, Scienze mediche- Nuclear medicine, Azienda ospedaliero-universitaria, Monserrato, Italy
M Loy, Scienze mediche- Endocrinology, Azienda ospedaliero-universitaria, Monserrato, Italy
F Boi, Scienze mediche- Endocrinology, Azienda ospedaliero-universitaria, Monserrato, Italy
S Mariotti, Scienze mediche- Endocrinology, Azienda ospedaliero-universitaria, Monserrato, Italy

Correspondence: Mario Piga, Email: pigam{at}medicina.unica.it

Abstract

Background: Amiodarone-induced thyrotoxicosis (AIT) is caused by excessive hormone synthesis and release (AIT I) or by a destructive process (AIT II). This differentiation has important therapeutic implications.

Purpose: To evaluate 99mTc-sestaMIBI (MIBI) thyroid scintigraphy in addition to other diagnostic tools in the diagnosis and management of AIT.

Subjects and methods: Thyroid 99mTcO4- and 99mTc-MIBI scintigraphies were performed in 20 consecutive AIT patients, along with a series of biochemical and instrumental investigations (measurement of thyrotropin, free thyroid hormones and thyroid autoantibodies; thyroid color flow Doppler sonography [CFDS] and thyroid radioiodine uptake [RAIU]).

Results: On the basis instrumental and laboratory data (excluding thyroid 99mTc-MIBI scintigraphy) and follow-up, AIT patients could be subdivided in 6 with AIT I, 10 with AIT II and 4 with indefinite forms of AIT (AIT Ind). 99mTc-MIBI uptake resulted normal/increased in all 6 patients with AIT I and absent in all 10 patients with AIT II. The remaining 4 patients with AIT Ind, showed in 2 cases low, patchy and persistent uptake and in the 2 evident MIBI uptake followed by a rapid wash out. MIBI scintigraphy was superior to all other diagnostic tools, including CFDS, (suggestive of AIT I in 3 patients with AIT II and of AIT II in 3 with AIT Ind) and RAIU, which was measurable in all patients with AIT I, bat also in 4/10 with AIT II.

Conclusion: Thyroid MIBI scintigraphy may be proposed as easy and high effective tool for the differential diagnosis of different forms of AIT.






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