Thyroid diagnostics-------------------

Modern diagnostic measures applied in nuclear medicine and detailed laboratory diagnostics safely reveal thyroid diseases.

Accurate diagnostics of thyroid diseases are based on 4 pillars:

  1. At first, a comprehensive examination includes ultrasound, establishing the size of the thyroid gland and revealing any nodules.
  2. A blood test to check levels of thyroid hormones is mandatory.
  3. If ultrasound suggests any changes, a nuclear medicine examination, thyroid scintigraphy, will be performed. It enables a distinction to be made between so-called hot and cold nodules, i.e. metabolically active and inactive nodules.
  4. During fine-needle aspiration, cell material may be taken from the thyroid for microscopic examination to be able to distinguish between benign and malignant changes.

We offer:

  • Thyroid ultrasound
  • Thyroid scintigraphy
  • Fine-needle aspiration

Thyroid ultrasound

Main areas of application:

  • Assessment of the thyroid structure
  • Enlargement of the thyroid (struma)
  • Imaging of nodules and cysts
  • Differential diagnostics of hyperthyroidism
  • Lymph nodes in the vicinity of the thyroid gland

Examination procedure

You will be asked to lie down for the examination which is radiation-free and has no side-effects. Therefore, it may be used frequently in patients and is well-suited for follow-up observation. Ultrasound is also very useful for monitoring the postoperative course of disease.

Thyroid scintigraphy

Thyroid scintigraphy ias a nuclear medicine procedure that produces a visual display of the uptake of iodine by the thyroid gland. The distribution of the uptake of iodine, in turn, allows conclusions to be drawn on thyroid function, thus providing indications of various diseases.

Main areas of application:

  • Evaluation of general and regional thyroid function
  • Evaluation of function and metabolism of nodular changes
  • Distinction between ‚normal‘, ‚warm‘ and ‚hot‘ nodules
  • Evidence of thyroid autonomy

The terms ‚cold‘ and ‚hot‘ are used to describe whether the thyroid nodules are more or less active than the remaining thyroid tissue. This gives rise to important conclusions on further management and treatment of respective nodules.

Examination procedure

In thyroid scintigraphy, a radioactive substance (technetium-99m) is used which is similar to the element iodine in its chemical nature. This tracer is injected into the patient's vein in a respective harmless amount and accumulates after about 20 minutes in the thyroid gland, i.e. the thyroid cells. The radiation emitted by technetium-99m (so-called gamma radiation) is recorded by a special camera (gamma camera), visualizing the thyroid gland to evaluate thyroid function. At the same time, the amount of radionuclide taken up by the thyroid is measured to determine the so-called Thyroid Technetium Uptake (TcTU). You will be asked to sit down for the examination which takes about 2-3 minutes.

Radiation exposure

The most commonly used radionuclide is technetium-99m. It is a pure gamma emitter with a short physical half-life of 6 hours and also a short biological half-life. Thus, the procedure involves only minimal exposure to radiation for patients. 

Fine-needle aspiration

Occasionally, sonography and scintigraphy provide indications to subject a thyroid nodule to fine-needle aspiration for further diagnostic evaluation.

Main areas of application:

  • Evidence or exclusion of thyroid carcinoma

Examination procedure

You will be asked to lie down for the examination. After cleansing the skin with antiseptic, with a fine needle cells are taken from the nodule being examined under sterile conditions and guided by ultrasound to be subject to subsequent microscopic evaluation. The intervention takes only a few seconds. The puncture is no more painful than taking a blood sample. The method is considered absolutely low-risk, slight bruising at the site of injection could be mentioned as a complication which can basically never be excluded completely. Fine-needle aspiration will not be performed in patients with an increased bleeding tendency or under anti-coagulant therapy. 

 

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