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Low uptake suggests thyroiditis, high uptake suggests Graves' disease, [5] and unevenness in uptake suggests the presence of a nodule. [citation needed] 123 I has a shorter half-life than 131 I (a half day vs. 8.1 days), so use of 123 I exposes the body to less radiation, at the expense of less time to evaluate delayed scan images. [6]
A cold nodule is a thyroid nodule that does not produce thyroid hormone. [1] On a radioactive iodine uptake test a cold nodule takes up less radioactive material than the surrounding thyroid tissue. [1] A cold nodule may be malignant or benign. [1] On scintigraphy cold nodules do not show but are easily shown on ultrasound. [2]
Iodine-123 (123 I) is a radioactive isotope of iodine used in nuclear medicine imaging, including single-photon emission computed tomography (SPECT) or SPECT/CT exams. The isotope's half-life is 13.2232 hours; [1] the decay by electron capture to tellurium-123 emits gamma radiation with a predominant energy of 159 keV (this is the gamma primarily used for imaging).
Iodine-123 whole body scan for thyroid cancer evaluation. The study above was performed after the total thyroidectomy and TSH stimulation with thyroid hormone medication withdrawal. The study shows a small residual thyroid tissue in the neck and a mediastinum lesion, consistent with the thyroid cancer metastatic disease.
Thyroid scan. A thyroid scan using a radioactive iodine uptake test can be used in viewing the thyroid. [19] A scan using iodine-123 showing a hot nodule, accompanied by a lower than normal TSH, is strong evidence that the nodule is not cancerous, as most hot nodules are benign. [20]
Thyroid cancer accounts for less than 1% of cancer cases and deaths in the UK. Around 2,700 people were diagnosed with thyroid cancer in the UK in 2011, and around 370 people died from the disease in 2012. [69] However, in South Korea, thyroid cancer was the 5th most prevalent cancer, which accounted for 7.7% of new cancer cases in 2020. [70]
Theranostics originated in the field of nuclear medicine; iodine isotope 131 for the diagnostic study and treatment of thyroid cancer was one of its earliest applications. [7] Nuclear medicine encompasses various substances, either alone or in combination, that can be used for diagnostic imaging and targeted therapy.
A nuclear medicine parathyroid scan demonstrates a parathyroid adenoma adjacent to the left inferior pole of the thyroid gland. The above study was performed with Technetium-Sestamibi (1st column) and Iodine-123 (2nd column) simultaneous imaging and the subtraction technique (3rd column).