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Clinical significance of metabolic superscan in patients with hyperthyroidism
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Abstract
MATERIAL AND METHODS: Forty-five hyperthyroid patients confirmed by clinical and laboratory results were enrolled in this work. In all patients, a 99mTc-pertechnetate thyroid uptake scan was acquired. On a different day, total body bone scan was acquired three hours post IV injection of 555-925 MBq of 99mTc-MDP. Serum FT3, FT4, TSH, Ca++, alkaline phosphatase (AP) and parathyroid hormone (PTH) were monitored in all patients as markers of thyroid and bone metabolism. Ten cases with no thyroid diseases were included as a control group. Patients with thyroiditis or long history of antithyroid drugs for more than one year were excluded from the study.
RESULTS: The patients were subdivided into three groups: Graves´ disease (GD) (n = 30), toxic nodular goiter (TNG) (n = 10) and autonomous toxic adenoma (AT) (n = 5). The TSH for the whole group was significantly suppressed compared to the control group with higher suppression in the Graves´ disease group than in the TNG or AT groups. 99mTc-pertechnetate uptake values in the Graves´ disease group were significantly higher than the TNG and AT groups (p < 0.05). Metabolic superscan (MSS) was noted in 90% of the Graves´ cases, 20% in TNG and in none of the AT group. There were no significant differences regarding Ca+, AP and PTH between the Graves´ and non-Graves´ groups (p > 0.05).
CONCLUSIONS: Disturbances in bone metabolism are more prevalent in Graves´ disease than in other types of hyperthyroidism. The addition of the bone scan to the diagnostic work up of patients with Graves´ disease is a sensitive indicator for metabolic bone changes and could help in the future management and follow up for this group of patients.
Abstract
MATERIAL AND METHODS: Forty-five hyperthyroid patients confirmed by clinical and laboratory results were enrolled in this work. In all patients, a 99mTc-pertechnetate thyroid uptake scan was acquired. On a different day, total body bone scan was acquired three hours post IV injection of 555-925 MBq of 99mTc-MDP. Serum FT3, FT4, TSH, Ca++, alkaline phosphatase (AP) and parathyroid hormone (PTH) were monitored in all patients as markers of thyroid and bone metabolism. Ten cases with no thyroid diseases were included as a control group. Patients with thyroiditis or long history of antithyroid drugs for more than one year were excluded from the study.
RESULTS: The patients were subdivided into three groups: Graves´ disease (GD) (n = 30), toxic nodular goiter (TNG) (n = 10) and autonomous toxic adenoma (AT) (n = 5). The TSH for the whole group was significantly suppressed compared to the control group with higher suppression in the Graves´ disease group than in the TNG or AT groups. 99mTc-pertechnetate uptake values in the Graves´ disease group were significantly higher than the TNG and AT groups (p < 0.05). Metabolic superscan (MSS) was noted in 90% of the Graves´ cases, 20% in TNG and in none of the AT group. There were no significant differences regarding Ca+, AP and PTH between the Graves´ and non-Graves´ groups (p > 0.05).
CONCLUSIONS: Disturbances in bone metabolism are more prevalent in Graves´ disease than in other types of hyperthyroidism. The addition of the bone scan to the diagnostic work up of patients with Graves´ disease is a sensitive indicator for metabolic bone changes and could help in the future management and follow up for this group of patients.
Keywords
hyperthyroidism; Graves’ disease; superscan; bone scan; metabolic bone changes
Title
Clinical significance of metabolic superscan in patients with hyperthyroidism
Journal
Issue
Pages
76-81
Published online
2007-05-23
Page views
757
Article views/downloads
2349
Bibliographic record
Nucl. Med. Rev 2007;10(2):76-81.
Keywords
hyperthyroidism
Graves’ disease
superscan
bone scan
metabolic bone changes
Authors
Magdy H. Kotb
Tarek El-Maghraby
Khaled Khalafallah
Walid Omar
Bahaa Demian Grace
Adil AL-Nahhas