Thyroid Nodules - Pediatric Thyroid Center at CHILDRENS HOSPITAL OF PHILADELPHIA
FINE NEEDLE ASPIRATION BIOPSY OF THE THYROID GLAND
THYROID SCAN
FINE NEEDLE ASPIRATION BIOPSY OF THE THYROID GLAND
THYROID SCAN
THYROID UPTAKE AND SCAN
What is a Thyroid Uptake and Scan? A nuclear medicine thyroid uptake and scan is a 2-day test. A thyroid uptake measures overall thyroid gland function. A thyroid scan shows the structure, size and location of your thyroid and the function of various portions of your gland. The first uptake will be done on day 1. You will come back the next day for another uptake and the scan. This procedure involves three visits to the Nuclear Medicine Department. **Before the Test If you are taking thyroid medications or preparations that contain iodine, you may be asked to stop them for a time before this test. Read this page to learn how to prepare for the test, how it works, how it is done, what you may feel during the test, and how to get your results. How Does the Uptake and Scan Work? Uptake For the uptake, you will swallow a small dose of radioactive material (tracer). This tracer collects in your thyroid gland and gives off gamma and beta rays. A sensor will detect how much of the tracer your thyroid absorbs. Scan In the second part of the exam, a small amount of tracer is injected into a vein, usually in your arm. Images of your thyroid are then taken with a camera. How Do I Prepare? 6 Weeks Before
Check with your physician regarding the timing of your medications (see guidelines below). If you are diabetic, please consult with your doctor before you change your diet or medication. Medication Hold Time Methimazole (Tapazole) 1 week Propylthiouracil (PTU) 1 week Triiodothyronine [Liothyronine (generic), Cytomel (brand name), Triostat (brand name)] 2 weeks Thyroxine [T4, levothyroxine (generic), Synthroid (brand name), Levoxyl (brand name)] 4 weeks Amiodarone 6 months Multivitamins 2 weeks Topical iodine 4 weeks IV contrast 2 weeks Lithium 6 weeks **Source: ACR‐SNM‐SPR Practice Guidelines 2009 and SNM Procedure Guideline 2006 On the Day of the Test
During the Test: What should I expect during and after the exam?
On Day 1-
For the scan, you will lie on your back on an imaging table with the camera positioned above you. We will take several images of your thyroid. Each image takes ten minutes. On Day 2-
How Safe Is This Procedure? Nuclear medicine procedures are very safe. The radioactive material is cleared quickly from your body. With a normally functioning thyroid gland, the whole body radiation dose is 0.03 rem, which is less than most routine X-ray procedures. After your test- The radiologist and technologist will not be able to give you results after your test is completed. A report will be sent to the doctor who ordered your test within one to two business days. Your doctor will share the results with you. |
Thyrogen SCAN:
DOSING & ADMINISTRATION Ablation ScheduleDay 1 : First Thyrogen Injection Day 2 : Second Thyrogen Injectio Day 3 Start radiation precautionsA whole-body scan may be performed Day 6-10 - 3-7 days after the administration of radioiactive iodine therapy Scanning and Thyroglobulin Diagnostic Testing Schedule Day 1 First Thyrogen Injection Day 2 Second Thyrogen Injection Day 3 Radioactive iodine scanning dose (for whole body scan) Day 5 Blood test for thyroglobulin Whole-body scan Thyroglobulin Only Testing ScheduleDay 1 First Thyrogen Injection Day 2 Second Thyrogen Injection Day 5 Blood test for thyroglobulin W *0.9 mg intramuscular injection to the buttock The mean apparent elimination half-life was 25 ± 10 hours. There is no requirement to measure TSH when using Thyrogen. Click here to download the printable version of the schedule to use with patients. Thyrogen® (thyrotropin alfa for injection) 0.9 mg/mL after reconstitution INDICATIONS AND USAGEThyrogen is a thyroid stimulating hormone indicated for: Diagnostic: Use as an adjunctive diagnostic tool for serum thyroglobulin (Tg) testing with or without radioiodine imaging in the follow-up of patients with well-differentiated thyroid cancer who have previously undergone thyroidectomy. Limitations of Use:
Use as an adjunctive treatment for radioiodine ablation of thyroid tissue remnants in patients who have undergone a near-total or total thyroidectomy for well-differentiated thyroid cancer and who do not have evidence of distant metastatic thyroid cancer. Limitations of Use:
There have been reports of death in non-thyroidectomized patients and in patients with distant metastatic thyroid cancer in which events leading to death occurred within 24 hours after administration of Thyrogen. Caution should be exercised in patients who have substantial thyroid tissue still in situ or functional thyroid cancer metastases, specifically in the elderly and those with a known history of heart disease. Hospitalization for administration of Thyrogen and post-administration observation in patients at risk should be considered. There are post marketing reports of stroke in young women with risk factors for stroke, and neurological findings suggestive of stroke (e.g., unilateral weakness) occurring within 72 hours of Thyrogen administration in patients without known central nervous system metastases. Patients should be well-hydrated prior to treatment with Thyrogen. Sudden, rapid and painful enlargement of residual thyroid tissue or distant metastases can occur following treatment with Thyrogen. Pretreatment with glucocorticoids should be considered for patients in whom tumor expansion may compromise vital anatomic structures. ADVERSE REACTIONS The most common adverse reactions reported in clinical trials were nausea and headache. USE IN SPECIFIC POPULATIONS: Pregnancy Category C: Animal reproduction studies have not been conducted with Thyrogen. It is also not known whether Thyrogen can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. Thyrogen should be given to a pregnant woman only if clearly needed. Nursing Mothers: It is not known whether the drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Thyrogen is administered to a nursing woman. Pediatric Use: Safety and effectiveness in pediatric patients have not been established. Geriatric Use: Results from controlled trials do not indicate a difference in the safety and efficacy of Thyrogen between adult patients less than 65 years and those over 65 years of age. Renal Impairment: Elimination of Thyrogen is significantly slower in dialysis-dependent end stage renal disease patients, resulting in prolonged elevation of TSH levels. |