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Martin Freesmeyer, Thomas Winkens, Andreas Darr, Diagnosis of Small Papillary Thyroid Cancer Via Sensor-Navigated 124Iodine PET/Ultrasound (124I-PET/US) Fusion, The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 1, 1 January 2015, Pages 13–14, https://doi.org/10.1210/jc.2014-3003
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A euthyroid 42-year-old female (TSH, 3.9 mU/L; free T3, 4.51 pmol/L; free T4, 11.16 pmol/L) was referred for thyroid diagnostics due to hypothyreosis and a single thyroid nodule. On ultrasound (US), a small (15[ap] × 6[rl] × 8[cc] mm), inhomogeneous hypoechoic area (Figure 1, B and E) had been found on the lateral margin of the right thyroid lobe. Although ultrasonography suggested potential malignancy, a thyroid scan (Figure 1A, scintigram 20 min after administration of 70 MBq 99mTcO4) had shown normal uptake (1.6%) and no significant focal aberration. Initial serum thyroglobulin levels were not determined.
We performed additional 124I-positron emission tomography (PET)/computed tomography (CT) (10-min PET scan 24 hours after administration of 0.98 MBq 124I) according to an established low-activity protocol (1), which revealed a distinct hypofunctional area in the right thyroid lobe (Supplemental Figure 1). A single photon emission computed tomography (SPECT)/CT is not available in our institution; therefore, a 123I-study was not performed.