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Medicine (Baltimore). 2016 Jul;95(27):e4170. doi: 10.1097/MD.0000000000004170.

Quantitative single-photon emission computed tomography/computed tomography for technetium pertechnetate thyroid uptake measurement.

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aDepartment of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul bWorld Class University, Department of Molecular Medicine and Biopharmaceutical Science, Graduate School of Convergence Science and Technology, Seoul National University, Suwon cDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine dDepartment of Nuclear Medicine, Konkuk University Medical Center eInstitute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.



Technetium pertechnetate (TcO4) is a radioactive tracer used to assess thyroid function by thyroid uptake system (TUS). However, the TUS often fails to deliver accurate measurements of the percent of thyroid uptake (%thyroid uptake) of TcO4. Here, we investigated the usefulness of quantitative single-photon emission computed tomography/computed tomography (SPECT/CT) after injection of TcO4 in detecting thyroid function abnormalities.


We retrospectively reviewed data from 50 patients (male:female = 15:35; age, 46.2 ± 16.3 years; 17 Graves disease, 13 thyroiditis, and 20 euthyroid). All patients underwent TcO4 quantitative SPECT/CT (185 MBq = 5 mCi), which yielded %thyroid uptake and standardized uptake value (SUV). Twenty-one (10 Graves disease and 11 thyroiditis) of the 50 patients also underwent conventional %thyroid uptake measurements using a TUS.


Quantitative SPECT/CT parameters (%thyroid uptake, SUVmean, and SUVmax) were the highest in Graves disease, second highest in euthyroid, and lowest in thyroiditis (P < 0.0001, Kruskal-Wallis test). TUS significantly overestimated the %thyroid uptake compared with SPECT/CT (P < 0.0001, paired t test) because other TcO4 sources in addition to thyroid, such as salivary glands and saliva, contributed to the %thyroid uptake result by TUS, whereas %thyroid uptake, SUVmean and SUVmax from the SPECT/CT were associated with the functional status of thyroid.


Quantitative SPECT/CT is more accurate than conventional TUS for measuring TcO4 %thyroid uptake. Quantitative measurements using SPECT/CT may facilitate more accurate assessment of thyroid tracer uptake.

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