Endocrinology: Guidelines
Cervical ultrasound scanning is considered a key examination, by all major thyroid and endocrine specialist societies for the postoperative follow-up of thyroid cancer patients to assess the risk of recurrence. Neck US imaging is readily available, non-invasive, relatively easy to perform, cost-effective, and can guide diagnostic and therapeutic procedures with low complication rates. Its main shortcoming is its operator-dependency. Because of the pivotal role of US in the care of thyroid cancer patients, the European Thyroid Association convened a panel of international experts to review technical aspects, indications, results, and limitations of cervical US in the initial staging and follow-up of thyroid cancer patients. The main aim is to establish guidelines for both a cervical US scanning protocol and US-guided diagnostic and therapeutic procedures in patients with thyroid cancer.
SNM Practice Guideline for Parathyroid Scintigraphy4.0 (2011)
Parathyroid scintigraphy is commonly performed using 99mTc-sestamibi in dual-isotope studies with 99mTc pertechnetate/99mTc-sestamibi or 99mTc pertechnetate/201Tl combinations. In the dual-isotope studies the pertechnetate image is subtracted from the 201Tl or 99mTc-sestamibi image, and what remains is potentially a parathyroid adenoma.
2009 EANM parathyroid guidelines(2009)
The present guidelines were issued by the Parathyroid Task Group of the European Association of Nuclear Medicine. The main focus was imaging of primary hyperparathyroidism. Dual-tracer and single-tracer parathyroid scintigraphy protocols were discussed as well as the various modalities of image acquisition.
ACR-SNMMI-SPR Practice Guideline for the Performance of Parathyroid Scintigraphy (2009)
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to guide interpreting physicians performing parathyroid scintigraphy in adult and pediatric patients. Additionally, correlation with other radiographic modalities such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), chest radiography, or with other radionuclide imaging studies may also be helpful.
ACR-SNMMI-SPR Practice Guideline for the Performance of Thyroid Scintigraphy and Uptake Measurements (2009)
This guideline was revised collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Nuclear Medicine (SNM). It is intended to guide interpreting physicians performing thyroid scintigraphy and in-vivo radioiodine thyroid uptake measurements in adult and pediatric patients. Additionally, correlation with other radiographic modalities such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), chest radiography, or with other radionuclide imaging studies may also be helpful.
SNM Procedure Guideline for Scintigraphy for Differentiated Papillary and Follicular Thyroid Cancer(2006)
Scintigraphy using 131I or 123I is used to determine the presence and extent of residual functioning thyroid tissue shortly post-thyroidectomy and, after 131I ablation, to detect the presence and location of functioning thyroid cancer, recurrences and/or metastases 18F-FDG PET may be helpful for patients with a rising serum thyroglobulin and negative or minimal iodine uptake. Other radiopharmaceuticals such as 201Tl and 99mTc sestamibi may also provide useful information.
(SNM) Thyroid Scintigraphy 3.0 (2006)
Thyroid scintigraphy is a procedure producing one or more planar images of the thyroid obtained after intravenous injection of 99mTc- pertechnetate or after the oral ingestion of radioactive iodine.
SNM Procedure Guideline for Thyroid Uptake Measurement 3.0 (2006)
Thyroid uptake determination is the measurement of the fraction of an administered amount of radioactive iodine that accumulates in the thyroid at selected times following ingestion. Thyroid uptake can be determined, less accurately, using intravenously administered 99mTc-pertechnetate and a gamma camera.