Thyroid Scan
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What is the test?
There are two types
of thyroid nuclear medicine tests. Both assess the health of
your thyroid, a gland in your neck that controls metabolism.
A thyroid scan produces a picture of the gland to help evaluate
any lumps or inflammation, or to investigate the cause of an
overactive thyroid. A radioactive iodine uptake test is performed
to see if your thyroid is functioning normally and to determine
why thyroid hormone levels may be elevated. For both types
of test, a small amount of a weakly radioactive substance,
known as a radionuclide, is either injected into a vein or
given to you as a pill
A thyroid scan is
usually ordered when a physical examination or laboratory finding
suggests that the thyroid is enlarged. If laboratory tests
show an overactive thyroid, a radioactive iodine uptake test
may be ordered at the same time.
A radioactive iodine
uptake test measures the amount of radioactivity in your
thyroid after you've been given a relatively small dose of
radioactive iodine in pill form. Your thyroid gland absorbs
iodine and uses it to make hormones. Therefore, the amount
of radioactive iodine detected in your thyroid gland corresponds
with the amount of hormone your thyroid is producing.
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How do I prepare
for the test?
If there is any chance
that you are pregnant, or if you are breast-feeding, let your
doctor know. Radionuclides could harm your nursing baby or a
developing fetus, so your doctor will use an alternative method
to diagnose the problem, such as ordering additional blood tests
or monitoring your symptoms over several weeks to see if they
resolve.
For about a week before
a thyroid scan, your doctor may ask you to avoid certain foods
and medicines that can interfere with the results, including
thyroid hormones and shellfish (which contain iodine). You might
have to fast entirely for several hours beforehand if you'll
be given a radioactive iodine pill for the test.You might also
need to have blood tests that check thyroid function.
The preparation for
a radioactive iodine uptake test is almost the same as for a
thyroid scan. However, because you are given radioactive iodine
in pill form for an uptake test, you need to wait four to six
hours, and possibly as long as a day, before having the scan.
(This gives the radioactive iodine time to reach your thyroid.)
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What happens
when the test is performed?
A radionuclide is either
injected into a vein or given to you as a pill. Timing of the
test then depends on the type of radionuclide your doctor uses,
and whether you will also have an uptake test. If you are having
only a thyroid scan and your doctor prefers to give a radionuclide
by intravenous injection, the scan can be done within 30-60 minutes.
If you are given radioactive iodine in pill form, you need to
wait four to six hours, and possibly as long as a day, before
having the scan. (This gives the radioactive iodine time to reach
your thyroid.) If you're having both a scan and the uptake test,
you are likely to receive radioactive iodine in pill form. This
allows one radionuclide to be used for both the scan and uptake
test, instead of two, and eliminates the need for an injection.
After you've received the radionuclide and have waited the appropriate amount
of time, a technician places a radioactivity detector-a camera specially designed
to take pictures of radioactive objects - against your neck and takes several
images. The camera itself doesn't expose you to any radiation. This portion of
the test usually takes about half an hour.
An uptake test only
takes several minutes and is performed while you are sitting
up. Using a device that resembles a Geiger counter, the doctor
or technician places a probe several inches in front of your
neck, where the thyroid gland is located, and measures the percentage
of radioactivity that is retained by the thyroid gland. You return
the next day for follow-up testing to obtain a second set of
uptake readings, which are then compared with the first set to
determine how much hormone has been formed and secreted in the
interim.
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What risks are
there from the test?
The risk from both varieties
of thyroid scan is minimal. The amount of radioactivity you are
exposed to is comparable to that from a routine x-ray. The amount
of radionuclide used is so small that it's unlikely to cause
side effects or allergic reactions.
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Must
I do anything special after the test is over?
No. The vast majority
of the weakly radioactive substances used in these tests are
cleared from your body within a day or two. But even before then,
you can interact normally with other people because there's no
risk of exposing them to significant amounts of radiation from
your body.
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How
long is it before the result of the test is known?
For the thyroid scan,
it takes an hour or more for the pictures to be developed and
additional time for a radiologist to examine them. Your doctor
will probably receive a report within a day or two. The scan
will show the outline, shape, and position of your thyroid so
that the doctor can determine whether it is enlarged and whether
there are any suspicious growths or nodules. The scan also provides
a rough measure of thyroid activity, although this has to be
confirmed with a radioactive iodine uptake test.
Uptake test results
are available immediately, but because the initial and follow-up
readings must be compared, it may take your doctor a day or two
to get back to you. To obtain results, your doctor determines
an uptake value, which is the net result of how much iodine is
picked up by the thyroid, how much is converted to hormone since
the time of administration, and how much is either leaked or
secreted into the bloodstream. (The thyroid normally secretes
hormone in an orderly fashion based on physical needs; leakage
is less controlled and indicates that the gland is damaged.)
A low reading of radioactivity suggests that your thyroid gland
has retained only a small amount of iodine. This generally indicates
that the thyroid gland is not producing excess thyroid hormone,
but has become inflamed and is unable to properly store the hormone,
which then leaks into the bloodstream. A high reading suggests
that your thyroid is overactive, producing an excessive amount
of thyroid hormone.
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