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Tectnetcium-99m pertechnetate thyroid scan – LEAP collimator
- Opposite lateral and ventral views of the neck and thorax were made. A focal intense area of uptake is observed on the midline of the neck with smooth margins.
- Opposite lateral views of the thorax show a linear area of uptake on the left lateral view that is not observed on the right lateral or ventral views. Normal uptake is observed in the heart and stomach.
- No evidence of ectopic thyroid tissue in the base of the tongue, neck or mediastinum.
Tectnetcium-99m pertechnetate thyroid scan – Pin-hole collimator
- A single ventral views shows the intense area of uptake is located in the left lobe of the thyroid. A faint area of uptake is observed in the right lobe of the thyroid gland.
- Pattern of uptake most consistent with bilateral nodular hyperplasia/multinodular adenomas
- Transient esophageal activity due to swallowing of saliva or gastroesophageal reflux
- Medical treatment – methimazole or I-131 treatment were accepted as this recommendation would vary
- This case was handled well by most candidates with a good overall score.
- Identification of transient esophageal activity due to swallowing of saliva or gastroesophageal reflux was most frequently missed aspect.
- Faint activity of the right lobe indicates abnormality in right lobe as well. Normal thyroid tissue would be completely suppressed and show no uptake.
- Some difficulty correctly identifying the views obtained (right vs left lateral).