Role of isotope scan, including positron emission tomography/computed tomography, in nodular goitre

Nuclear medicine techniques were first used in clinical practice for diagnosing and treating thyroid diseases in the 1950s, and are still an integral part of thyroid nodules work-up. Thyroid imaging with iodine or iodine-analogue isotopes is the only examination able to prove the presence of autonomously functioning thyroid tissue, which excludes malignancy with a high probability. In addition, a thyroid scan with technetium-99m-methoxyisobutylisonitrile is able to avoid unnecessary surgical procedures for cytologically inconclusive thyroid nodules, as confirmed by meta-analysis and cost-effectiveness studies. Finally, positron emission tomography alone, and positron emission tomography combined with computed tomography scans with 18F-fluoro-2-deoxy-d-glucose are also promising for diagnosing thyroid diseases, but further studies are needed before introducing them to clinical practice.