No.

7,

‘ioi.

THYROI1)

SCANNING

USING

By

YEN

WANG,

N1,l).,

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I’Ii’ISiIUR(;lI,

NGER’s

gamma

used large

organ

trast

the

tested.

In

ates.2

their

phantoms,

the 0.5

contrast and Ihe size and also carefully that

tile

grees

capabilit’ resolution

spected may

eral nlinutes, radioactivity organ quality. resolution

In

illdividual

for

same

the

It

is now

per

cent

lu;.

gamna

general

with the

The

tile

gamma

degree necessary

of

higher

and contrast to use

camera observed

has

changed. a 10 to

Ihe a

present

Picker

iodide *

thyroid crstal

1 OI)1

Francis

studs’

with

the

l)een

used

for

the General

t Associate Pennsylvania.

a 3 b’

pilantom, Magnascanner,

Departments

of

Hospital,

Professor

of

and

Radiology,

Pittsburgh,

Radiology,

out

cpm.,

time

range 40

The

constant

per

differential cent and

scan

total

scanning

time

2 incil

eter)

of Pittsburgh

School

RESU

L’rS

the

Picker

thyroid

filling

defects.

resolution

and

various

testing

2 is the

the left side nodule (measuring

with

Anger’s

University

maximum 40,

phan-

It has optimal

factors.

Figure

carried

were:

shows

i

tom

METHOD

was

factors

minutes.

12

scanning AND

scan-

collimator.

27 cm./min.

Figure 15

colltrast.

MA’I’ERIAL

mechanical

ap-

have about

25

the

focusing

dot i6, cut-off

about

with with

lead

rates-4,500

speed

studied. filled first

crystal

hole

presenting

scanned

iodide

scanning

was

was

was

31

second, background

the

were

phantom

This

counting

study would lead resolution photo-

months

I’s’.

3 by 2 inch ner and a

degree of with a low

of

of

filling

25 j.sc of 1”.

patients

nodules

tilyroid

with

phantom with

Two

thyroid

j.c

the in tenl)e carefully

Picker throid defects was filled

canlera.

Ihe

each

evaluation

A

‘.

of the

on

intensity

$

picture and

desired

morphologic

4

tile

distinct

tile

a function on iligh

gland. have used

proximately

that

sufficient

be

.

in-

anlount in

function,

to

dethe

exposure to sev-

on the accumulates

governing dots must

resolution for to overexposure

maximuni

contrast

The nlinutes

Factors of tile

according Ihe

thyroid We

organ. a few

important,

selected resolution.

ganlma

of

studing not so (jot should

size

tile

produce the six

to produce

photograph. sits’ and

optimum

dots/cm.2

is

graphs

of

depending which

order

ill

resolu-

using

number of (jots. of the (lots were They have found

to

area of the run from

with

a detail I)V

at

364

docuassoci-

set-tip

utilization

requires

times

achieved cm.

(MED.)f

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condevice

is carefully Becker and

a sufficient brightness selected.

best

camera’s contrast

of this

experimental

al)out

of

tion

This by

a report

in

J).Sc.

CAMERA*

I’ENNSVLv.NIA

and

tile

resolution

GAMMA

1)een

studies

Recently,

detail

l)een

mented

has

in dynamic

scanning.

and

ilave

camera’’2

generally

THE

in

the

of

Medicine,

dot

scan.

contains about

lower

pole

The a I

and

Presbyterian-University

hot

lobe

distinct .2 cm. in another Hospital

small, and

Pennsylvania,

University

of

Pittsburgh

School

869

of

Medicine,

Presbvterian-t’niversity

Hospital,

on

cold diam-

Pittsburgh,

St.

870

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11G.

A (lot scan

2.

The

various

scanning

the

technique

relatively the

of

filling

right,

defects

shown in Figure i. demonstrated. The

is described

in the

cool,

nodule

a

slightly

Phantom are

ill

the cool

distinct hot nodule in (measuring about 1.2 cr11. another the the tile

smaller,

upper same various

phantom. Ihe

same

scintillation

relatively

phantom

camera

was with

experience, because

a fine desired

l:Ic.

4.

40,000

seen

lower diameter)

cool,

Some essential resolution were

4 demonstrates

ill

On

the

a

to

sillgle

dot technique good resolution. resolution

shown

defects

are

technique

is described

ranges intensity

at

scanning

of

and

1.5

film

count an

was

on

the

(lot

1mg-

in

more

scan

of

clearl

v

Figure

the

in

time. with

best

2.

text.

Figure occurring

in 3

the right:

same

per

stud\’,

I .5

and

of a dial tile

radioactivity on

the

counts counts

on

are per

used.

stud.

resolu

the

taken

with The

sizes,

can

l)e

machine.

of

the defects

in

1,

by

can

be for

camera.

the

set

large

As

2 is too

Anger

tioll

counts

40,000

size

size

inlagillg

and the demon-.

imaging

imaging

noted,

lobes well

about

different

Ihe

means

So,ooo

at

with 2.

the of’ tile

was obtained per stud. the

illustrates

c

size The

minutes.

l)etween tile two tilling defects are

changes,

used F’igure

imaging of 290.

is a function

resolution counts

30,000-60,000

difference various

tile

of’ count

lile

the factor

about

eXpoSed

accumulation

strated.

depending

-

plLitltOil)

The

regardFrom

changes

and

the

filling

than

pinhole

was

with

of

various

demonstrated

different

in

test

factors tested.

#{149} T

a pole and

nodule

used

of the same Phantom counts; iiiiddl’. 6o,ooo counts; with various degrees of resolution, Pictures

pole. shows

‘lhe

i.

-

.

A photoscan

.

ure

pole. Figure 3, the photoscan of phantom, clearl\’ demonstrates filling defects in tile thyroid

collimator. ing better we

tipper lobe tile

11G.

text.

_____

phantom

Left: mire

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Thyroid

No.

‘),

Scanning

Using

Camera

tile Gamma

871

2.0

‘.5 tic.

Three

.

The

gamma

resolution

imaging

for

the

and

is very

little we

1 .5,

optimum

stud\. enlarged, be used

difference the

imaging

the thyroid the imaging or the distance

the imaging

larger

size

6. the

set

Three

distortion

gamma

the center

to

toni

size

setting

are

is changed.

taken

with

A better

i,

and

1.5

resolution

is

pinhole

of the

may the

I

to

the of

gland Figure

1.4

th\roid

2 imaging

is obtained

points

out

the

center

placing

pinhole

pictures

sizes.

with

a

1.5

is demonstrated. tilling defects

slightly increased dot. Resolution

in

by a worsens

necessity

of

the

of

thyroid

collimator. In or blurring The resolution the phantom

defocusing of as defocusing

is the is

increased.

center

of the same A better collimator.

collimator.

tile

at the center of tile 7 the effect of defocusing

of the dots of various

6 sllows off

and

properl\’

markedl\need to collima-

Figure due

positioning

HIGH OFF CENTER

CENTERED

camera the

between size

gland

size of between

increased.

neck

I)hantom at

phan

Since

in tile

LOW OFF CENTER lic.

same imaging

distortion.

cllOse

If

t()r and tile

the

of

as the

varies

some

shows

and

there i

pictures

scans

size.

tile frame

size

camera

of the

phantom resolution

setting

mire taken

is obtained

when

with the

a change center

in the of

the

position phantom

of is

Yen

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872

lic.

7.

Three

of the only

camera

gamma

image

dots.

Left:

Wang

pictures of the same phantom settings are taken blur; middle: blur; right: maximum blur. A better

with ‘defocusing’ (blurring) resolution is obtained with

blur. ILLUSTRATIVE

I. ‘t’his

CASE

74

CASES

year

old

female

experienced

general weakness mind weight loss since March 1965. She had noted an enlargement of the neck for about 2 years. Clinically, the diagnosis was

hvperthyroidism. was

palpable

side blood

of

roid

range.

A nodule, in

the cells

the

The

neck.

was The

2 cm. one-third

lower

24.6

in

diameter,

of

the

left

T-3 uptake of the red per cent at the hyperthy-

patient

was

given

82.8

for

ic

of

thyroid scanning. Figure 8, A and B shows the polaroid picture made with the scintillation camera and the photoscan ohji:n

1966

AUGUST,

tamed with a mechanical scanner. The thyroid lobes are long and enlarged and are encroaching on the sternal notch. The palpable nodule is demonstrated lobe

and

in shows

surrounding

the

lower

hyperfunction

thyroid

one-half

of

compared

the to

left the

tissue.

CASE H. This 8 year old female was admitted with abdominal pain, fever and headache. Admission physical examination revealed a large mass in the right neck. This was soft, well circumscribed and measured about 4.5 cm. in diameter. The patient had no thyroid svmptoms. She was given 6.6 c of 1#{176}’ for thyroid

0 l’ic.

8.

(A)

A gamma

camera

picture hot

nodule

and

(B) a photoscan in the lower one-half

of

Case

of the

I showing

left

lobe.

the enlarged

lobes

with

a

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\oL.

tic.

Th’roid

No.

7,

. (A) A gamma camera in the latero-superior aspect is displaced to the left.

scanning.

and

Both

the

the

pect of the originating proved

picture

right

(Fig. gland pressing

right from

be displaced to the on the supero-lateral

to

lobe. The obviously the right lobe was

to be an

adenoma

the

Gamma

Camera

left, asmass and

cool excised

mark.

As

far

concerned, difference

been

able

small

as 1.5

3

Scanning by 2 inch

about

12 to

adequate the oral in

tile

same tile

of

50 of

ioo

to

c

of

1131. With

the

b

is the time an anatomic

scanner,

tile picture

landmark. camera,

half

of

that

tile

mechanical with

a

is

gives

anatomic

School

ver

two

\Ve as

systems.

demonstrate cm.

is little

a nodule

in diameter

either

by

Radiology Pittsburgh

of Medicine

Pittsburgh,

Hospital

Pennsylvania author

Drs.

Gilbert

ter

for

their

i.

AXGER,

15213

wishes H.

tion 2.

location with time

a

valuable

life

help

acknowledge John

and

in this

,.

H. 0. camera.

Gamma

N,icleoith.c,

ray

and

196,,

J., BIRKER, R., and Contrast and detail resolution lation camera. Strahientherapie, GoI’i’sHAI.K, A., and .ANGER, BECKER,

Plication

land-

to gratefully

Alexander

1).McAlhis-

work.

REFERENCES

time

a mechanical

scan clear

resolution

probably

Presbyterian-University

The

tile

scanning

using

of of

using

scanning

and the Altilough

required

actual

is

gland

is an

Ordinarily, scanning and

radioactivity

camera,

there

4 to 6 minutes. The real difference these two systems of thyroid scan-

the scintillation is less than sized

provided

using a takes

2.0

uptake

thyroid

system.

University

gland usually

in the thyroid. dose for thyroid

scintillation

between of

i6 minutes,

count tracer range

CONCLUSION

time for a thyroid crystal scanner

amount

is about sling

AND

of decreased

entire

these to

to

area

The

the

between

have

scanning

pathologically.

as

there

Department COMMENT

873

(B) a photoscan of Case II showing a large lobe. This proved to be a large adenoma.

and

of the

Using

scintillation camera picture 9, A and B) showed the

photoscan

entire thyroid due to a mass

Scanning

of

scintillation

positron scintilla2!, 56-59. H.

L\NGEND0RFF,

of .Anger 1965,

H. camera:

atomic medicine. In: Progress Scanning. Volume I. Grune New York, 1965, PP. 78-106.

0.

scintil127.

Clinical

ap-

progress

in

in Radioisotope & Stratton, Inc.,