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Review
. 2025 Jun 5;61(6):1043.
doi: 10.3390/medicina61061043.

A Narrative Review of the Odyssey of Thyroid Cancer Diagnosis: Can 99mTc-SESTAMIBI Molecular Imaging Replace Fine Needle Aspiration Biopsy?

Ioannis Iakovou  1 , Nikitas Papadopoulos  1 , Paraskevi Exadaktylou  1 , Christos Melidis  2   3 , Georgia Koutsouki  1 , Ilias Katsadouros  1 , Savvas Frangos  4 , Ioannis Koutelidakis  5 , Kalliopi Kotsa  6 , Evanthia Giannoula  1
Affiliations
Review

A Narrative Review of the Odyssey of Thyroid Cancer Diagnosis: Can 99mTc-SESTAMIBI Molecular Imaging Replace Fine Needle Aspiration Biopsy?

Ioannis Iakovou et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Many diagnostic methods exist for identifying thyroid malignancy, but most of them resemble an odyssey, as the journey from palpating a nodule to receiving a definitive diagnose is often long and costly. The aim of the present study is to investigate the role of Sestamibi scintigraphy in the characterization of cytological indeterminate thyroid nodules. Materials and Methods: A focused literature review was conducted, emphasizing the comparison between Fine Needle Aspiration Biopsy (FNAB), the main diagnostic method for thyroid cancer, and Sestamibi. Results: It is widely accepted that Sestamibi is the primary alternative for patients with non-diagnostic FNAB. As shown in the literature, Sestamibi has a high negative predictive value in excluding thyroid malignancy. Conclusions: Much like Odysseus' adventurous 10-year journey returning to Ithaca, the path to diagnosing thyroid cancer is not straightforward. Molecular imaging with 99mTc-Sestamibi may serve as a valuable adjunct in evaluating thyroid nodules with inconclusive cytological findings.

Keywords: Bethesda; Fine Needle Aspiration Biopsy; Sestamibi scintigraphy; nodule; thyroid malignancy.

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Conflict of interest statement

Author Christos Melidis was employed by the company CAP Santé and milliVolt.eu. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A malignant thyroid nodule with indeterminate cytological features on FNA and a positive SESTAMIBI scan.
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References

    1. Giannoula E., Melidis C., Frangos S., Papadopoulos N., Koutsouki G., Iakovou I. Ecological Study on Thyroid Cancer Incidence and Mortality in Association with European Union Member States’ Air Pollution. Int. J. Environ. Res. Public Health. 2020;18:153. doi: 10.3390/ijerph18010153. - DOI - PMC - PubMed
    1. Dean D.S., Gharib H. Epidemiology of thyroid nodules. Best Pract. Res. Clin. Endocrinol. Metab. 2008;22:901–911. doi: 10.1016/j.beem.2008.09.019. - DOI - PubMed
    1. Wong R., Farrell S.G., Grossmann M. Thyroid nodules: Diagnosis and management. Med. J. Aust. 2018;209:92–98. doi: 10.5694/mja17.01204. - DOI - PubMed
    1. Tessler F.N., Middleton W.D., Grant E.G., Hoang J.K., Berland L.L., Teefey S.A., Cronan J.J., Beland M.D., Desser T.S., Frates M.C., et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J. Am. Coll. Radiol. JACR. 2017;14:587–595. doi: 10.1016/j.jacr.2017.01.046. - DOI - PubMed
    1. Russ G., Bonnema S.J., Erdogan M.F., Durante C., Ngu R., Leenhardt L. European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. Eur. Thyroid J. 2017;6:225–237. doi: 10.1159/000478927. - DOI - PMC - PubMed

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