Incidentally Detected Thyroid Follicular Adenoma on Myocardial Perfusion Scintigraphy with Tc-99m MIBI

  • Meral Mert
  • Murat Sipahi


Technetium-99m sestamibi (Tc-99m MIBI) is a routinely used radiopharmaceutical for myocardial perfusion scintigraphy (MPS). Here, we present a case of a 76-year-old woman with mild transient chest pain but normal laboratory examination results who underwent Tc-99m sestamibi (MIBI) myocardial perfusion imaging, and an abnormal focal radionuclide uptake in the left lobe of the thyroid gland was detected. After that, the patient underwent left hemithyroidectomy, and the result of the pathology came out as follicular adenoma. In this case, we wanted to discuss the significance of MIBI uptake in thyroid nodules and discuss the importance of evaluating raw data images for the detection of noncardiac pathologies in myocardial perfusion scintigraphy.


Thyroid nodules Tc-99m MIBI Extracardiac findings Myocardial perfusion scintigraphy Follicular adenoma 


  1. 1.
    McBiles M, Albert T, Cote M. Sestamibi parathyroid imaging. Semin Nucl Med. 1995;25:221–34.CrossRefGoogle Scholar
  2. 2.
    Coakley A, Kettle AG, Wells CP, O’Doherety MJ, Collins RE. Technetium-99m-sestamibi: a new agent for parathyroid imaging. Nucl Med Commun. 1989;10:791–4.CrossRefGoogle Scholar
  3. 3.
    Bucerius J, Ahmadzadehfar H, Biersack H. 99mTc-Sestamibi clinical applications. Berlin: Springer; 2012.CrossRefGoogle Scholar
  4. 4.
    Giejda K, Piszczek S, Stembrowicz-Nowakowska Z, Saracyn M, Dziuk M, Kamiński G. Incidentally recognised thyroid focal uptake of 99mTc-sestamibi during stress myocardial perfusion scintigraphy. Endokrynol Pol. 2015;66:521–5. Scholar
  5. 5.
    Földes I, Lévay A, Stotz G. Comparative scanning of thyroid nodules with technetium-99m pertechnetate and technetium-99m methoxyisobutylisonitrile. Eur J Nucl Med. 1993;20:330–3.CrossRefGoogle Scholar
  6. 6.
    Williams KA, Hill KA, Sheridan CM. Noncardiac findings on dual-isotope myocardial perfusion SPECT. J Nucl Cardiol. 2003;10:395–402.CrossRefGoogle Scholar
  7. 7.
    Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132:658–65. Scholar
  8. 8.
    Trimboli P, Treglia G, Guidobaldi L, Saggiorato E, Nigri G, Crescenzi A, et al. Clinical characteristics as predictors of malignancy in patients with indeterminate thyroid cytology: a meta-analysis. Endocrine. 2014;46:52–9. Scholar
  9. 9.
    Giovanella L, Suriano S, Maffioli M, Ceriani L, Spriano G. (99m)Tc-sestamibi scanning in thyroid nodules with nondiagnostic cytology. Head Neck. 2010;32:607–11. Scholar
  10. 10.
    Leidig-Bruckner G, Cichorowski G, Sattler P, Bruckner T, Sattler B. Evaluation of thyroid nodules—combined use of 99mTc-methylisobutylnitrile scintigraphy and aspiration cytology to assess risk of malignancy and stratify patients for surgical or nonsurgical therapy—a retrospective cohort study. Clin Endocrinol. 2012;76:749–58. Scholar
  11. 11.
    Saggiorato E, Angusti T, Rosas R, Martinese M, Finessi M, Arecco F, et al. 99mTc-MIBI imaging in the presurgical characterization of thyroid follicular neoplasms: relationship to multidrug resistance protein expression. J Nucl Med. 2009;50:1785–93. Scholar
  12. 12.
    Treglia G, Caldarella C, Saggiorato E, Ceriani L, Orlandi F, Salvatori M, et al. Diagnostic performance of (99m)Tc-MIBI scan in predicting the malignancy of thyroid nodules: a meta-analysis. Endocrine. 2013;44:70–8. Scholar
  13. 13.
    Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Meral Mert
    • 1
  • Murat Sipahi
    • 2
  1. 1.Department of Endocrinology and MetabolismBakirkoy Dr. Sadi Konuk Training and Research Hospital, Health Sciences University (SBÜ)IstanbulTurkey
  2. 2.Department of Nuclear MedicineBakirkoy Dr. Sadi Konuk Training and Research HospitalIstanbulTurkey

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