What is the primary purpose of investigating thyroid nodules?

Thyroid nodules, though often benign, sometimes require diagnostic investigation due to the risk of malignancy. Traditional methods like fine needle aspiration cytology (FNAC) have limitations, thus the need for advanced methods. The study explores how using Myoview and DMSA scans together, along with FNAC, can improve accuracy and reduce the need for invasive procedures, which directly addresses the limitations of previous approaches.

What are Myoview and DMSA scans, and how are they used?

Myoview and DMSA scans are types of thyroid scans using radiopharmaceuticals. Myoview and DMSA are used to evaluate thyroid nodules, focusing on their ability to distinguish between benign and malignant growths. The study found that the absence of tracer accumulation in both Myoview and DMSA scans strongly suggests a benign nodule. Quantitative analysis of Myoview scans, measuring the Myoview retention index, further helped in differentiating between benign and malignant lesions, particularly in the case of higher grade malignancies.

What are the differences between conventional thyroid scans, Myoview scans, and combined Myoview and DMSA scans?

Conventional 99mTc pertechnetate scans are described as having limited value in distinguishing between benign and malignant nodules, highlighting the need for improved diagnostic techniques. Early-phase Myoview scans have high uptake in both benign and malignant nodules, indicating they are not specific enough for a diagnosis. In contrast, combined Myoview and DMSA scans provided more valuable diagnostic information.

What is the significance of the Myoview retention index in the diagnosis?

The Myoview retention index is a quantitative measure used in the study. A high retention index of Myoview in malignant lesions compared to benign lesions suggested malignancy. A cutoff point of >14% was identified as being able to separate between benign and malignant lesions. This is important because it offers a quantitative measure to differentiate between benign and malignant nodules.

What are the key findings regarding the use of Myoview and DMSA scans?

The study found that Myoview uptake in cold nodules is more indicative of the aggressiveness or grade of a malignant tumor. To accurately differentiate between benign and malignant lesions, the combination of both Myoview and DMSA scans, along with the use of a regression equation, is needed. This approach offers a comprehensive, less invasive path for thyroid nodule diagnosis and can potentially reduce the need for more invasive procedures such as biopsies.

Visual representation of Myoview and DMSA scans illuminating the thyroid gland, symbolizing advanced thyroid nodule diagnostics.

Thyroid Scans vs. Biopsy: Which Test Is Best for Spotting Cancer?

Avery Sinclair in Health & Wellness December 2025 • 4 min read.

"A new study explores how combining thyroid scans can improve accuracy in detecting malignant thyroid nodules, potentially reducing the need for unnecessary biopsies."

The journey of diagnosing thyroid nodules can be filled with uncertainty. While most thyroid nodules are benign, the possibility of malignancy always looms, leading to anxiety and the need for accurate diagnostic tools. Traditionally, fine needle aspiration cytology (FNAC) has been a cornerstone in evaluating these nodules, but its limitations in certain cases have prompted the search for more reliable, non-invasive methods.

Thyroid scintigraphy, or thyroid scanning, has been used to assess thyroid nodules, but questions remain regarding its role. Although critical for determination of autonomously functioning thyroid tissue, conventional scanning has limitations in distinguishing between benign and malignant nodules. Researchers have explored various radiopharmaceuticals to improve the accuracy of thyroid imaging.

This article delves into a study comparing conventional thyroid scintigraphy with newer techniques using 99mTc tetrofosmin (Myoview) and 99mTc (V) DMSA, combined with FNAC, to evaluate solitary thyroid nodules. We'll explore how these methods can improve the accuracy of diagnosis and potentially reduce the need for invasive procedures.

Myoview and DMSA: A Combined Approach to Thyroid Nodule Evaluation

Visual representation of Myoview and DMSA scans illuminating the thyroid gland, symbolizing advanced thyroid nodule diagnostics.

The study involved 103 patients, predominantly women, with solitary thyroid nodules. All patients underwent a comprehensive evaluation, including a detailed medical history, physical examination, thyroid function tests, and various thyroid scans, including conventional 99mTc pertechnetate scans, 99mTc tetrofosmin (Myoview) scans, and 99mTc (V) DMSA scans. Cytologic assessments were also performed on thyroid nodules that appeared "cold" on conventional scans.

Researchers analyzed the qualitative and quantitative aspects of Myoview and DMSA scans to assess their effectiveness in differentiating between benign and malignant thyroid nodules. The study aimed to determine the diagnostic value of these radioisotopes and verify their accuracy in detecting differentiated thyroid carcinoma.

Conventional 99mTc pertechnetate scans: These scans had limited value in distinguishing between benign and malignant nodules.
Early-phase Myoview scans: High uptake in the early phase was observed in both malignant and benign nodules, indicating it's not specific for malignancy.
Combined Myoview and DMSA scans: Researchers found that combining Myoview and DMSA scans provided valuable diagnostic information. Absence of tracer accumulation in both scans strongly suggested a benign nodule.
Quantitative Analysis: High retention index of Myoview in malignant lesions compared to benign lesions suggested malignancy. A cut-off point >14% could separate between benign and malignant lesions.

The study revealed a significant correlation between the grade of malignancy and Myoview retention index, meaning higher-grade malignancies tended to have higher Myoview retention. Statistical analysis identified factors, including Myoview image quality, Myoview retention index, and DMSA uptake, that could predict the presence of malignancy.

Improving Thyroid Nodule Assessment: The Future of Diagnosis

The study suggests that Myoview uptake in cold nodules is more indicative of the aggressiveness or grade of a malignant tumor rather than simply distinguishing between benign and malignant lesions. To differentiate between these two, both Myoview and DMSA scans, combined with a regression equation, are needed.

This research highlights the potential of combining different imaging techniques to improve diagnostic accuracy. The use of Myoview and DMSA scans can offer a less invasive route to identifying potential thyroid cancers, and refining the selection process for FNAC, ensuring that biopsies are performed when they are most likely to provide valuable information.

Future studies should explore the findings and refine the diagnostic algorithms to improve the detection of thyroid malignancies while minimizing unnecessary invasive procedures, ultimately leading to better patient outcomes and reduced anxiety for individuals with thyroid nodules.