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

TL;DR

This paper reviews whether 99mTc-Sestamibi imaging can replace fine needle aspiration biopsy for diagnosing thyroid cancer.

Contribution

The paper evaluates the potential of 99mTc-Sestamibi as an alternative to FNAB for indeterminate thyroid nodules.

Findings

Sestamibi has a high negative predictive value for excluding thyroid malignancy.

Sestamibi is a primary alternative for patients with non-diagnostic fine needle aspiration biopsy results.

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.

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