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

Sep 23, 2026

Uploaded by Sarah

Background and objectives: Multiple diagnostic approaches exist for identifying thyroid malignancy, yet the path from detecting a thyroid nodule to reaching a definitive diagnosis is often lengthy and costly. This narrative review investigates the role of 99mTc-Sestamibi scintigraphy in characterizing cytologically indeterminate thyroid nodules. Methods: A focused literature review compares Fine Needle Aspiration Biopsy (FNAB) with Sestamibi molecular imaging. Results: Sestamibi is an accepted alternative, with high negative predictive value for excluding malignancy. Conclusions: 99mTc-Sestamibi may support evaluation when cytology remains inconclusive.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Introduction

Thyroid cancer diagnostic journey and risk context

Diagnostic workflow and imaging options

The Cicones: Ultrasound

Ultrasound assessment and malignancy-associated features

Review 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 and Evanthia Giannoula 1 1 Second Academic Nuclear Medicine Department, Academic General Hospital “AHEPA”, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; [iiakovou@auth.gr](iiakovou@auth.gr) (I.I.); [n_papadopoulos@outlook.com](n_papadopoulos@outlook.com) (N.P.); [koutsoukig@gmail.com](koutsoukig@gmail.com) (G.K.); [hliask77@gmail.com](hliask77@gmail.com) (I.K.); [eva_giann@hotmail.com](eva_giann@hotmail.com) (E.G.) 2 CAP Santé, Radiation Therapy, Clinique Maymard, 20200 Bastia, France; [melichristos@hotmail.com](melichristos@hotmail.com)[ ](melichristos@hotmail.com)[3](3 milliVolt.eu)[ milliVolt.eu](3 milliVolt.eu) (A Health Physics Company), 20200 Bastia, France 4 Nuclear Medicine Department and Thyroid Cancer Clinic, Bank of Cyprus Oncology Center, 2404 Nicosia, Cyprus; [savvas.frangos@bococ.org.cy](savvas.frangos@bococ.org.cy) 5 Second Department of Surgery, General Hospital of Thessaloniki “G. Gennimatas”, School of Medicine, Aristotle University of Thessaloniki, 54635 Thessaloniki, Greece; [iokoutel@gmail.com](iokoutel@gmail.com) 6 First Department of Internal Medicine, Academic General Hospital “AHEPA”, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; [kkalli@auth.gr](kkalli@auth.gr) * [Correspondence: voulaexadaktylou@hotmail.com](Correspondence: voulaexadaktylou@hotmail.com) 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 Academic Editor: KonstantinosDimas Received: 7 April 2025 Revised: 30 May 2025 Accepted: 3 June 2025 Published: 5 June 2025 Citation: Iakovou, I.; Papadopoulos, N.; Exadaktylou, P.; Melidis, C.; Koutsouki, G.; Katsadouros, I.; Frangos, S.; Koutelidakis, I.; Kotsa, K.; Giannoula, E. A Narrative Review of the Odyssey of Thyroid Cancer Diagnosis: Can 99mTc-SESTAMIBIMolecular Imaging Replace Fine Needle Aspiration Biopsy? Medicina 2025, 61, 1043. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/medicina61061043](10.3390/medicina61061043) [Copyright:](Copyright:) © 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) . 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 withinconclusive cytological findings. Keywords: thyroid malignancy; Sestamibi scintigraphy; Fine Needle Aspiration Biopsy; Bethesda; nodule 1. Introduction The word odyssey has come to mean a journey of epic pr

FAQs

What diagnostic problem does the review address for thyroid cancer?

It addresses the long, challenging process from detecting thyroid nodules to obtaining a definitive thyroid cancer diagnosis, especially when cytology is indeterminate.

How does the review compare Sestamibi scintigraphy with FNAB?

It compares Fine Needle Aspiration Biopsy (FNAB), the main diagnostic method, against 99mTc-Sestamibi molecular imaging for evaluating thyroid nodules.

What value does Sestamibi provide according to the review’s findings?

The review reports that Sestamibi has a high negative predictive value for excluding thyroid malignancy and is widely accepted as an alternative after non-diagnostic FNAB.

Sep 23, 2026

Uploaded by Sarah