Clinical Examination and 131 Cs Scanning in the Diagnosis of Cold Nodules of the Thyroid

The usefulness of ¹³¹Cs scanning in preoperative diagnosis of ¹³¹I cold nodules of the thyroid that present no clear clinical sign of malignancy is discussed. The results of clinical examination of 283 thyroid nodules, associated in 139 cases with ¹³¹Cs scanning, are correlated with the histologic nature. In nodules that were classified as cold, warm or hot in the ¹³¹Cs scan, the incidence of malignancy was 2.6, 12.3 and 25 %, respectively. In the nodules that, on the basis of clinical examination, were classified as probably benign, dubious or suspected for malignancy, the incidence of cancer was, respectively, 3.6, 26.3 and 72.7 %. Malignancy ocurred in 16 of 144 patients that were selected for surgical treatment only on the basis of clinical data and in 17 of 139 patients that were selected on the basis of clinical examination associated with ¹³¹Cs scanning. The accuracy of clinical preoperative diagnosis of thyroid cold nodules does not seem to be significantly improved by association of ¹³¹Cs scanning.