The Thyroid Clinic at the Department of Nuclear Medicine offers complete and extensive diagnostics and treatments of all thyroid diseases.
Latest techniques in nuclear medicine are used. Particularly patients with ambiguous thyroid nodules, hyperthyroidism (Graves’ disease, hot nodules – see figures 1+2) and thyroid cancer are attended. Our clinic has 5 single rooms for treatments
Interdisciplinary Thyroid Center
Seven disciplines regularly work together at the Thyroid Center of the University Hospital of Zurich (Head: Prof. Dr. med. Hans Steinert). Experts from nuclear medicine, endocrinology, otorhinolaryngology, general surgery, pathology, radiotherapy and oncology meet weekly at the interdisciplinary thyroid board. Here the diagnostic findings of the patients are presented and the patients are quickly allocated to the right department.
Frequent diseases of the thyroid
Hypo- or hyperthyroidism
In hyperthyroidism occurs an increased secretion of thyroid hormones into the blood. The cause can be Grave’s disease, which is an autoimmune disease, or hot nodules (thyroid autonomy).
At Grave’s disease thyreostatic drugs are applied. If drug therapy isn’t successful radioiodine therapy or, in case of a big thyroid, surgery is indicated.
Hot thyroid nodules (figures 2+3) can selectively be eliminated by radioiodine therapy. For big nodules surgery is necessary. Hashimotos thyroiditis first causes hyperthyroidism and often results in hypothyroidism in the progression of the disease. Substitution of thyroid hormones is necessary.
Particularly in elderly patients symptoms of thyroid disorders are frequently misjudged. Directed diagnostics enable quick clarification and initiation of specific treatment.
Figure 1: Morbus Basedow
Figure 2: Autonomy of the Thyroid
Thyroid enlargement (goiter)
In regions with lack of iodine cumulatively thyroid growth occurs. A so called goiter evolves (figures 3+4). In further progression thyroid nodules develop which can change to ‘hot nodules’ during time figure 3) The goiter is examined by ultrasound and scintigraphy.
Figure 3: Struma diffusa et multinodosa with Figure 4: Struma diffusa et multinodosa with
hot areales cold areales
Nodules in the thyroid can be caused by cysts, benign nodules or thyroid cancer. The nodules are investigated by ultrasound, scintigraphy and fine needle aspiration. All examinations can be performed at our clinic in one day.
One principal domain of our department represents diagnosis, treatment and follow up of patients with thyroid cancer (figure 5). For investigation of suspect thyroid nodules ultrasound and fine needle aspiration are used. We mediate quick appointments for surgery with experienced thyroid surgeons. Frequently a radioiodine therapy is necessary after surgery. We also attend patients in cancer follow up to ensure definite cure from thyroid cancer. Latest diagnostic techniques in nuclear medicine (SPECT/CT, PET/CT, PET/MR) are available at the University Hospital of Zurich.
Figure 5: Thyroid carzinoma with retrojugular (lymph node) metastasis with radioiodine uptake
Diagnostic and therapeutic techniques
Ultrasound of the thyroid
Thyroid ultrasound enables exact sizing of the thyroid, evaluation of structure and detection of nodules. Doppler ultrasonography is used to evaluate perfusion. Ultrasound is applied to examine enlarged thyroids (goiter), thyroid nodules and diseases with hyperthyroidism.
Scintigraphy of the thyroid
Thyroid function can be examined with a scintigraphy (figures 1-5). This is applied in particular for investigation of hyperthyroidism, to detect so called hot nodules (autonomy) and inactive nodules (cold nodules).
At radioiodine therapy radioactive iodine (radioiodine) is used for treatment. Radioiodine therapy is used for the treatment of Graves’ disease, hot nodules and thyroid cancer. The preparation for radioiodine therapy is performed ambulant in our clinic .In general, admission to our nuclear medical ward for 4 – 5 days is required for radioiodine therapy.