On a nuclear medicine thyroid scan, a cold nodule is most suspicious for malignancy.

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Multiple Choice

On a nuclear medicine thyroid scan, a cold nodule is most suspicious for malignancy.

On a thyroid scan that uses radioactive tracer, a cold nodule does not take up the tracer. Malignant thyroid nodules are often non-functioning or less able to trap iodine, so they appear as cold areas compared with the normal thyroid tissue. In contrast, hot nodules show increased uptake because they are autonomously functioning tissue and are usually benign. Therefore, a cold nodule is the pattern that carries the greater concern for malignancy and typically prompts tissue sampling to determine if cancer is present. Of course, many cold nodules are benign, so imaging is followed by cytology to confirm, rather than relying on the scan alone.

On a thyroid scan that uses radioactive tracer, a cold nodule does not take up the tracer. Malignant thyroid nodules are often non-functioning or less able to trap iodine, so they appear as cold areas compared with the normal thyroid tissue. In contrast, hot nodules show increased uptake because they are autonomously functioning tissue and are usually benign. Therefore, a cold nodule is the pattern that carries the greater concern for malignancy and typically prompts tissue sampling to determine if cancer is present. Of course, many cold nodules are benign, so imaging is followed by cytology to confirm, rather than relying on the scan alone.

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