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A 52-year-old male asked:

If i had a thyroid scan that read: left lobe of gland is mildly enlarged at 5.8cm x 1.7 x 2.2 . there is a avascular 3 mm hypoechoic nodule in the lower pole of the left lobe. how would i know if it was " hot or cold"?

4 doctor answers12 doctors weighed in
Dr. Guido Davidzon
Nuclear Medicine 20 years experience
Different tests: You had a thyroid ultrasound which evaluates the anatomy of your thyroid gland. To find out if a thyroid nodule is hot or cold you need a nuclear thyroid scan aka i-123 uptake and scan. This latter is a functional test of your thyroid and characterizes nodules as hot, cold or warm (isointense). However, a 3 mm nodule is likely to small to characterize with a nuclear thyroid scan.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Gerald Mandell
Nuclear Medicine 54 years experience
I would repeat thyroid ultrasound in a few months. if there is no or little change in size or character of nodule, it is most likely benign.
Jan 2, 2013
Dr. Quang Nguyen
Specializes in Endocrinology
Can't tell: The test you stated above is a thyroid ultrasound. It is not a scan. You can't tell if something is hot or cold definitively on a thyroid ultrasound. You need a thyroid scan (using radioactive iodine) to know if something is hot or cold. If your TSH was normal, you probably didn't have a scan for a nodule that small (3 mm).
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Gerald Mandell
Nuclear Medicine 54 years experience
No way: The thyroid scan with i123 radiopharmaceutical is accumulated by the thyroid gland. Scan shows no activity in area of avascular or cold nodule. Ultrasound of thyroid can determine if the nodule is probably cyst or neoplasm. 3mm is quite small. Follow up esamination with us in a few months to see if stable or growing. Might have biopsy of the lesion if suspicious for something other than cyst.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Brad Eilerman
Endocrinology 22 years experience
Ultrasound results: What you are describing are ultrasound results. A hypoechoic nodule of 3 mm of size is nearly 100% benign. The only reason to assess if a nodule is overactive (hot) or underactive (cold) is in general hyperthyroidism. If the nodule is hot, then it can be the target of therapy. This is done through a i-131 uptake and scan.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. David Geffner
Endocrinology 56 years experience
It is unlikely that a 3mm nodule would cause hyperthyroidism. Check your thyroid function tests.
Mar 3, 2013
Dr. Brad Eilerman
Endocrinology 22 years experience
Provided original answer
I agree
Mar 3, 2013
Last updated Oct 24, 2017

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