Should I have this test?

[lbds]

I recently had an ultrasound that showed a small (0.6 cm x 0.5 cm) nodule.  My family doctor wants me to have a nuclear scan.  I told her I had read that nuclear scans aren't useful in distinguishing between benign and malignant nodules, but she said I'm wrong.  History -- I'm 57, was diagnosed with hypothyroidism 4 years ago, currently on 125 mcg of levothyroxine, mother had thyroid cancer at age 77.
    I don't want to go off medication for the 6 weeks the hospital requires if this test isn't likely to provide any information.   What should I do?  

[Mark Lupo, M.D.]

There is no role for a scan in this situation.  The current American Thyroid Association Guidelines clearly reflect that a scan has a very limited role in thyroid nodule evaluation.  This is particularly true with a small nodule in a patient on levothyroxine.

The best thing to do, esp with mom's history, is find a thyroidologist who does his/her own ultrasound to carefully look at this nodule to see if there are any suspicious features.  But at 0.6cm, would be inclined usually to recheck ultrasound in 4-6 months.

[charlie99]

nuclear scan can show hot and cold nodules one is for cancer, I don't remember which.  I had the nuclear scan when my thyroid was huge.    My nodule was fine. They suggested we do Ultrasound every 6 months.  I am not into watching things, I mean watch them do what.  So I had my thyroid removed.  I was having airway problems it was so big, and I was hyperthyroid so my heart rate was so fast, I was on Inderal and that was making me sick.  That is my experience with it.