CG14GZZ
Planar Nuclear Medicine Imaging Adrenal Glands, Bilateral to None with None, Iodine 131 (I-131) Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | C Nuclear Medicine |
| Body System | G Endocrine System |
| Operation | 1 Planar Nuclear Medicine Imaging |
| Body Part | 4 Adrenal Glands, Bilateral |
| Approach | G Iodine 131 (I-131) |
| Device | Z None |
| Qualifier | Z None |
Operation Definition
Introduction of radioactive materials into the body for single plane display of images developed from the capture of radioactive emissions
Procedure Overview
This family describes single-plane radioactive imaging of endocrine glands, most often a thyroid scan and sometimes a parathyroid or adrenal scan. A small amount of radioactive iodine or technetium pertechnetate is swallowed or injected, the gland absorbs it in proportion to how active its cells are, and a gamma camera held in one or two fixed positions captures flat, two-dimensional pictures of the uptake pattern.
Physicians use this scan to tell apart different causes of an overactive thyroid, such as Graves' disease versus a single toxic nodule, to characterize a thyroid nodule found on ultrasound, or to look for residual or recurrent thyroid cancer tissue after surgery. A parathyroid version, usually done with a sestamibi tracer, helps locate an overactive parathyroid gland before surgery. The scan is painless and usually completed within an hour of the tracer being given, though thyroid studies sometimes require the patient to return for delayed images.
Anatomy & Axis Detail
Adrenal Glands, Bilateral
Paired small glands sitting atop each kidney, the adrenals produce catecholamines from their medulla and steroid hormones from their cortex, and imaging both sides together allows direct comparison of uptake between glands, which is central to distinguishing unilateral disease such as a pheochromocytoma or adenoma from bilateral hyperplasia. Agents like MIBG localize to catecholamine-storing medullary tissue, while cortical agents target steroid-producing tissue, so the choice of radiopharmaceutical depends heavily on the suspected pathology being cortical versus medullary. Because the glands are deep, small, and closely related to the kidneys, liver, and spleen, planar images require careful positioning and often delayed acquisitions to allow background clearance, and bilateral symmetry on the images itself becomes a key diagnostic clue when one side shows discordant uptake.
Radionuclide: Iodine 131 (I-131)
Iodine 131 (I-131) identifies use of this radionuclide, which serves both diagnostic thyroid scanning and, at higher doses, therapeutic ablation of thyroid tissue or metastatic thyroid cancer. Its higher energy and longer half-life compared to Iodine 123 make it suited for therapeutic as well as diagnostic use, distinguishing it from the shorter-lived, purely diagnostic I-123.
Coding & Documentation
Coding from this family depends on documentation showing that only flat, single-position images were acquired, without a rotational SPECT component. The report should identify the tracer, the gland imaged, and the camera views obtained. A frequent mistake is applying this code when the department actually performed a combined uptake-and-scan visit; the uptake measurement and the imaging are distinct root operations and both must be captured if both were done. Another recurring error is defaulting to "planar" because that is the more familiar term, when the technologist's protocol notes actually describe a SPECT acquisition.
Commonly Confused With
The closest look-alike is Tomographic Nuclear Medicine Imaging of the endocrine system, which differs only in whether the camera rotated to produce 3D reconstructions; dual-phase parathyroid protocols in particular are frequently planar-only despite reports that use the word "tomographic" loosely. It is also confused with Nonimaging Nuclear Medicine Uptake, which measures gland function as a percentage or count rate and produces no picture at all.