Pulmonary sequestration: a 131I whole body scintigraphy false-positive result

Spinapolice, Elena Giulia; Chytiris, Spyridon; Fuccio, Chiara; Leporati, Paola; Volpato, G; Villani, Laura; Trifirò, Giuseppe; Chiovato, Luca

doi:10.1007/s12149-014-0838-5

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…The following sections illustrate with examples the physiologic and nonthyroid pathologic variants on radioiodine scintigrams (Table) (7,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30).…”

Section: Radioiodine Imaging Protocolmentioning

confidence: 99%

Pictorial Review of False-Positive Results on Radioiodine Scintigrams of Patients with Differentiated Thyroid Cancer

Chudgar¹,

Shah²

2017

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Radioiodine has served an important role in the diagnostic workup and treatment of patients with differentiated thyroid cancer for more than 6 decades. The interpretation of radioiodine scintigraphic studies should be performed in conjunction with a comprehensive history, histopathologic correlation, and pertinent laboratory values, as well as correlation with available anatomic images and the findings from physical examination. A thorough understanding of the physiology and biodistribution of radioiodine is critical when interpreting radioiodine scintigraphic studies to avoid misinterpretation of physiologic and nonthyroid pathologic variants as thyroid cancer metastases. Differentiating a false-positive finding from a true metastasis on pretherapy radioiodine scintigrams is important to determine the appropriate radioiodine treatment dose. The correct interpretation of posttherapy radioiodine scintigraphic studies is also important to determine if repeat radioiodine treatment will be necessary and for the future clinical and imaging followup of the patient. A variety of different factors, such as the presence of the sodium-iodide symporter and the passive diffusion or retention of radioiodine in normal and pathologic structures, can result in false-positive results on radioiodine scintigrams. Numerous false-positive findings have been reported in the literature and are further demonstrated with the increasing availability of single photon emission computed tomography (SPECT) integrated with computed tomography (CT) as true dual-modality imaging (SPECT/CT). SPECT/CT has been documented to be of incremental value in the accurate anatomic localization and characterization of radioiodine uptake as false-positive findings, particularly in cases with discordant findings of a low serum thyroglobulin level but positive findings on radioiodine whole-body planar scintigrams. The objectives of this review are to describe the physiology and biodistribution of radioiodine and to provide examples of false-positive results on radioiodine scintigrams, with clinical and anatomic correlation, in the following categories of radioiodine uptake: functional uptake secondary to sodium-iodide symporter expression, radioiodine retention, nonthyroid neoplasms, inflammatory or infectious uptake, contamination, and other causes. RSNA, 2017.

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Section: Radioiodine Imaging Protocolmentioning

confidence: 99%

Pictorial Review of False-Positive Results on Radioiodine Scintigrams of Patients with Differentiated Thyroid Cancer

Chudgar¹,

Shah²

2017

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“…Pathologically benign etiologies in the chest have also been recognized to accumulate 131 I, including bronchiectasis, respiratory bronchiolitis, pulmonary tuberculosis, pulmonary aspergilloma, breast fibroadenoma, pleuropericardial cyst, hyperplastic thymus, bronchial atresia with mucocele, and pulmonary sequestration [ 27 , 28 , 29 ]. Potential mechanisms of 131 I uptake in these entities were deemed as increased concentration of 131 I due to the hyperemia of the inflamed mucosa, the leakage of 131 I into bronchial tree or lung parenchyma because of increased permeability, and the accumulation of tracheobronchial secretions due to decreased clearance [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Treatment of Acute Pleural Effusion following Radioiodine Remnant Ablation Post Lobectomy for Thyroid Cancer

Qiu

Wang

et al. 2022

Diagnostics

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Radioiodine remnant ablation (RRA) was previously demonstrated to be a safe and effective alternative to completion thyroidectomy for patients with differentiated thyroid cancer (DTC). However, its side effects have not been fully investigated, particularly in patients with lobectomy. We reported a young euthyroidal female who underwent RRA post lobectomy and lymph node dissection for papillary thyroid cancer, whose post-ablation 131I-whole-body scan accidentally showed diffuse radioiodine distribution on chest-mimicking pulmonary metastases. Immediately-added single-photon emission computed tomography/computed tomography (SPECT/CT), nevertheless, revealed a 131I-accumulating swollen left thyroid lobe and emerging pleural effusion, which relieved after short-term treatment with prednisone. In summary, acute pleural effusion ascribed to RRA-induced thoracic duct compression was reported for the first time. 131I-lobectomy-induced pleural effusion could be precisely diagnosed by SPECT/CT and efficiently manipulated via treating radiation thyroiditis with the short-term administration of corticosteroid.

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