Iodine uptake in the chest in the follow-up of well-differentiated thyroid cancer

• Published in: Revista española de medicina nuclear Vol. 30; no. 1; pp. 24 - 28
• Main Authors: García Alonso, M.P., Balsa Bretón, M.A., Paniagua Correa, C., Castillejos Rodríguez, L., Penín González, F.J., Elviro Peña, R., Ortega Valle, A., Mariana Monguía, A., Vásquez Tineo, S.I., Mendoza Paulini, A., Pey Illera, C.
• Format: Journal Article
• Language: English; Spanish
• Published: Spain Elsevier España 2011
• Subjects: 131I; 131Iodine; Aged; Anti-Bacterial Agents - therapeutic use; Biomarkers, Tumor; Bronchiectasis; Bronchiectasis - diagnostic imaging; Bronchiectasis - etiology; Bronchitis - complications; Bronchitis - drug therapy; Bronquiectasias; Carcinoma - blood; Carcinoma - diagnostic imaging; Carcinoma - radiotherapy; Carcinoma - secondary; Carcinoma - surgery; Carcinoma de tiroides; Combined Modality Therapy; Diagnosis, Differential; False Positive Reactions; Female; Humans; Iodine Radioisotopes - pharmacokinetics; Iodine Radioisotopes - therapeutic use; Lung - diagnostic imaging; Lung Neoplasms - diagnosis; Lung Neoplasms - secondary; Radionuclide Imaging; Radiopharmaceuticals - pharmacokinetics; Radiopharmaceuticals - therapeutic use; Thyroglobulin; Thyroglobulin - blood; Thyroid carcinoma; Thyroid Neoplasms - blood; Thyroid Neoplasms - diagnostic imaging; Thyroid Neoplasms - radiotherapy; Thyroid Neoplasms - secondary; Thyroid Neoplasms - surgery; Thyroidectomy; Tiroglobulina; Whole Body Imaging; 131Iodine; Thyroglobulin; Bronquiectasias; Bronchiectasis; Carcinoma de tiroides; 131I; Thyroid carcinoma; Tiroglobulina
• ISSN: 1578-200X; 1578-200X
• DOI: 10.1016/S1578-200X(11)70004-3

Differentiated thyroid cancer is a disease having a very good prognosis when treated adequately. Ablation treatment with 131I is frequently adjunct to surgery in these patients since it improves survival. Radioiodine whole-body scan is one of the imaging modality of choice in the follow-up of patients with this kind of pathology. After ablation treatment of the thyroid gland, any radioiodine accumulation in a non-physiological location usually means the presence of functioning metastasis. Recognition of potential false-positives is essential to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine. We report a case of uptake in the chest due to bronchiectasis, potentially masquerading as pulmonary metastasis.
El cáncer diferenciado de tiroides es una enfermedad con muy buen pronóstico si se trata adecuadamente. El tratamiento ablativo con 131I frecuentemente se asocia al tratamiento quirúrgico en estos pacientes ya que mejora la supervivencia, y el rastreo corporal total con 131I es una de las modalidades de diagnóstico de elección en el seguimiento de esta enfermedad. Tras tratamiento ablativo del tejido tiroideo, cualquier depósito del radiotrazador en una localización no fisiológica representa habitualmente la presencia de metástasis. Así pues, será fundamental el reconocimiento de cualquier posible falso positivo con el fin de evitar la radiación innecesaria debida a tratamientos inadecuados. Presentamos un caso clínico de captación torácica por bronquiectasias que puede malinterpretarse como metástasis pulmonar.