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C-1833 - the role of MRI and SPECT/CT in I-131 avid bone lesions of differentiated thyroid carcinoma

A. Oral1, B. Yazici1, C. Eraslan1, M. ARGIN2, K. KUMANLIOGLU2; 1 Izmir/TR 2 IZMIR/TR Type: Educational Exhibit
Area of Interests: Nuclear medicine, Hybrid Imaging, Bones
Imaging Techniques: MR, Nuclear medicine conventional, SPECT-CT
Procedures: Staging, Localisation, Ablation procedures
Special Focus: Cancer
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Learning objectives: * To illustrate magnetic resonance imaging (MRI) and single-photon emission computed tomography/computed tomography (SPECT/CT) findings of I-131 avid bone lesions in differentiated thyroid carcinoma (DTC) patients.  

Background: Radioiodine is the most specific radionuclide for differentiated thyroid carcinoma (DTC) imaging. I-131 uptakes on whole body scintigraphy (WBS) are usually caused by residual thyroid tissue and metastasis of DTC. Also false positive I-131 uptakes mimicking metastasis could be seen on WBS that may c[...]

Findings and procedure details: Imaging protocol:   Planar I-131 WBS was performed in both anterior and posterior projections using dual-head gamma-camera with high-energy, parallel-hole collimators. Continuous acquisition mode was used at a table speed of 8 cm/min with a 1,024 x 256 matrix. The photopeak was 364 keV wit[...]

Conclusion: We suggest that non-metastatic I-131 uptakes on bone structures must be kept in mind in interpreting I-131 WBS’s. In patients’ notably discordant clinical and laboratory data SPECT/CT and MRI is recommended to avoid misdiagnosis and unnecessary radioiodine treatments.  

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References: Yazici B, Oral A, Eraslan C et al. False-Positive 131I Uptake in a Benign Bone Lesion on Post-therapy Scan. Clin Nucl Med 2016; 41: 63-5. Shapiro B, Rufini V, Jarwan A et al. Artifacts, anatomical and physiological variants, and unrelated diseases that might cause false-positive whole-body 131-I s[...]

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