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Radioiodine whole body scan pitfalls in differentiated thyroid cancer

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Abstract

Purpose

whole body scan (WBS) performed following diagnostic or therapeutic administration of I-131 is useful in patients with differentiated thyroid carcinoma. However, it can be falsely positive in various circumstances. We aimed to report a series of pitfalls in a clinical perspective.

Methods

A search in the database PubMed utilizing the following terms: “false radioiodine uptake” and “false positive iodine 131 scan” has been made in January 2023. Among the 346 studies screened, 230 were included in this review, with a total of 370 cases collected. Physiological uptakes were excluded. For each patient, sex, age, dose of I-131 administered, region and specific organ of uptake and cause of false uptake were evaluated.

Results

370 cases of false radioiodine uptake were reported, 19.1% in the head-neck region, 34.2% in the chest, 14.8% in the abdomen, 20.8% in the pelvis, and 11.1% in the soft tissues and skeletal system. The origin of false radioiodine uptake was referred to non-tumoral diseases in 205/370 cases (55.1%), benign tumors in 108/370 cases (29.5%), malignant tumors in 25/370 cases (6.7%), and other causes in 32/370 cases (8.7%).

Conclusions

WBS is useful in the follow-up of patients with differentiated thyroid carcinoma, however it can be falsely positive in various circumstances. For this reason, it is critically important to correlate the scintigraphic result with patient’s medical history, serum thyroglobulin levels, additional imaging studies and cytologic and/or histologic result.

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Authors and Affiliations

  1. Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

    Cristina Basso, Alessandra Colapinto, Valentina Vicennati, Alessandra Gambineri, Carla Pelusi, Guido Di Dalmazi, Uberto Pagotto & Andrea Repaci

  2. Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

    Cristina Basso, Alessandra Colapinto, Valentina Vicennati, Alessandra Gambineri, Carla Pelusi, Guido Di Dalmazi & Uberto Pagotto

  3. Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

    Elisa Lodi Rizzini

  4. Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

    Elena Tabacchi, Arber Golemi, Letizia Calderoni & Stefano Fanti

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U.P.: Writing—Review & Editing, Supervision. A.R.: Conceptualization, Methodology, Writing—Review & Editing. G.D.D.: Validation, Writing—Review & Editing. A.C.: Writing—Review & Editing. C.B.: Conceptualization, Methodology, Data curation, Writing—Original draft preparation. All authors reviewed the manuscript, have accepted responsibility for the entire content of this manuscript, and approved its submission.

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Basso, C., Colapinto, A., Vicennati, V. et al. Radioiodine whole body scan pitfalls in differentiated thyroid cancer. Endocrine 85, 493–508 (2024). https://doi.org/10.1007/s12020-024-03754-y

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