Skip to main content
SpringerLink
Log in

Cardiac blood pool activity on postablation radioiodine imaging

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

There are reports on physiologic and pathologic mediastinal uptake on radioiodine imaging in patients with thyroid carcinoma. The most commonly reported physiologic causes of mediastinal uptake are esophageal retention of salivary secretion and uptake by hyperplastic or normal thymus gland. In this study, we evaluated physiologic cardiac blood pool (CBP) activity and its associated findings on radioiodine imaging.

Methods

Cardiac blood pool activity was evaluated in 186 postablation and 32 posttherapy scans. After oral radioiodine administration, imaging was initiated on day 7. Thyroglobulin, anti-thyroglobulin and TSH blood level determination was carried out in all patients. Whole-body scans were inspected with regard to residual thyroid uptake, esophageal uptake, CBP activity, hepatic activity and metastatic iodine uptake. Uptake in the residual thyroid tissue was graded visually as mild (m), moderate (M) and significant (S). Whenever CBP activity was detected on visual inspection, its intensity was graded as mild (1), moderate (2), and significant (3).

Results

Cardiac blood pool activity was detected in 61 postablation scans (33 %). Residual thyroid uptake was observed in all patients with CBP. A significant correlation existed between the intensity of uptake and the presence of CBP (p < 0.05). The mean Tg in patients with CBP was significantly higher than those without CBP (p < 0.05). Cardiac blood pool activity was not observed in any posttherapy scans and in those scans with distant metastases in the postablation group. Linear or irregular activity pattern thought to be due to esophagus was detected in 4 % of postablation scans.

Conclusions

The results have revealed CBP to be common on postablation scans. Its presence correlated with the intensity of residual thyroid uptake and had a significant association with increased thyroglobulin levels. Its absence on posttherapy scans despite increased Tg levels suggested that this activity is due to labeled thyroid hormones released by the residual thyroid tissue. Its presence might imply a high level of blood radiation dose.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bakheet SM, Powe J, Hammami MM. Radioiodine uptake in the chest. J Nucl Med. 1997;38:984–6.

    CAS  PubMed  Google Scholar 

  2. Wilson LM, Barrington SF, Morrison ID, Kettle AG, O’Doherty MJ, Coakley AJ. Therapeutic implications of thymic uptake of radioiodine in thyroid carcinoma. Eur J Nucl Med. 1998;25:622–8.

    Article  CAS  PubMed  Google Scholar 

  3. Ziessman HA, Bahar H, Fahey FH, Dubiansky V. Hepatic visualization of Iodine-131 whole-body thyroid cancer scans. J Nucl Med. 1987;28:1408–11.

    CAS  PubMed  Google Scholar 

  4. Chung JK, Lee YJ, Jeong JM, Lee DS, Lee MC, Cho BY, et al. Clinical significance of hepatic visualization on Iodine-131 whole-body scan in patients with thyroid carcinoma. J Nucl Med. 1997;38:1191–5.

    CAS  PubMed  Google Scholar 

  5. Myant NB. Early effects of radioiodine on human thyroid function. Clin Sci. 1953;12:235–45.

    CAS  PubMed  Google Scholar 

  6. Hammersley PAG, Al-saadi A, Chittenden S, Flux GD, McCready VR, Harmer CL. Value of protein-bound radioactive iodine measurements in the management of differentiated thyroid cancer treated with I-131. Br J Radiol. 2001;74:429–33.

    Article  CAS  PubMed  Google Scholar 

  7. Hanscheid H, Lassmann M, Luster M, Thomas SR, Pacini F, Ceccarelli C, et al. Iodine biokinetics and dosimetry in radioiodine therapy of thyroid cancer: procedures and results of a prospective international controlled study of ablation after rTSH and hormone withdrawal. J Nucl Med. 2006;47:648–54.

    PubMed  Google Scholar 

  8. Verburg FA, Lassmannn M, Mader U, Luster M, Reiners C, Hanscheid H. The absorbed dose to the blood is a better predictor of ablation success than the administered I-131 activity in thyroid cancer patients. Eur J Nucl Med. 2011;38:673–80.

    Article  CAS  Google Scholar 

  9. Ronga G, Filesi M, Ventroni G, Vestri AR, Signore A. Value of first serum thyroglobulin level after total thyroidectomy for the diagnosis of metastases from differentiated thyroid carcinoma. Eur J Nucl Med. 1999;26:1448–52.

    Article  CAS  PubMed  Google Scholar 

  10. Jong-Ryool Oh, Ahn Byeong-Cheol. False-positive uptake on radioiodine whole-body scintigraphy: physiologic and pathologic variants unrelated to thyroid cancer. Am J Nucl Med Mol Imaging. 2012;2:362–85.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Faculty of Medicine, Başkent University, Fevzi Çak. Cad. 10. sk. No: 45, 06480, Bahçelievler, Ankara, Turkey

    Ayşe Aktaş, Beyza Kocabaş, Seval Erhamamcı, Arzu Gençoğlu & Cevdet Liman

Authors
  1. Ayşe Aktaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Beyza Kocabaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seval Erhamamcı
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Arzu Gençoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cevdet Liman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ayşe Aktaş.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aktaş, A., Kocabaş, B., Erhamamcı, S. et al. Cardiac blood pool activity on postablation radioiodine imaging. Ann Nucl Med 29, 170–176 (2015). https://doi.org/10.1007/s12149-014-0925-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-014-0925-7

Keywords

Search

Navigation