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.

中文翻译：

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放射性碘全身扫描治疗分化型甲状腺癌的陷阱

摘要

目的

I-131 诊断或治疗后进行的全身扫描 (WBS) 对于分化型甲状腺癌患者非常有用。然而，在各种情况下，它可能会出现误报。我们的目的是从临床角度报告一系列陷阱。

方法

2023 年 1 月，使用以下术语在 PubMed 数据库中进行了检索：“假放射性碘摄取”和“假阳性碘 131 扫描”。在筛选的 346 项研究中，本次综述纳入了 230 项，总计 370 例病例集。排除生理吸收。对于每位患者，评估性别、年龄、I-131施用剂量、摄取区域和具体器官以及错误摄取的原因。

结果

报告放射性碘假摄取370例，其中19.1%发生在头颈部，34.2%发生在胸部，14.8%发生在腹部，20.8%发生在骨盆，11.1%发生在软组织和骨骼系统。假性放射性碘摄取的来源为非肿瘤性疾病205/370例（55.1%），良性肿瘤108/370例（29.5%），恶性肿瘤25/370例（6.7%），以及其他原因32/370 例 (8.7%)。

结论

WBS 可用于分化型甲状腺癌患者的随访，但在各种情况下可能会出现假阳性。因此，将闪烁扫描结果与患者病史、血清甲状腺球蛋白水平、其他影像学研究以及细胞学和/或组织学结果关联起来至关重要。