Radioiodine whole body scan pitfalls in differentiated thyroid cancer.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Pub Date : 2024-08-01 Epub Date: 2024-03-18 DOI:10.1007/s12020-024-03754-y

Cristina Basso, Alessandra Colapinto, Valentina Vicennati, Alessandra Gambineri, Carla Pelusi, Guido Di Dalmazi, Elisa Lodi Rizzini, Elena Tabacchi, Arber Golemi, Letizia Calderoni, Stefano Fanti, Uberto Pagotto, Andrea Repaci

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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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分化型甲状腺癌的放射性碘全身扫描误区。

目的：对分化型甲状腺癌患者进行 I-131 诊断或治疗后进行的全身扫描（WBS）非常有用。然而，在各种情况下都可能出现假阳性。我们旨在从临床角度报告一系列误区：方法：利用以下术语在 PubMed 数据库中进行搜索：方法：2023 年 1 月，我们利用以下词条在 PubM 数据库中进行了搜索："放射性碘摄取假阳性 "和 "碘 131 扫描假阳性"。在筛选出的 346 项研究中，有 230 项被纳入本综述，共收集到 370 个病例。生理摄取被排除在外。对每位患者的性别、年龄、I-131 给药剂量、摄取区域和具体器官以及误摄取原因进行了评估：结果：共报告了 370 例假放射性碘摄取病例，其中头颈部占 19.1%，胸部占 34.2%，腹部占 14.8%，骨盆占 20.8%，软组织和骨骼系统占 11.1%。205/370例（55.1%）放射性碘假摄取的原因为非肿瘤性疾病，108/370例（29.5%）为良性肿瘤，25/370例（6.7%）为恶性肿瘤，32/370例（8.7%）为其他原因：结论：WBS对分化型甲状腺癌患者的随访非常有用，但在各种情况下都可能出现假阳性。因此，将闪烁成像结果与患者的病史、血清甲状腺球蛋白水平、其他影像学检查以及细胞学和/或组织学结果联系起来至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.