JRSM > Volume 101, Number 6 > Pp. 319-320

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Grand round

Asymmetric breast uptake of radioiodine in a patient with thyroid malignancy: metastases or not?

A Sinha Specialist Registrar  ¹ K M Bradley Consultant Radiologist  ² J Steatham Superintendent Radiographer  ³   A Weaver Consultant Oncologist  ⁴

¹ Department of Radiology and Nuclear Medicine, John Radcliffe Hospital Headley Way, Oxford OX3 9DU, UK
² Department of Radiology and Nuclear Medicine, John Radcliffe Hospital Headley Way, Oxford OX3 9DU, UK
³ Churchill Hospital Old Road, Oxford OX3 7LJ, UK
⁴ Churchill Hospital Old Road, Oxford OX3 7LJ, UK

Correspondence to: Aabha Sinha sinhaaabha{at}hotmail.com

SUMMARY

Various physiological processes can cause potentially misleading appearances in radioiodine whole body scans; proper understanding of the causes of these can therefore obviate diagnostic errors. Whole-body radioiodine scintigraphy with I¹³¹ or I¹²³ is an accurate form of imaging used for management of differentiated thyroid carcinoma. Following thyroidectomy, any residual thyroid tissue or metastatic disease is ablated with high dose I¹³¹ and diagnostic images are acquired, demonstrating residual thyroid tissue and metastatic disease. However, atypical physiological uptake of I¹³¹ can simulate metastases.

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