Location of functioning metastases from differentiated thyroid carcinoma by simultaneous double isotope acquisition of I-131 whole body scan and bone scan

J Endocrinol Invest. 2004 Oct;27(9):866-9. doi: 10.1007/BF03346282.

Abstract

In a young patient with differentiated thyroid carcinoma (DTC), previously submitted to total thyroidectomy and I-131 therapy for ablation of thyroid remnant, a follow-up 1-131 diagnostic whole body scan (WBS) demonstrated four small abnormal I-131 uptake areas. Two of these were projected over the thoracic region and corresponded to lung nodules, as later demonstrated by lung computerized tomography (CT)-scan. The remaining two areas were found in the lumbar-pelvic region, but their precise location could not be determined. Standard bone Rx examination and bone scan were negative. After I-131 therapy, we simultaneously acquired a I-131 WBS and a Tc-99m oxidronate bone scan by setting a dual window on the gamma camera. Comparing the I-131 and bone images we were able to identify the 4th lumbar vertebra and right ilium as the bone segments to be studied by a radiological approach. Eventually, the thin slice CT-scan demonstrated the presence of two small osteolytic lesions in these areas. In conclusion, the simultaneous acquisition of images both from I-131 and a bone-seeking agent may be useful to locate functioning bone metastases from DTC.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carcinoma, Papillary / diagnosis*
  • Carcinoma, Papillary / secondary*
  • Humans
  • Iodine Radioisotopes
  • Male
  • Radionuclide Imaging*
  • Radiopharmaceuticals
  • Spinal Neoplasms / diagnosis*
  • Spinal Neoplasms / secondary*
  • Technetium Tc 99m Medronate / analogs & derivatives*
  • Thyroid Neoplasms / pathology*
  • Tomography, X-Ray Computed*

Substances

  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • technetium Tc 99m hydroxymethylene diphosphonate
  • Technetium Tc 99m Medronate