Elevated Iodine Uptake at Autogenous Bone Graft Harvest Sites

Yang, Jigang MD, PhD*†; Codreanu, Ion MD, PhD; Servaes, Sabah MD; Zhuang, Hongming MD, PhD

Clinical Nuclear Medicine:
doi: 10.1097/RLU.0b013e31825b25a7
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Abstract: A 16-year-old adolescent girl post total thyroidectomy for papillary thyroid carcinoma presented for postsurgical radioablative therapy. A whole-body 123I scintigraphy revealed not only expected activity in the thyroid bed but also asymmetric tracer distribution in the mandible and 2 foci of increased 123I accumulation in the distal left lower extremity. SPECT/CT images localized the activity to the donor sites of an autologous left fibular bone graft, harvested 8 years earlier to repair her mandible. Our case demonstrates that iodine accumulation can occur at the site of bone surgery many years after intervention and should be differentiated from iodine-avid metastases.

Author Information

From the *Department of Nuclear Medicine, Beijing Friendship Hospital of Capital Medical University, Beijing, China; and †Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA.

Received for publication March 19, 2012; and revision accepted March 27, 2012.

Conflicts of interest and sources of funding: Dr Yang was partially supported by the Natural Science Foundation of China (No. 81101069) and the Beijing Natural Science Foundation (No. 7112035). The other authors have nothing to declare.

Reprints: Hongming Zhuang, MD, PhD, Department of Radiology, The Children’s Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104. E-mail: zhuang@email.chop.edu.

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1. Sioka C, Dimakopoulos N, Kouraklis G, et al.. False-positive whole-body scan after I-131 therapy in a patient with intestinal scar. Clin Nucl Med. 2006; 31: 232–233.
2. McDougall IR. Whole-body scintigraphy with radioiodine-131. A comprehensive list of false-positives with some examples. Clin Nucl Med. 1995; 20: 869–875.
3. Bakheet SM, Hammami MM. False-positive radioiodine whole-body scan in thyroid cancer patients due to unrelated pathology. Clin Nucl Med. 1994; 19: 325–329.
4. Matheja P, Lerch H, Schmid KW, et al.. Frontal sinus mucocele mimicking a metastasis of papillary thyroid carcinoma. J Nucl Med. 1997; 38: 1022–1024.
5. Wadhwa SS, Mansberg R. Benign oral disease as a cause of false-positive iodine-131 scans. Clin Nucl Med. 1998; 23: 747–749.
6. Jong I, Taubman K, Schlicht S. Bronchiectasis simulating pulmonary metastases on iodine-131 scintigraphy in well-differentiated thyroid carcinoma. Clin Nucl Med. 2005; 30: 688–689.
7. Shapiro B, Rufini V, Jarwan A, et al.. Artifacts, anatomical and physiological variants, and unrelated diseases that might cause false-positive whole-body 131-I scans in patients with thyroid cancer. Semin Nucl Med. 2000; 30: 115–132.
8. Caplan RH, Gundersen GA, Abellera RM, et al.. Uptake of iodine-131 by a Meckel’s diverticulum mimicking metastatic thyroid cancer. Clin Nucl Med. 1987; 12: 760–762.
9. Broekhuizen-de Gast H, van Isselt H, Roef M, et al.. Oncocytoma of the parotid gland causing false-positive result on I-131 whole-body scintigraphy. Clin Nucl Med. 2011; 36: 701–703.
10. Qiu ZL, Xu YH, Song HJ, et al.. Unusual 131I uptake in a benign mucinous cystadenoma of the ovary in a patient with papillary thyroid cancer. Clin Nucl Med. 2010; 35: 965–966.
11. Flug J, Lameka K, Lee R, et al.. False-positive I-131 uptake by an ovarian serous cystadenofibroma. Clin Nucl Med. 2012; 37: 178–180.
12. Li D, Meng Z, Zhang G, et al.. Visualization of thyroglossal duct cyst in differentiated thyroid cancer patient. Clin Nucl Med. 2010; 35: 499–504.
13. Omur O, Ozbek SS, Akgun A, et al.. False-positive I-131 accumulation in a hepatic hydatid cyst. Clin Nucl Med. 2007; 32: 930–932.
14. Bural GG, Peel RL, Mountz JM. Benign epithelial cyst mimicking thyroid cancer metastasis: a false-positive finding on post-therapy I-131 scan. Clin Nucl Med. 2012; 37: 88–90.
15. Mulazimoglu M, Koca S, Tamam MO, et al.. False-positive findings in post-treatment iodine-131 whole-body scintigraphy in a nasolacrimal sac cyst, confirmed with SPECT/CT and MRI. Clin Nucl Med. 2011; 36: 805–807.
16. Kayano D, Michigishi T, Ichiyanagi K, et al.. I-131 uptake in a thymic cyst. Clin Nucl Med. 2010; 35: 438–439.
17. Utamakul C, Sritara C, Kositwattanarerk A, et al.. I-131 uptake in bilateral ovarian endometrial cysts. Clin Nucl Med. 2009; 34: 537–538.
18. Schmidt M, Dietlein M, Schroder U, et al.. False-positive uptake of I-131 in a laryngocele mimicking thyroid remnant after thyroidectomy for papillary thyroid carcinoma. Clin Nucl Med. 2006; 31: 716–717.
19. Modoni S, Martino G, Guerra M, et al.. Unusual radioiodine uptake caused by metallic sutures in the skull in a patient with thyroid cancer. Clin Nucl Med. 2000; 25: 1053–1054.
20. Sathekge MM, Mokgoro NP, Mpikashe P, et al.. I-123 uptake by intrathoracic stomach. Clin Nucl Med. 2005; 30: 42.

thyroid carcinoma; false-positive; bone graft

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