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Nuclear Medicine Community

Nuclear Medicine Community

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  • Category: General
    Description: This community provides latest cases, discussions, news, publications and more valuable information for the Nuclear Medicine subspecialty. Join now - it's free!
    About Group
    Category: General Created: Saturday, 17 April 2010 Group Admin: Radiolopolis Team Description: This community provides latest cases, discussions, news, publications and more valuable information for the Nuclear Medicine subspecialty. Join now - it's free!
  • If anyone has cases that they can contribute for the Case Review Series in Nuclear Medicine I am interested in corresponding with you. We could use CNS cases, unusual general nuclear medicine cases, artifacts and QA example and PET/CT cases with more novel radio tracers, especially from those who are practicing in Europe. The FDA in the US is a little behind in approving newer PET radio tracers.
    3 years ago

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This community provides latest cases, discussions, news, publications and more valuable information for the Nuclear Medicine subspecialty. Join now - it's free!
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General
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Saturday, 17 April 2010
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Radiolopolis Team
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Random Cases

Papillary thyroid cancer metastasis versus liver hemangioma?
Papillary thyroid cancer metastasis versus liver hemangioma?
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Featured case

Papillary thyroid cancer metastasis versus liver hemangioma?
I have an interesting case I would like to share and ask for your opinion (I'll upload the images later on in the case gallery): A patient was treated with RAI 10 days ago (pathology: papillary thyroid carcinoma, s/p total thyroidectomy several months ago, on thyrogen stimulation therapy). On the initial I-123 uptake scan (left half, right image) on the day of treatment there was a tiny focus of uptake in the epigastric area (you can appreciate it adjacent to the lesser curvature), which was attributed to scatter artifact from neighboring stomach based on SPECT (right half, bottom image). 10 days later patient comes back for follow-up and I-131 scan shows now a dominating focus of iodine uptake on whole body planar scintigraphy in the epigastric area (left half, left image). SPECT-CT confirmed the focus within the tip of the lateral liver lobe (right half, top image - can't get hotter!). The thyroid bed has only little uptake. The non-con CT (attenuation correction CT for SPECT/CT) does no show any lesion. Question: Did you ever encounter such a situation? What is your opinion? Would a benign entity such as a hemangioma behave like this? There are less than a handfull reports out there reporting iodine avid hemangioma. Only one I saw reported a case in the liver. (Hell J Nucl Med. 2009 May-Aug;12(2):177-8.) Unfortunately the one in the liver does not even have an abstract or is accessible online at all! (Personal opinion: these articles then should not appear in PubMed!) The differential diagnosis would be in our case thyroid met but this is somewhat atypical. We would also like to include other diagnoses. We recommended MRI. Any comments?

Papillary thyroid cancer metastasis versus liver hemangioma?

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