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False-Positive Radioiodine Uptake From an Intracranial Surgical Clip
James P Walsh, Justin B Sims1, Pooya Iranpour2
1Department of Radiology and Imaging Sciences, Indiana University School of Medicine.
Clinical Nuclear Medicine
|January 13, 2022
Summary
A metallic surgical clip caused a false-positive radioiodine uptake in a papillary thyroid cancer patient. Awareness of this uncommon finding can prevent unnecessary diagnostic workups and treatments.
Area of Science:
- Nuclear medicine
- Oncology
- Surgical pathology
Background:
- Papillary thyroid cancer management often involves radioactive iodine (131I) therapy and post-treatment scans.
- Surgical clips are commonly used in neck dissections for hemostasis and identification.
Observation:
- A post-therapy 131I scan revealed unexpected radioiodine uptake in the left supraorbital region.
- This uptake was precisely localized to a metallic surgical clip previously placed during bilateral neck dissections.
Findings:
- The supraorbital radioiodine uptake represented a false-positive finding, not metastatic disease.
- The metallic surgical clip mimicked radioactive iodine accumulation on the scan.
Implications:
- Recognizing this artifact is crucial for accurate interpretation of post-therapy 131I scans in thyroid cancer patients.
- This knowledge can prevent misdiagnosis, unnecessary investigations, and potentially harmful treatments for patients.
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