Importance of performing SPECT/CT in thyroid Cancer patients with central neck uptake in whole body Iodine scan: A...

The planar whole body iodine scan (WBIS) has traditionally been used as the primary imaging technique for assessment of patients with thyroid cancer. This case report examines the imaging findings of a 61-year-old male with follicular thyroid carcinoma who underwent total thyroidectomy and received adjuvant radioactive iodine (RAI) treatment. A planar post-ablation WBIS revealed the commonly seen pattern of multiple foci of iodine uptake in the central neck region suggesting postsurgical thyroid remnant, thyroglossal duct remnant and central lymph node metastasis. However, single photon emission computed tomography (SPECT) / computed tomography (CT) imaging excluded lymph node metastasis and revealed iodine contamination over the mentum superimposed on the thyroid bed. This case report highlights the importance of utilizing SPECT /CT even for patients with apparently central neck uptake to prevent incorrect staging and treatment planning. In this report, we also present a review of the literature highlighting various pitfalls that can affect the interpretation of the WBIS and potentially result in false-positive findings in the neck region.