Abnormal I-131 case study

Examination: Whole Body Iodine Scan

Clinical Information: 79 year old female with prior history of thyroid cancer

Following thyrogen stimulation performed according to standard protocol. 4.10 mCi I-131 was administered to the patient orally. At 48 hours after radiopharmaceutical administration, anterior and posterior whole body images were acquired along with with anterior and posterior images of the head, neck, thorax, abdomen, and pelvis.

The study demonstrates increased activity in the mediastinum and the two foci of increased activity in the right abdomen. Mediastinal activity appears abnormal and is most concerning for recurrent disease. Activity in the abdomen may be physiologic. For these regions, a chest, abdomen and pelvic CT is advised for fursther investigation.

The calculated uptake at the level of the thyroid bed is 0.4%. No focal site of abnormal increased activity is seen at this level on the acquired images.

IMPRESSION:

Abnormal whole body iodine scan with increased activity in the mediastinum that is most concerning for recurrent disease. Additional sites of uptake are noted in the right abdomen but this may be physiologic. CT scan of the chest, abdomen, and pelvis is advised for further investigation.

END IMPRESSION

Abnormal Parathyroid Scan

FINAL REPORT:

Examination: Nuclear Medicine parathyroid study

Clinical Indication: 79 year old female with hyperparathyroidism

Technique: After the intravenous administration of 24.2 mCi of Technetium 99m labeled sestamibi. Anterior planar imaging over the neck and upper chest was performed at 15 minutes and at three hous. SPECT imaging was also performed.

Findings: Physiologic distribution of radiotracer is seen. There is a focus of activity within the mid pole of the right thyroid consistent with parathyroid adenoma.

Impression:

Parathyroid adenoma at the mid pole of the right thyroid

END IMPRESSION