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Comparison of 123I and 131I for Whole-Body Imaging in Thyroid Cancer

Salil D. Sarkar, MD1, Tomy P. Kalapparambath, MD1 and Christopher J. Palestro, MD1

1 Division of Nuclear Medicine, Department of Radiology, Long Island Jewish Medical Center, New Hyde Park, New York



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FIGURE 1. An 81-y-old man with papillary thyroid cancer presented with radiographic evidence of pulmonary metastases. Posterior whole-body images at 24 h with 123I (left) and 131I (middle) are unremarkable (thyroid bed uptake was noted with both tracers on anterior images, not shown). Stomach and bowel activities are noted in abdomen. Posterior 131I image at 96 h (right) shows uptake in pulmonary and left cervical metastases (arrows).

 


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FIGURE 2. (A) A 63-y-old man with Hürthle cell thyroid cancer had distant metastases and persistent disease despite 2 prior treatments with 131I. Anterior whole-body 123I image (left) is negative for metastases. Midline chest activity is in esophagus. Corresponding 131I image (right) shows diffuse pulmonary and right cervical nodal metastases (arrows). This patient received larger amount of 123I (185 MBq) than of 131I (148 MBq). (B) A 53-y-old woman with follicular thyroid cancer and distant metastases received 4 prior 131I treatments for persistent disease. Anterior whole-body 123I image (left) shows metastases in left hip, right femur, and left proximal humerus. These foci are better seen on 131I image (right), which additionally shows diffuse uptake in lungs and focal lesions in skull and right iliac bone (arrows). Midline chest activity is in esophagus.

 





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