Fig. 23.1
(a–b) A 12-year-old boy affected by papillary thyroid carcinoma (pT3 pN0 pMx). After total thyroidectomy, diagnostic 123I WBS shows radioiodine uptake in thyroid remnants (a). After RAI assessment, any focus of radioiodine uptake is evident in thyroid bed, as for complete metabolic RAI response (b)
23.1.3.2 Case 23.2 Diagnostic 123I WBS in DTC Staging: Remnant and Lymph Node Involvement (Fig. 23.2)
Fig. 23.2
A 15-year-old boy with diagnosis of papillary thyroid carcinoma underwent total thyroidectomy (pT2 pN+ pMx). After total thyroidectomy, diagnostic 123I WBS shows radioiodine uptake in thyroid bed with evidence of neck lymph node uptake
23.1.3.3 Case 23.3 Diagnostic 123I WBS in DTC Restaging: Relapse of Disease in Lymph Nodes and Lungs (Focal Pattern) (Fig. 23.3)
Fig. 23.3
A 16-year-old girl affected by papillary thyroid carcinoma underwent total thyroidectomy (pT3 pN+ pMx) at the age of 14 years, followed by RAI therapy with complete metabolic response. Follow-up was negative up to 2 years later when thyroglobulin level increased, and restaging by 123I WBS was performed showing radioiodine uptake in neck lymph node (on right side) and in both lungs (focal pattern)
23.1.3.4 Case 23.4 Diagnostic 123I WBS IN DTC Staging: Lymph Nodes and Lungs (Diffuse Pattern) (Fig. 23.4)
Fig. 23.4
A 7-year-old boy with diagnosis of papillary thyroid carcinoma underwent total thyroidectomy (pT4 pN+ pMx). After total thyroidectomy, diagnostic 123I WBS shows radioiodine uptake in the neck (two areas of focal uptake in upper jugular and upper cervical region, as for remnant and thyroglossal duct, respectively) with evidence of mild and diffuse radioiodine uptake (miliary pulmonary involvement is a frequent pattern in young patients affected by DTC)
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