title: Radioiodine sinus uptake related to mucosal thickening or aspergilloma: a case series of an unrecognized event well evidenced by SPECT/CT.
abstract: BACKGROUND
  False-positive radioiodine (RAI) uptake related to chronic sinusitis and mucocele has only rarely been reported in patients with differentiated thyroid cancer (DTC) even with the recent use of single photon emission tomography with computed tomography (SPECT/CT) acquisition. No other etiology of sinus RAI uptake has been mentioned to date.
  
  
  OBJECTIVE
  We report five cases of DTC patients with sinus RAI uptake on post-RAI scintigraphy. SPECT/CT clearly localized RAI uptake either in the sphenoid, the maxillary or the frontal sinus and highly suspected mucosal thickening in four patients and sinus aspergilloma in one patient.
  
  
  CONCLUSIONS
  These data confirm the possibility of false-positive sinus RAI uptake, provide a new cause of such benign uptake, i.e. sinus aspergilloma, and demonstrate the clinical relevance of head and neck SPECT/CT acquisition in the diagnosis of such uptake. Nuclear medicine physicians should be aware of this pitfall when interpreting post-RAI scintigraphy.
authors.affiliation: Department of Nuclear Medicine and Thyroid Unit, François Baclesse Cancer Centre, 3 Avenue Général Harris - BP 5026, F-14076, CAEN Cedex 05, France. r.ciappuccini@baclesse.unicancer.fr.|INSERM U1086 "Cancers et Préventions", François Baclesse Cancer Centre, Caen, France. r.ciappuccini@baclesse.unicancer.fr.
authors.forename: Renaud
authors.initials: R
authors.lastname: Ciappuccini
authors.affiliation: Department of Head and Neck Surgery, François Baclesse Cancer Centre, Caen, France.
authors.forename: David
authors.initials: D
authors.lastname: Blanchard
authors.affiliation: Department of Head and Neck Surgery, François Baclesse Cancer Centre, Caen, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Rame
authors.affiliation: Department of Head and Neck Surgery, François Baclesse Cancer Centre, Caen, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: de Raucourt
authors.affiliation: INSERM U1086 "Cancers et Préventions", François Baclesse Cancer Centre, Caen, France.|Department of Head and Neck Surgery, University Hospital, Caen, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Babin
authors.affiliation: Department of Nuclear Medicine and Thyroid Unit, François Baclesse Cancer Centre, 3 Avenue Général Harris - BP 5026, F-14076, CAEN Cedex 05, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bardet
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001228:Aspergillosis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D019275:Radiopharmaceuticals; D020545:Respiratory Mucosa / Q000000981:diagnostic imaging / Q000473:pathology; D000072098:Single Photon Emission Computed Tomography Computed Tomography; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals
keywords: Aspergilloma; Case report; Differentiated thyroid cancer; Radioiodine; SPECT/CT; Sinus