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Original Article
Pak J Nucl Med. 2021; 11(1): 0-0

Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women

Authors: Andrew C. Sher, Nadia F. Mahmood, Robert C Orth, Shireen E Hayatghaibi, Marla B.K. Sammer, Victor J Seghers.

View PDF HTML FullText DOI: 10.24911/PJNMed.175-1598982543

Abstract

Background: Pediatric thyroid cancer is the second most common cancer among girls ages 15-19, with lymph node involvement and pulmonary metastasis more common than in adults. In interpreting Whole Body I-123 scintigraphy, differentiation between physiologic breast uptake and rib or lung metastasis can be challenging. While radioiodine uptake in lactating breasts has been recognized for over 65 years, breast uptake in nulliparous girls and young women has not previously been documented. Methods: Female nulliparous patients < 21 years old with primary thyroid cancer requiring whole-body I-123 scintigraphy with anterior and lateral planar images from 9/25/2014 through 3/22/2017 were eligible for inclusion. Four physicians with training in nuclear radiology evaluated the anterior and lateral spot views for the presence of breast activity on a 5-point Likert scale. Fleiss’ Kappa and Monte Carlo simulations were used to calculate mean Likert values, reader agreement, and 95% CIs. Results: For this study, 27 patients met inclusion criteria (mean age=15.9+/-2.3 years). Breast activity was present in 20/27 (74%) of patients. Mean Likert scores and agreement were: present on frontal images= 3.9 +/- 1.2, κ=0.74 (0.61–0.83); limited to the lower thorax on frontal images= 4.0 +/- 1.2, κ=0.77 (0.63 – 0.88); present on lateral images= 4.2 +/- 1.2, κ=0.85 (0.71 – 0.93); and present given all projections= 4.2 +/- 1.3, κ=0.85 (0.71 – 0.94). Conclusion: Breast activity on whole body I-123 scintigraphy is present in the majority of nulliparous young women. However, any suspicious uptake in the chest must be further characterized using lateral views of chest to differentiate between physiological breast uptake or pathological uptake in ribs or lungs. We recommend routine lateral images of pediatric patients undergoing radioactive iodine scintigraphy for evaluation of thyroid cancer.

Keywords:   Breast, Lung, Metastases, Radioiodine Uptake, I-123 Scintigraphy, Thyroid Cancer, Pediatric


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Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women


Authors
Andrew C Sher
Singleton Department of Pediatric Radiology Texas Childrens Hospital 6107 Fannin Street, Suite 470 Houston, TX, 77030, USA
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Nadia F Mahmood
Singleton Department of Pediatric Radiology Texas Childrens Hospital 6107 Fannin Street, Suite 470 Houston, TX, 77030, USA
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Robert C Orth
Department of Radiology Childrens Hospital of Wisconsin 8915 W. Connell Ct. Milwaukee, WI 53226
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Shireen E Hayatghaibi
Singleton Department of Pediatric Radiology Texas Children’s Hospital 6107 Fannin Street, Suite 470 Houston, TX, 77030, USA
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Marla B K Sammer
Singleton Department of Pediatric Radiology Texas Childrens Hospital 6107 Fannin Street, Suite 470 Houston, TX, 77030, USA
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Victor J Seghers
Singleton Department of Pediatric Radiology Texas Childrens Hospital 6107 Fannin Street, Suite 470 Houston, TX, 77030, USA
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Correspondence to:
. Victor J Seghers, Singleton Department of Pediatric Radiology Texas Children’s Hospital 6107 Fannin Street, Suite 470 Houston, TX, 77030, USA; vjsegher@texaschildrens.org

Publication history
Received 01 Sep 2020
Revised 02 Oct 2020
Accepted 05 Oct 2020
Published online 22 Jan 2021
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How to cite this article

Pubmed Style

Sher AC, Mahmood NF, Orth RC, Hayatghaibi SE, Sammer MB, Seghers VJ. Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women. doi:10.24911/PJNMed.175-1598982543


Web Style

Sher AC, Mahmood NF, Orth RC, Hayatghaibi SE, Sammer MB, Seghers VJ. Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women. http://www.pjnmed.com/?mno=130751 [Access: August 02, 2021]. doi:10.24911/PJNMed.175-1598982543


AMA (American Medical Association) Style

Sher AC, Mahmood NF, Orth RC, Hayatghaibi SE, Sammer MB, Seghers VJ. Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women. doi:10.24911/PJNMed.175-1598982543


Vancouver/ICMJE Style

Sher AC, Mahmood NF, Orth RC, Hayatghaibi SE, Sammer MB, Seghers VJ. Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women. doi:10.24911/PJNMed.175-1598982543


Harvard Style

Sher, A. C., Mahmood, . N. F., Orth, . R. C., Hayatghaibi, . S. E., Sammer, . M. B. & Seghers, . V. J. (2021) Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women. doi:10.24911/PJNMed.175-1598982543


Turabian Style

Sher, Andrew C., Nadia F. Mahmood, Robert C Orth, Shireen E Hayatghaibi, Marla B.K. Sammer, and Victor J Seghers. 2021. Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women. doi:10.24911/PJNMed.175-1598982543


Chicago Style

Sher, Andrew C., Nadia F. Mahmood, Robert C Orth, Shireen E Hayatghaibi, Marla B.K. Sammer, and Victor J Seghers. "Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women." doi:10.24911/PJNMed.175-1598982543


MLA (The Modern Language Association) Style

Sher, Andrew C., Nadia F. Mahmood, Robert C Orth, Shireen E Hayatghaibi, Marla B.K. Sammer, and Victor J Seghers. "Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women." doi:10.24911/PJNMed.175-1598982543


APA (American Psychological Association) Style

Sher, A. C., Mahmood, . N. F., Orth, . R. C., Hayatghaibi, . S. E., Sammer, . M. B. & Seghers, . V. J. (2021) Radioactive Iodine uptake in the breast tissue of Nulliparous adolescent girls and young women. doi:10.24911/PJNMed.175-1598982543


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