INTERESTING IMAGE Radioiodine Pooling in Dilated Greater Saphenous Vein Mimicking Contamination Erhan Varoglu, MD,* Mustafa Yildirim, MD,* Rezan Bayrakdar, MD,* A. Mecit Kantarci, MD,† and Hatice Uslu, MD* Abstract: A 58-year-old man was referred for I-131 whole-body scan on day 7 after I-131 ablation to evaluate follicular carcinoma metastases. I-131 whole-body scanning revealed increased uptake in the lower neck representing postoperative residual thyroid tissue. In addition, I-131 uptake in the liver was increased in excess of diffuse physiologic hepatic uptake. Increased superficial I-131 uptake in the left calf suggested contamination. Doppler ultrasonography revealed a dilated left greater saphenous vein in the same region. Dilatation and enlargement of the greater saphenous vein was also shown on radionuclide venography with Tc-99m-labeled red blood cells. I-131 pooling in dilated veins may mimic contamination or metastases. Key Words: I-131 whole-body scan, radionuclide venography, Doppler ultrasonography (Clin Nucl Med 2003;28: 866 – 868) REFERENCES 1. Rosenbaum RC, Johnston GS, Walente WA. Frequency of hepatic visualisation during I-131 imaging for metastatic thyroid carcinoma. Clin Nucl Med. 1988;13:657. 2. Mantoni M. Ultrasound of limb veins. Eur Radiol. 2001;11:1557. 3. Forbes K, Stevenson AJ. The use of power Doppler ultrasound in the diagnosis of isolated deep venous thrombosis of the calf. Clin Radiol. 1998;53:752. 4. Mohamadiyeh MK, Shaban AA, el-Desouki M, et al. Role of radionu- clide venography in the detection of proximal deep vein thrombosis: a prospective comparative study. Nucl Med Commun. 1993;14:1014. 5. Kempi V, van der Linden W. Diagnosis of deep vein thrombosis with in vivo 99mTc-labeled red blood cells. Eur J Nucl Med. 1981;6:5. 6. Lisbona R, Derbekyan V, Novales–Diaz JA, et al. Tc-99m red blood cell venography in deep venous thrombosis of the lower limb. An overview. Clin Nucl Med. 1985;10:208. 7. Caner B, Ozmen M, Dincer A, et al. Detection of deep vein thrombosis: combined flow and blood pool radionuclide venography vs contrast venography. Angiology. 1991;42:796. 8. Spieth ME, Kasner DL. Varicose veins demonstrated on sestamibi tumor imaging. Clin Nucl Med. 2002;27:737. 9. Roman MR, Angelides S, Gibson MG. Unusually prolonged pooling of Tc-99m MDP in varicose veins. Clin Nucl Med. 2001;26:1034. 10. Keadle DM, Light D, Bauman JM. Mesenteric varices mimicking right lower quadrant inflammation on hepatobiliary imaging. Clin Nucl Med. 2001;26:548. Received for publication October 24, 2002; Revision accepted March 21, 2003. From the Departments of *Nuclear Medicine and †Radiology, Ataturk University, Medical Faculty, Erzurum, Turkey. Reprints: Erhan Varoglu, MD, Ataturk University, Medical Faculty, Depart- ment of Nuclear Medicine, Erzurum, Turkey. E-mail: evaro35@ hotmail.com. Copyright © 2003 by Lippincott Williams & Wilkins 0363-9762/03/2810-0866 DOI: 10.1097/01.rlu.0000090938.27244.09 Clinical Nuclear Medicine • Volume 28, Number 10, October 2003 866