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Figure 1. A post-surgical patient with papillary carcinoma and no nodes detected at surgery. Post-therapy imaging (anterior projection) reveals an unexpected chain of nodal involvement in the right neck. This scan was obtained 5 days after treatment with 3.7 GBq of iodine-131. The dark spot is in the thyroid bed (arrow) and the linear array represents the right anterior cervical chain of nodes (arrowheads). A follow-up scan subsequently confirmed that all the activity in the nodes had been obliterated.

Figure 1. A post-surgical patient with papillary carcinoma and no nodes detected at surgery. Post-therapy imaging (anterior projection) reveals an unexpected chain of nodal involvement in the right neck. This scan was obtained 5 days after treatment with 3.7 GBq of iodine-131. The dark spot is in the thyroid bed (arrow) and the linear array represents the right anterior cervical chain of nodes (arrowheads). A follow-up scan subsequently confirmed that all the activity in the nodes had been obliterated.

confronted by a life-threatening lesion, external beam radiation therapy may be required in order to obtain early benefit. However, iodine avidity is often seen, even after high dose radiation.

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