The radioactive handkerchief sign. A contamination artifact in I-131 imaging for metastatic thyroid carcinoma

Clin Nucl Med. 1990 Jul;15(7):491-4. doi: 10.1097/00003072-199007000-00008.


False-positive findings suggestive of metastatic functioning thyroid carcinoma have been well documented in I-131 whole-body imaging. These artifacts are often associated with contamination from radioiodine-containing body secretions. Recently, a contaminated handkerchief on an iodine-131 whole-body scan was reported. In the following study, two additional cases involving the sequestration of I-131 contaminated handkerchiefs in patients' pockets are presented, and the literature regarding these false-positive findings is reviewed. Although rare, this "radioactive handkerchief sign" may cause serious misinterpretation of a focal radioiodine accumulation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • False Positive Reactions
  • Female
  • Humans
  • Iodine Radioisotopes* / pharmacokinetics
  • Male
  • Middle Aged
  • Nasal Mucosa / metabolism
  • Neoplasm Metastasis / diagnostic imaging*
  • Radionuclide Imaging
  • Thyroid Neoplasms / diagnostic imaging*


  • Iodine Radioisotopes