Reoperative surgery in the neck for recurrent differentiated thyroid cancer (DTC) is associated with increased morbidity compared with primary surgery. Radioguided occult lesion localization was recently proposed in patients with DTC recurrences. Here we report on the combination of radioguided occult lesion localization procedure to preoperative SPECT/CT in 2 patients with DTC recurrences. This combination was proved to be simple and technically feasible. Addition of SPECT/CT to conventional preoperative planar scans provided an accurate 3-dimensional road map for neck exploration.