TY - JOUR
T1 - Thyroid incidentaloma identified by 18F-fluorodeoxyglucose positron emission tomography with CT (FDG-PET/CT)
T2 - Clinical and pathological relevance
AU - Pagano, L.
AU - Samà, M. T.
AU - Morani, F.
AU - Prodam, F.
AU - Rudoni, M.
AU - Boldorini, R.
AU - Valente, G.
AU - Marzullo, P.
AU - Baldelli, R.
AU - Appetecchia, M.
AU - Isidoro, C.
AU - Aimaretti, Gianluca
PY - 2011/10
Y1 - 2011/10
N2 - Objective The percentage of patients with thyroid cancer incidentally diagnosed during a 18F-fluorodeoxyglucose Positron Emission Tomography with computed tomography (CT) (FDG-PET/CT) for nonthyroid diseases ranges between 26% and 50%. Design Retrospective assessment of the clinical and pathological features of thyroid incidentalomas at FDG-PET/CT, aiming to identify potential predictors of malignancy. Patients Fifty-two patients with incidental thyroid uptake at FDG-PET/CT were retrospectively included [38 W, age 64 ·1 ± 12 ·5 years (mean ± SD)]. An arbitrary cut-off level of 5 ·0 for the 'maximum standardized uptake value' (SUV max) was chosen to differentiate benign from malignant tumours. Complete thyroid function, neck ultrasonography (US) features, and cyto-histological results were reported for all cases. Results In our institution, the prevalence of incidental thyroid 18F-fluorodeoxyglucose (18F-FDG) uptake was nearly 1 ·76%. The prevalence of focal uptake correlated with greater risk of malignancy (P < 0 ·01). In particular, the euthyroidism (P < 0 ·003) and a SUV max >5 ·0 (P < 0 ·0001) were associated with the diagnosis of thyroid cancer. Diffusely increased FDG-PET/CT uptake in the thyroid was related to benign conditions. Conclusions The presence of focal uptake with high SUV max and euthyroidism correlate with high likelihood of malignancy. Performing a neck US would have to be recommended in all patients with euthyroidism and an incidental FDG-PET/CT focal thyroid uptake. We do not suggest to use FDG-PET/CT as a screening tool for thyroid cancer in the general population, because of both its high cost and low incidence of thyroid incidentaloma at FDG-PET/CT.
AB - Objective The percentage of patients with thyroid cancer incidentally diagnosed during a 18F-fluorodeoxyglucose Positron Emission Tomography with computed tomography (CT) (FDG-PET/CT) for nonthyroid diseases ranges between 26% and 50%. Design Retrospective assessment of the clinical and pathological features of thyroid incidentalomas at FDG-PET/CT, aiming to identify potential predictors of malignancy. Patients Fifty-two patients with incidental thyroid uptake at FDG-PET/CT were retrospectively included [38 W, age 64 ·1 ± 12 ·5 years (mean ± SD)]. An arbitrary cut-off level of 5 ·0 for the 'maximum standardized uptake value' (SUV max) was chosen to differentiate benign from malignant tumours. Complete thyroid function, neck ultrasonography (US) features, and cyto-histological results were reported for all cases. Results In our institution, the prevalence of incidental thyroid 18F-fluorodeoxyglucose (18F-FDG) uptake was nearly 1 ·76%. The prevalence of focal uptake correlated with greater risk of malignancy (P < 0 ·01). In particular, the euthyroidism (P < 0 ·003) and a SUV max >5 ·0 (P < 0 ·0001) were associated with the diagnosis of thyroid cancer. Diffusely increased FDG-PET/CT uptake in the thyroid was related to benign conditions. Conclusions The presence of focal uptake with high SUV max and euthyroidism correlate with high likelihood of malignancy. Performing a neck US would have to be recommended in all patients with euthyroidism and an incidental FDG-PET/CT focal thyroid uptake. We do not suggest to use FDG-PET/CT as a screening tool for thyroid cancer in the general population, because of both its high cost and low incidence of thyroid incidentaloma at FDG-PET/CT.
UR - http://www.scopus.com/inward/record.url?scp=80052547885&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2265.2011.04107.x
DO - 10.1111/j.1365-2265.2011.04107.x
M3 - Article
SN - 0300-0664
VL - 75
SP - 528
EP - 534
JO - Clinical Endocrinology
JF - Clinical Endocrinology
IS - 4
ER -