Role of 18F-fluorodeoxyglucose  Positron Emission Tomography/Computed Tomography  in the Evaluation of Cytologically Indeterminate Thyroid Nodules

Büyükdereli, Gulgün; Aktar, Yasemin; Kara, Ertan; Uğuz, Aysun; Sönmez, Hüsnü

doi:10.5812/iranjradiol.21186

Cited by 9 publications

(4 citation statements)

References 22 publications

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“…However, there is inconsistent information about the diagnostic role of SUV max values for determining malignancy. Some studies have shown no significant difference between the SUV max values of benign and malignant thyroid nodules (16)(17)(18), whereas numerous others have suggested its usefulness for identifying malignant lesions (14,19,20). The importance of SUV max and its definitive cut-off value for predicting malignancy have not yet been established among patients with 18F-FDG PET/CT-positive thyroid nodules.…”

Section: Discussionmentioning

confidence: 99%

Hounsfield unit value has null effect on thyroid nodules at 18F-FDG PET/CT scans

Haydardedeoğlu¹,

Bağır²,

Torun³

et al. 2018

Archives of Endocrinology and Metabolism

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Objectives: Detection rate of thyroid nodules is increasing with the use of new imaging modalities, especially in screening for malignancies. Positron emission tomography/computed tomography (PET/ CT)-positive thyroid nodules should be differentiated for malignancy to avoid unnecessary operations and further follow-up. Most trials evaluate the role of SUV max , but there is no definitive information about the utility of Hounsfield unit (HU) values for prediction of malignancy. This study aimed to evaluate the HU values beside SUV max for detecting malignancy risk of PET/CT-positive thyroid nodules. Subjects and methods: Results of 98 cancer patients who had fine needle aspiration biopsy (FNAB) for thyroid nodules detected on PET/CT between January 2011 and December 2015 were assessed. The FNABs and surgical pathological results were recorded. Results: FNABs revealed benign results in 32 patients (32.7%), malignant in 18 (18.4%), non-diagnostic in 20 (20.4%), and indeterminate in 28 (28.5%). Twenty-four patients underwent thyroidectomy. The mean HU values were not significantly different in benign and malignant nodules (p = 0.73). However, the mean SUV max was significantly higher (p < 0.001) in malignant ones. Area under curve (AUC) was 0.824 for SUV max ; the cutoff value was over 5.55 (p < 0.001), with 80% sensitivity, 84.5% specificity. Conclusions: Our current study demonstrated that HU value does not add any additional valuable information for discriminating between malignant and benign thyroid nodules. We also defined a SUV max cutoff value of 5.55 for malignant potential of thyroid nodules detected on PET/CT.

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Section: Discussionmentioning

confidence: 99%

Hounsfield unit value has null effect on thyroid nodules at 18F-FDG PET/CT scans

Haydardedeoğlu¹,

Bağır²,

Torun³

et al. 2018

Archives of Endocrinology and Metabolism

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“…There is increasing evidence noting the differentiation between Hürthle cell carcinoma and follicular adenomas on PET [ 84 , 85 ]. In a study enrolling 46 patients with indeterminate results on FNA, which surveyed the efficacy of PET/CT for detecting malignant lesions, the sensitivity, specificity, and positive predictive and negative predictive values were 94%, 62%, 59%, and 95%, respectively [ 86 ]. Pre-ablative 18 FDG-PET is helpful for the further assessment of malignant FDG-avid LNs in patients with PTMC or papillary thyroid carcinoma (PTC) [ 86 ].…”

Section: Indicationsmentioning

confidence: 99%

“…In a study enrolling 46 patients with indeterminate results on FNA, which surveyed the efficacy of PET/CT for detecting malignant lesions, the sensitivity, specificity, and positive predictive and negative predictive values were 94%, 62%, 59%, and 95%, respectively [ 86 ]. Pre-ablative 18 FDG-PET is helpful for the further assessment of malignant FDG-avid LNs in patients with PTMC or papillary thyroid carcinoma (PTC) [ 86 ]. For patients who have low-SUV follicular neoplasms (SUVmax <5) and are unsuitable or unwilling to undergo surgery, RFA could be a viable alternative [ 85 ].…”

Section: Indicationsmentioning

confidence: 99%

2022 Taiwan clinical multicenter expert consensus and recommendations for thyroid radiofrequency ablation

Wang¹,

Chen²,

Wang³

et al. 2023

Ultrasonography

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Radiofrequency ablation (RFA) is a minimally invasive management strategy which has been widely applied on thyroid benign and recurrent malignant lesions as an alternative to surgery in Taiwan. Experts from the academies associated with interventional radiology, endocrinology, and endocrine surgeons collaborated to develop the first consensus regarding thyroid RFA in Taiwan.The modified Delphi method was used to reach a consensus. By comprehensive review of recent and valuable literature and expert opinions, the recommendations included indications, pre-procedural evaluations, procedural techniques, post-procedural monitoring, efficacy, and safety, providing a comprehensive review of the application of RFA. The consensus effectively consolidates advice regarding thyroid RFA in clinical practice for local experts.

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“…Thus, the sensitivity of 18 FDG-PET in identifying malignant tumors > 1 cm is high (Kresnik et al 2003, Kim et al 2007, Sebastianes et al 2007, Traugott et al 2010, Muñoz Pérez et al 2013, Buyukdereli et al 2016, Pathak et al 2016, Piccardo et al 2016.…”

Section: F-fluorodeoxyglucose Positron Emission Tomographymentioning

confidence: 99%

Usefulness of accessible imaging methods in thyroid nodules with indeterminate cytology

Rosário

Rocha

Mourão

2021

Endocrine-Related Cancer

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In thyroid nodules (TN) submitted to fine-needle aspiration (FNA), Bethesda categories III and IV are considered “indeterminate” cytology. This result corresponds to 10-25% of all FNAs and the risk of malignancy (RoM) ranges from 10% to 30% for category III and from 15% to 40% for category IV. This review analyzed the practical applicability of accessible imaging method in the management of patients with cytologically indeterminate TN > 1 cm (ITN). When ITN are highly suspicious on ultrasonography (US), the RoM supports surgical indication even in the absence of additional tests. The same can be applied to ITN of intermediate suspicion but with elevated stiffness on elastography. Follow-up without additional tests is acceptable in the case of ITN with low-risk cytology and low-suspicion appearance on US and elastography (if obtained). In the case of ITN without highly suspicious US appearance, 123I scintigraphy may be obtained in patients with TSH < 1-1.5 mIU/L to rule out hyperfunctioning nodules before requesting diagnostic methods that are more expensive and less accessible. In addition, in ITN with not very suspicious US appearance, 18FDG-PET may be obtained. If this method does not reveal nodular uptake, the risk of the nodule corresponding to a macrocarcinoma is sufficiently low in order to allow follow-up. The positive predictive value of focal nodular uptake on 18FDG-PET depends on the pre-test RoM, cytological findings, and maximum SUV. There is currently no evidence for the use of computed tomography, magnetic resonance imaging or imaging using 99mTc-MIBI to define the nature of ITN.

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Role of 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Evaluation of Cytologically Indeterminate Thyroid Nodules

Cited by 9 publications

References 22 publications

Hounsfield unit value has null effect on thyroid nodules at 18F-FDG PET/CT scans

Hounsfield unit value has null effect on thyroid nodules at 18F-FDG PET/CT scans

2022 Taiwan clinical multicenter expert consensus and recommendations for thyroid radiofrequency ablation

Usefulness of accessible imaging methods in thyroid nodules with indeterminate cytology

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