Diagnostic Value of FDG PET-CT Quantitative Parameters and Deauville-Like 5 Point-Scale in Predicting Malignancy of Focal Thyroid Incidentaloma

Thuillier, Philippe; Bourhis, David; Roudaut, Nathalie; Crouzeix, Geneviève; Alavi, Zarrin; Schick, Ulrike; Robin, Philippe; Kerlan, V.; Salaun, Pierre–Yves; Abgral, Ronan

doi:10.3389/fmed.2019.00024

Cited by 13 publications

(11 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We observed FDG SUVmax values to be significantly higher in patients with thyroid malignancies compared to patients with no thyroid malignancies, however, with an overlap in SUVmax values between benign and malignant lesions; this is in accordance with the literature where, e.g., Thuillier et al [ 22 ] reported higher SUVmax values in malignant lesions than in benign lesions, however, not significantly different. Highest SUVmax values were also found in malignant lesions in a study by Hagenimana [ 23 ], but again no SUVmax cut-off value to distinguish between benign and malignant lesions could be identified.…”

Section: Discussionsupporting

confidence: 92%

Long-Term Follow-Up of Thyroid Incidentalomas Visualized with 18F-Fluorodeoxyglucose Positron Emission Tomography—Impact of Thyroid Scintigraphy in the Diagnostic Work-Up

et al. 2021

View full text Add to dashboard Cite

Our objective was to evaluate the frequency of malignancy in incidental thyroidal uptake on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in a cohort of Danish patients, and furthermore to evaluate the impact of thyroid scinti-graphy in the diagnostic work-up. All whole-body PET/CT reports from 1 January 2010 to 31 December 2013 were retrospectively reviewed and further analyzed if visually increased thyroidal FDG uptake was reported. Patient electronic files were searched for further thyroid evaluation. Of 13,195 18F-FDG-PET/CT scans in 9114 patients, 312 PET/CT reports mentioned incidental thyroid FDG-uptake, and 279 patients were included in the study (3.1%). The thyroid was further investigated in 137 patients (49%), and 75 patients underwent thyroid scintigraphy. A total of 57 patients had a thyroid biopsy and 21 proceeded to surgery. Surgical specimens displayed malignancy in 10 cases, and one thyroid malignancy was found by autopsy. Hence, 11 patients were diagnosed with thyroid malignancies among 279 patients with incidental thyroid 18F-FDG uptake (3.9%). In 34 patients, a biopsy was avoided due to the results of the thyroid scintigraphy. We conclude that patients with thyroid incidentalomas can benefit from further diagnostic work-up including a thyroid scintigraphy.

show abstract

Section: Discussionsupporting

confidence: 92%

Long-Term Follow-Up of Thyroid Incidentalomas Visualized with 18F-Fluorodeoxyglucose Positron Emission Tomography—Impact of Thyroid Scintigraphy in the Diagnostic Work-Up

et al. 2021

View full text Add to dashboard Cite

show abstract

“…There are studies on TIs reporting that MTV, TLG, or both are useful parameters in distinguishing malignant lesions from benign ones[ 27 - 31 ], while other reported different conclusions[ 32 ]. The roles of MTV and TLG in other cancers are still open to debate[ 33 - 36 ].…”

Section: Discussionmentioning

confidence: 99%

Characterization of focal hypermetabolic thyroid incidentaloma: An analysis with F-18 fluorodeoxyglucose positron emission tomography/computed tomography parameters

Lee¹,

Chung²,

Lee³

et al. 2022

WJCC

View full text Add to dashboard Cite

BACKGROUND Incidentally found thyroid tumor (thyroid incidentaloma, TI) on F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is reported in 2.5%-5% of patients being investigated for non-thyroid purposes. Up to 50% of these cases have been diagnosed to be malignant by cytological/histological results. Ultrasonography (US) and fine-needle aspiration cytology are recommended for thyroid nodules with high FDG uptake (hypermetabolism) that are 1 cm or greater in size. It is important to accurately determine whether a suspicious hypermetabolic TI is malignant or benign. AIM To distinguish malignant hypermetabolic TIs from benign disease by analyzing F-18 FDG PET-CT parameters and to identify a cut-off value. METHODS Totally, 12761 images of patients who underwent F-18 FDG PET-CT for non-thyroid purposes at our hospital between January 2016 and December 2020 were retrospectively reviewed, and 339 patients [185 men (mean age: 68 ± 11.2) and 154 women (mean age: 63 ± 15.0)] were found to have abnormal, either focal or diffuse, thyroid FDG uptake. After a thorough review of their medical records, US, and cytological/histological reports, 46 eligible patients with focal hypermetabolic TI were included in this study. The TIs were categorized as malignant and benign according to the cytological/histological reports, and four PET parameters [standardized uptake value (SUV) max , SUV peak , SUV mean , and metabolic tumor volume (MTV)] were measured on FDG PET-CT. Total lesion glycolysis (TLG) was calculated by multiplying the SUV mean by MTV. Both parametric and non-parametric methods were used to compare the five parameters between malignant and benign lesions. Receiver operating characteristic (ROC) curve analysis was performed to identify a cut-off value. RESULTS Each of the 46 patients [12 men (26.1%; mean age: 62 ± 13.1 years) and 34 women (73.9%; mean age: 60 ± 12.0 years)] with focal hypermetabolic TIs had one focal hypermetabolic TI. Among them, 26 (56.5%) were malignant and 20 (43.5%) were benign. SUV max , SUV peak , SUV mean , and TLG were all higher in malignant lesions than benign ones, but the difference was statistically significant ( P = 0.012) only for SUV max . There was a positive linear correlation ( r = 0.339) between SUV max and the diagnosis of malignancy. ROC curve analysis for SUV max revealed an area under the curve of 0.702 ( P < 0.05, 95% confidence interval: 0.550-0.855) and SUV max cut-off of 8.5 with a sensitivity of 0.615 and a specificity of 0.789. CONCLUSION ...

show abstract

“…These results are promising since they confirmed most of our previous findings. Different approaches have been tested to identify [ 18 F]FDG-avid nodules at high risk of malignancy with some disappointing results, mostly lacking of any type of validation [10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

[18F]FDG-PET/CT Texture Analysis in “Hot” Thyroid Nodules: Results of the validation Cohort

Sollini

Kirienko

Magnoni

et al. 2019

BJSTR

View full text Add to dashboard Cite

Background: significance of thyroid nodule 2-deoxy-2-[18F]fluoro-D-glucose ([ 18 F] FDG) uptake on positron emission tomography/computed tomography (PET/CT) scans remains controversial. We aimed to validate our previous results on the ability of texture analysis to predict final diagnosis in [ 18 F]FDG-avid thyroid nodules. Methods:We retrospectively evaluated medical records of all patients who performed an [ 18 F]FDG-PET/CT from January 2017 to December 2018. Those patients who presented a thyroid nodule described in the medical records and performed a fine needle aspiration in our institution were considered for the analysis. Cytological and/ or histological results were used as reference standard to define the final diagnosis. In case of negative cytology, the nodule was considered benign. In case of non-diagnostic or inconclusive results ultrasound, follow-up and/or further cytology/histology was used as final diagnosis. LifeX software was used for image segmentation (threshold of 40% SUV max ) and for textural features extraction. The 7 features previously identified as possible diagnostic biomarkers were tested by logistic regression. Receiver operating characteristic (ROC) curves were plotted and for each curve, the area under the curve (AUC) was calculated. Statistical analysis was performed with STATA package. Results:We identified 498 medical reports describing [ 18 F]FDG uptake in a thyroid nodule. Fifty-two patients performed further diagnostic steps in our institution. Twelve patients/52, referred to ultrasonographers, did not perform cytology. Eight/52 patients were excluded from the analysis because a final diagnosis was not available. Accordingly, 32 patients were analyzed. Nineteen out of 32 patients had benign nodules while in 13/32 cases a malignancy (primary thyroid cancer = 12, metastases = 1) was diagnosed. Conventional PET parameters and histogram-based features were calculated for all patients, while second and higher-order features were available for only 15/32 patients. Skewness and kurtosis resulted significantly different in benign and malignant nodules (p = 0.03 and = 0.02, respectively) and showed the best AUC (=0.75).Conclusions: texture analysis may be useful to characterize [ 18 F]FDG-avid thyroid nodules and to refine the selection of patients to be referred for cytology.

show abstract

Diagnostic Value of FDG PET-CT Quantitative Parameters and Deauville-Like 5 Point-Scale in Predicting Malignancy of Focal Thyroid Incidentaloma

Cited by 13 publications

References 23 publications

Long-Term Follow-Up of Thyroid Incidentalomas Visualized with 18F-Fluorodeoxyglucose Positron Emission Tomography—Impact of Thyroid Scintigraphy in the Diagnostic Work-Up

Long-Term Follow-Up of Thyroid Incidentalomas Visualized with 18F-Fluorodeoxyglucose Positron Emission Tomography—Impact of Thyroid Scintigraphy in the Diagnostic Work-Up

Characterization of focal hypermetabolic thyroid incidentaloma: An analysis with F-18 fluorodeoxyglucose positron emission tomography/computed tomography parameters

[18F]FDG-PET/CT Texture Analysis in “Hot” Thyroid Nodules: Results of the validation Cohort

Contact Info

Product

Resources

About