High incidence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodexyglucose positron emission tomography in relatively young healthy subjects: results of 3-year follow-up

Ohba, Kenji; Nishizawa, Sadahiko; Matsushita, Akio; Inubushi, Masayuki; Nagayama, Koji; Iwaki, Hiroyuki; Matsunaga, Hideyuki; Suzuki, Shingo; Sasaki, Shigekazu; Osuga, Yutaka; Okada, Hiroyuki; Nakamura, Hirotoshi

doi:10.1507/endocrj.k10e-008

Cited by 50 publications

(52 citation statements)

References 15 publications

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“…The significance of incidental focal thyroid uptake on 18 F-FDG PET study was first described in 2001 [10]. Many research studies are currently available on this topic, with different results on focal uptake of tracer on 18 F-FDG PET [3,4,5,6,8,9,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38]; however, a large UK series has yet to be reported. We report one of the largest studies on the evaluation of incidental focal 18 F-FDG uptake in the thyroid.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Significance of Incidental Focal Thyroid Uptake on <sup>18</sup>F-FDG PET Study in a Large Patient Cohort: Retrospective Single-Centre Experience in the United Kingdom

Agrawal¹,

Weaver²,

Ul-Hassan³

et al. 2015

Eur Thyroid J

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Objective: To assess the prevalence and pathological nature of incidental focal thyroid uptake on ¹⁸F-FDG (2-[¹⁸F]-fluoro-2-deoxy-D-glucose) PET (positron emission tomography) and examine the role of the maximum standardised uptake value (SUV_max) to differentiate benign from malignant thyroid pathology. Material and Methods:¹⁸F-FDG PET reports were retrospectively reviewed. Incidental focal tracer uptake in the thyroid was noted in 147 patients (0.5%). Patients with known primary thyroid malignancy were excluded. The final diagnosis was made following ultrasonography of the neck, fine-needle aspiration cytology (FNAC) or histopathology of the surgically resected specimen where surgery was indicated. A Mann-Whitney U test was used to compare the SUV_max of benign and malignant thyroid pathology. Receiver operating characteristic (ROC) analysis was performed to identify an SUV_max cutoff in differentiating benign from malignant pathology. Results: A final diagnosis was achieved in 47/147 (32%) of the patients. The diagnoses included benign lesions in 36 patients and malignancy in 9 patients. In 2 patients, FNAC demonstrated indeterminate follicular lesions; however, surgical excision was not performed. There was a highly significant difference in the mean SUV_max of malignant focal thyroid uptake (15.7 ± 5.9) compared to that of benign lesions (7.1 ± 6.8) with a p value of 0.000123. An SUV_max of 9.1 achieved a sensitivity of 81.6%, specificity of 100% and area under the curve of 0.915 in the ROC analysis differentiating benign from malignant disease. Conclusion: The malignancy potential of incidental focal thyroid uptake remains high and warrants prompt and appropriate follow-up by the clinician. The SUV_max may aid in further characterisation of the lesion and its management.

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Section: Discussionmentioning

confidence: 99%

Incidence and Significance of Incidental Focal Thyroid Uptake on <sup>18</sup>F-FDG PET Study in a Large Patient Cohort: Retrospective Single-Centre Experience in the United Kingdom

Agrawal¹,

Weaver²,

Ul-Hassan³

et al. 2015

Eur Thyroid J

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“…La prevalencia de incidentaloma tiroideos objetivados por PET varía de 1,2-8,4%, con una incidencia de lesiones malignas del 14 al 30,9%, según diferentes estudios (3,(19)(20)(21). La prevalencia de lesiones incidentales tiroideas en pacientes con cáncer parece ser similar a la objetivada en pacientes sanos (3,21).…”

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Angiosarcoma primario de mama y carcinoma papilar de tiroides sincrónico: presentación de un caso

et al. 2013

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: El angiosarcoma primario de mama constituye un tumor infrecuente que se desarrolla de forma predominante en mujeres en la tercera y cuarta décadas de la vida. Los nódulos tiroideos incidentales son aquellos que se objetivan en pruebas de imagen realizadas por otra causa y se observan en menos de un 10% con la tomografía por emisión de positrones (PET). Objetivo: Presentar el caso excepcional de una paciente con angiosarcoma primario de mama y un carcinoma papilar de tiroides sincrónicos. Caso clínico: Mujer de 34 años con angiosarcoma primario en la mama derecha sometida a mastectomía simple. En el estudio de extensión se halló un incidentaloma tiroideo derecho compatible con carcinoma papilar que requirió tiroidectomía total y linfadenectomía del compartimento central cervical en un segundo tiempo. Comentario: Los angiosarcomas primarios suponen menos del 0,05% de todos los tumores primarios malignos de la mama. El diagnóstico definitivo de estos tumores viene definido por el estudio anatomopatológico, que establece tres grados: alto, bajo e intermedio, los cuales se relacionan de forma directa con la supervivencia. La prevalencia de los incidentalomas malignos tiroideos objetivados por PET varía del 14-30,9%, según diferentes estudios. La planificación del tratamiento quirúrgico de las neoplasias incidentales tiroideas en pacientes con otro tumor primario debe analizarse de forma individualizada, según la supervivencia esperada del tumor primario. PALABRAS CLAVE: Angiosarcoma primario mama, carcinoma papilar tiroides, nódulo incidental tiroideo SUMMARY Background:The primary angiosarcoma of breast is a rare tumor that develops predominantly in women in the third and fourth decades of life. Incidental thyroid nodules are observed in imaging tests performed for other reasons and it´s observed in less than 10% with the positron emission tomography (PET). Aims: To report the exceptional case of a patient with primary angiosarcoma of the breast and synchronous thyroid papillary carcinoma. Clinical case: Female patient 34 year old with primary angiosarcoma in the right breast, submitted to a simple mastectomy. In the extension study we found an incidental thyroid papillary carcinoma that required a total thyroidectomy and central cervical lymphadenectomy in a second time. Comments: The primary angiosarcoma are less than 0.05% of all primary malignant tumors of the breast. The definitive diagnosis is determined by the pathology, which defines three grades: high, low and intermediate, which relate directly to survival. Prevalence of malignant thyroid incidentalomas observed by PET varies from 14 to 30.9%, according different studies. Planning the surgical treatment of incidental thyroid malignancies in patients with other primary tumor should be analyzed individually, according the expected survival of the primary tumor.

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“…the clinical significance of FDG-avidity in benign thyroid nodules has not been well characterized. In a previous report [16], 6 patients with benign thyroid nodules were followed up with annual US and observed for a period of 3 years. One patient showed an increase in the nodule diameter, by more than 2-fold, during the follow-up period, whereas the other 5 patients exhibited negligible changes.…”

Section: )mentioning

confidence: 99%

“…F-FDG-PET has been described previously [16]. Focal uptake was visually categorized as positive by radiologists if the uptake was determined to be higher than that of the normal thyroid background.…”

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Factors associated with fluorine-18-fluorodeoxyglucose uptake in benign thyroid nodules

et al. 2013

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High incidence of thyroid cancer in focal thyroid incidentaloma detected by 18F-fluorodexyglucose positron emission tomography in relatively young healthy subjects: results of 3-year follow-up

Cited by 50 publications

References 15 publications

Incidence and Significance of Incidental Focal Thyroid Uptake on <sup>18</sup>F-FDG PET Study in a Large Patient Cohort: Retrospective Single-Centre Experience in the United Kingdom

Incidence and Significance of Incidental Focal Thyroid Uptake on <sup>18</sup>F-FDG PET Study in a Large Patient Cohort: Retrospective Single-Centre Experience in the United Kingdom

Angiosarcoma primario de mama y carcinoma papilar de tiroides sincrónico: presentación de un caso

Factors associated with fluorine-18-fluorodeoxyglucose uptake in benign thyroid nodules

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