Limited diagnostic and predictive values of dual-time-point 18F FDG PET/CT for differentiation of incidentally detected thyroid nodules

Kim, Seong-Jang; Kim, Bo Hyun; Jeon, Yun Kyung; Kim, Sang Soo; Kim, In Joo

doi:10.1007/s12149-011-0468-0

Cited by 20 publications

(15 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most of the 22 patients with malignancies had primary thyroid carcinomas (20 papillary carcinotients with non-thyroid cancer was 8.4%, which was similar to the 9% reported in a previous study that investigated both focal and diffuse 18 F-FDG uptake lesions in thyroid gland (3). The incidence of thyroid incidentalomas (focal lesions) was 5.3% in our study, which was slightly higher than the 1.2−4.3% in other reports in both patients with malignancies and healthy subjects (8)(9)(10)(11). It seemed that this difference resulted from the population in the present study, which included only patients with nonthyroidal malignancies, and previous studies.…”

Section: Discussioncontrasting

confidence: 81%

Incidental Thyroid Lesions Detected on¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/CT in Patients with Non-Thyroidal Cancer: Clinical Implications and the Value of Ultrasound

Lee

Shin

Han

et al. 2014

J Korean Soc Radiol

View full text Add to dashboard Cite

Section: Discussioncontrasting

confidence: 81%

Incidental Thyroid Lesions Detected on¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/CT in Patients with Non-Thyroidal Cancer: Clinical Implications and the Value of Ultrasound

Lee

Shin

Han

et al. 2014

J Korean Soc Radiol

View full text Add to dashboard Cite

“…Various studies have considered different criteria for PET positivity; ranging from any focal increased uptake in the region of the thyroid nodule above background [11], [12], [17], [18] to different SUVmax cut-offs ranging from 2 to 7 [13], [15], [20], [21]. However, some studies did not find a SUVmax cut-off to be a definite predictor for malignancy [22]. Area under SUVmax curve >175.5 or the heterogeneity factor of FDG uptake >2.751 have also been considered to define FDG-PET positivity [16], [23].…”

Section: Discussionmentioning

confidence: 99%

A prospective cohort study to assess the role of FDG-PET in differentiating benign and malignant follicular neoplasms

Pathak

Goertzen

Nason

et al. 2016

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

BackgroundFollicular and Hürthle cell neoplasms are diagnostic challenges. This prospective study was designed to evaluate the efficacy of [18F]-2-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) in predicting the risk of malignancy in follicular/Hürthle cell neoplasms.Materials and methodsFifty thyroid nodules showing follicular/Hürthle cell neoplasm on prior ultrasonography guided fine needle aspiration cytology (FNAC) were recruited into this study. A FDG-PET/CT scan, performed for neck and superior mediastinum, was reported by a single observer, blinded to the surgical and pathology findings. Receiver operating characteristic (ROC) curve analysis of maximum standardized uptake value (SUVmax) and the area under the curve (AUROC) were used to assess discrimination between benign from malignant nodules. Youden index was used to identify the optimal cut-off SUVmax for diagnosing malignancy. Sensitivity, specificity, predictive values and overall accuracy were used as measures of performance.ResultsOur study group comprises of 31 benign and 19 malignant thyroid nodules. After excluding all Hürthle cell adenomas, the AUROC for discriminating benign and malignant non-Hürthle cell neoplasms was 0.79 (95% CI, 0.64–0.94; p = 0.001); with SUVmax of 3.25 as the best cut-off for the purpose. PET/CT had sensitivity of 79% (95% CI, 54–93%), specificity of 83% (95% CI, 60–94%), positive predictive value (PPV) of 79% (95% CI, 54–93%), and negative predictive value (NPV) of 83% (95% CI, 60–94%). The overall accuracy was 81%.ConclusionsFDG-PET/CT can help in differentiating benign and malignant non-Hürthle cell neoplasms. SUVmax of 3.25 was found to be the best for identifying malignant non-Hürthle cell follicular neoplasms.

show abstract

“…But there was no significant difference in SUVmax of the initial image (SUV1) between the two groups. Kim et al [34] previously reported that dual-time-point 18 F-FDG PET/CT was not a useful method for differentiating malignant and benign nodules through an analysis of a total of 50 patients. They found no statistical differences of dual-phase PET parameters (SUV1, SUV2, and RI) between benign and malignant thyroid lesions.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Role of Dual-Time-Point 18F-FDG PET/CT in Differential Diagnosis of the Thyroid Incidentaloma

Lee

Park

et al. 2013

Nucl Med Mol Imaging

View full text Add to dashboard Cite

Thyroid incidentalomas are common findings during imaging studies including 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for cancer evaluation. Although the overall incidence of incidental thyroid uptake detected on PET imaging is low, clinical attention should be warranted owing to the high incidence of harboring primary thyroid malignancy. We retrospectively reviewed 2,368 dual-time-point 18F-FDG PET/CT cases that were undertaken for cancer evaluation from November 2007 to February 2009, to determine the clinical impact of dual-time-point imaging in the differential diagnosis of thyroid incidentalomas. Focal thyroid uptake was identified in 64 PET cases and final diagnosis was clarified with cytology/histology in a total of 27 patients with 18F-FDG-avid incidental thyroid lesion. The maximum standardized uptake value (SUVmax) of the initial image (SUV1) and SUVmax of the delayed image (SUV2) were determined, and the retention index (RI) was calculated by dividing the difference between SUV2 and SUV1 by SUV1 (i.e., RI = [SUV2 - SUV1]/SUV1 × 100). These indices were compared between patient groups that were proven to have pathologically benign or malignant thyroid lesions. There was no statistically significant difference in SUV1 between benign and malignant lesions. SUV2 and RI of the malignant lesions were significantly higher than the benign lesions. The areas under the ROC curves showed that SUV2 and RI have the ability to discriminate between benign and malignant thyroid lesions. The predictability of dual-time-point PET parameters for thyroid malignancy was assessed by ROC curve analyses. When SUV2 of 3.9 was used as cut-off threshold, malignancy on the pathology could be predicted with a sensitivity of 87.5 % and specificity of 75 %. A thyroid lesion that shows RI greater than 12.5 % could be expected to be malignant (sensitivity 88.9 %, specificity 66.3 %). All malignant lesions showed an increase in SUVmax on the delayed images compared with the initial images. But in the group of benign lesions, 37.5 % (6/16) showed a decrease or no change in SUVmax. Dual-time-point 18F-FDG PET/CT, obtaining additional images 2 h after injection, seems to be a complementary method for the differentiation between malignancy and benignity of incidental thyroid lesions.

show abstract

Limited diagnostic and predictive values of dual-time-point 18F FDG PET/CT for differentiation of incidentally detected thyroid nodules

Abstract: The dual-time-point (18)F FDG PET/CT is not a useful method for differentiating malignant and benign nodules.

Cited by 20 publications

References 27 publications

Incidental Thyroid Lesions Detected on¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/CT in Patients with Non-Thyroidal Cancer: Clinical Implications and the Value of Ultrasound

Incidental Thyroid Lesions Detected on¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/CT in Patients with Non-Thyroidal Cancer: Clinical Implications and the Value of Ultrasound

A prospective cohort study to assess the role of FDG-PET in differentiating benign and malignant follicular neoplasms

The Clinical Role of Dual-Time-Point 18F-FDG PET/CT in Differential Diagnosis of the Thyroid Incidentaloma

Contact Info

Product

Resources

About

Limited diagnostic and predictive values of dual-time-point 18F FDG PET/CT for differentiation of incidentally detected thyroid nodules

Abstract: The dual-time-point (18)F FDG PET/CT is not a useful method for differentiating malignant and benign nodules.

Cited by 20 publications

References 27 publications

Incidental Thyroid Lesions Detected on18F-Fluorodeoxyglucose Positron Emission Tomography/CT in Patients with Non-Thyroidal Cancer: Clinical Implications and the Value of Ultrasound

Incidental Thyroid Lesions Detected on18F-Fluorodeoxyglucose Positron Emission Tomography/CT in Patients with Non-Thyroidal Cancer: Clinical Implications and the Value of Ultrasound

A prospective cohort study to assess the role of FDG-PET in differentiating benign and malignant follicular neoplasms

The Clinical Role of Dual-Time-Point 18F-FDG PET/CT in Differential Diagnosis of the Thyroid Incidentaloma

Contact Info

Product

Resources

About

Incidental Thyroid Lesions Detected on¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/CT in Patients with Non-Thyroidal Cancer: Clinical Implications and the Value of Ultrasound

Incidental Thyroid Lesions Detected on¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/CT in Patients with Non-Thyroidal Cancer: Clinical Implications and the Value of Ultrasound