Preoperative evaluation of thyroid nodules with 18FDG-PET/CT

Mitchell, Jamie; Grant, Frederick D.; Evenson, Amy; Parker, J. Anthony; Hasselgren, Per-Olof J.; Parangi, Sareh

doi:10.1016/j.surg.2005.08.031

Cited by 101 publications

(87 citation statements)

References 22 publications

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“…Twenty-one of 22 patients with indeterminate FNAs that were PET negative (SUV <5) had benign pathology, yielding a 95% negative predictive value. 44 A more recent study by de Geus-Oei yielded a similar result. 45 If FDG thyroid imaging could be done economically, perhaps by limiting images to the thyroid region, and these results were confirmed in other studies, a negative PET study on an indeterminate aspirate might be a useful tool, particularly in a person who is at high risk for surgery.…”

Section: The Indeterminate Aspirate: What Is New and What Is On The Hsupporting

confidence: 55%

Thyroid Nodules 2006: Managing what has been known for over 50 years

Garber

2006

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Section: The Indeterminate Aspirate: What Is New and What Is On The Hsupporting

confidence: 55%

Thyroid Nodules 2006: Managing what has been known for over 50 years

Garber

2006

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“…One group analyzed SUVmax in surgically resected thyroid tumors, where differentiation between benign and malignant is relatively accurate since tissue specimens could be used for final pathological diagnosis [10−14]. Mitchell and colleagues examined 48 various types of surgically resected thyroid nodules and reported that SUVmax could distinguish benign and malignant nodules [11]. In contrast, four studies which examined nodules with indeterminate FNAB cytology found no significant difference in SUVmax A B be completely excluded in six subjects diagnosed as having "benign" or indeterminate nodules by FNAB.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2010

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Abstract. As 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is becoming a common imaging modality, the number of thyroid incidentalomas identified by FDG-PET (PET incidentaloma) is increasing. The purpose of this study was to elucidate the risk of cancer in focal thyroid PET incidentaloma in healthy subjects of relatively younger age as well as the usefulness of repeated FDG-PET. The study was conducted with an observation period of three years. A total of 1,501 healthy volunteers (mean age, 43.5±9.7 years) underwent the first FDG-PET from August 2003 to July 2004. When focal thyroid PET incidentaloma was found, further diagnostic examination was conducted. When thyroid cancer was suspected, surgical resection was performed with the patient's agreement. Patients with PET incidentaloma without surgery were offered annual US and FDG-PET and finally FNAB was performed in the fourth year. Focal thyroid PET incidentaloma was observed in 20 subjects. The final diagnoses in 20 subjects were malignant in 11 (ten papillary thyroid carcinoma (PTC) and one thyroid carcinoma showing thymus-like differentiation), indeterminate in one, and benign in eight subjects. Seven patients not treated surgically at the first examination had annual FDG-PET. One patient with PTC showed increasing SUVmax, but another with a benign nodule exhibited a similar increase. Others (one with PTC, one with an indeterminate nodule, and three with benign nodules) exhibited negligible SUVmax changes. When closely examined, focal thyroid PET incidentaloma in relatively young healthy adults has a high probability of malignancy. Repeated FDG-PET to follow up patients with thyroid nodules is ineffective.

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“…However, mixed results were reported using these imaging modalities. For example, Mitchell et al (23) reported that 18FDG-PET with sensitivity of 60% and a specificity of 91% based on 48 malignant lesions and 33 benign lesions, which performed similarly with sonographic diagnosis (91.4-92.5% specificity) when the ratio of anteroposterior to transverse diameter ratio was >1. Basharat et al (24) has compared thyroid scan with FNAB and suggests fine needle aspiration cytology is more specific than sensitive whereas thyroid scan is more sensitive than specific in detecting thyroid malignancy.…”

Section: Discussionmentioning

confidence: 99%

Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis

et al. 2016

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Abstract. The aim of the present study was to compare the multidetector computed tomography (MDCT) features of benign and malignant nodules in patients with chronic lymphocytic thyroiditis (CLT). MDCT findings, including the size, solid percentage, calcification, margin, capsule, anteroposterior-transverse diameter ratio as well as the mode and the degree of enhancement of 137 thyroid nodules in 127 CLT cases were retrospectively analyzed. Furthermore, the correlation between MDCT findings and pathological results combined with the CT perfusion imaging was analyzed for the differences between benign and malignant nodules. A total of 77.5% (31/40) of malignant nodules were completely solid, and 33% (32/97) of benign nodules were predominantly cystic. Compared with the benign nodules, micro-calcification and internal calcification were more frequently observed in the malignant nodules (P<0.05). MDCT features such as ill-defined margin, absence of capsule or incomplete capsule or homogeneous enhancement were more likely to be present in the malignant nodules (P<0.05). Nevertheless, no significant difference was observed in the enhancement degree at arterial or venous phase between benign and malignant nodules (P>0.05). MDCT features are useful in differentiating the benign and malignant nodules in CLT patients, and it may be essential for a radiologist to review the MDCT characteristics of nodules in the clinical practice.

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Preoperative evaluation of thyroid nodules with 18FDG-PET/CT

Cited by 101 publications

References 22 publications

Thyroid Nodules 2006: Managing what has been known for over 50 years

Thyroid Nodules 2006: Managing what has been known for over 50 years

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

Multidetector computed tomography analysis of benign and malignant nodules in patients with chronic lymphocytic thyroiditis

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