Prevalence and Risk of Malignancy of Thyroid Incidentalomas Detected by ¹⁸F-Fluorodeoxyglucose Positron-Emission Tomography

Fine‐needle aspiration in all thyroid incidentalomas at 18F‐FDG PET/CT: Can EU‐TIRADS revise the dogma?

“…However, the large majority of TIs harbours a benign lesion and the indication for performing FNAC in all these lesions is an ineffective diagnostic approach. Here, we found a cancer rate quite in line with that generally reported in TIs at 18 F‐FDG PET/CT, and this finding prompted us to retrospectively analyse US features as predictors of malignancy. Indeed, little can be said about the ability of neck US, and in particular, no data on the reliability of the EU‐TIRADS classification in stratifying the risk of malignancy in focal 18 F‐FDG PET/CT TIs have been published.…”

“…Indeed, due to the high frequency of thyroid disease in general population, thyroid incidentalomas (TI) have represented a frequent scenario and a relevant challenge in clinical practice . In this context, the increasing worldwide diffusion of 18 F‐FDG PET/CT led to a significantly increased detection of incidental thyroid 18 F‐FDG uptake . In particular, the overall prevalence of TI at 18 F‐FDG PET/CT is reported to be about 3% of all PET/CT scans, being 1.5% for diffuse uptake and 2% focal uptake .…”

“…In this context, the increasing worldwide diffusion of 18 F‐FDG PET/CT led to a significantly increased detection of incidental thyroid 18 F‐FDG uptake . In particular, the overall prevalence of TI at 18 F‐FDG PET/CT is reported to be about 3% of all PET/CT scans, being 1.5% for diffuse uptake and 2% focal uptake . However, while diffuse 18 F‐FDG TI does not represent a warning being generally associated with autoimmune thyroid disorders (ie Hashimoto's or Graves' disease) and rarely due to thyroidal lymphoma, focal 18 F‐FDG TI is of great concern as it may harbour a cancer with a rate of about one‐third of the cases .…”

“…[2][3][4] In particular, the overall prevalence of TI at 18 F-FDG PET/ CT is reported to be about 3% of all PET/CT scans, 3,4 being 1.5% for diffuse uptake and 2% focal uptake. [2][3][4] However, while diffuse 18 F-FDG TI does not represent a warning being generally associated with autoimmune thyroid disorders (ie Hashimoto's or Graves' disease) and rarely due to thyroidal lymphoma, 3,4 focal 18 F-FDG TI is of great concern as it may harbour a cancer with a rate of about one-third of the cases. 2,4 Following all the above issues, in the presence of focal TI at 18 F-FDG PET/CT, the main aim is to exclude malignancy.…”

“…[2][3][4] However, while diffuse 18 F-FDG TI does not represent a warning being generally associated with autoimmune thyroid disorders (ie Hashimoto's or Graves' disease) and rarely due to thyroidal lymphoma, 3,4 focal 18 F-FDG TI is of great concern as it may harbour a cancer with a rate of about one-third of the cases. 2,4 Following all the above issues, in the presence of focal TI at 18 F-FDG PET/CT, the main aim is to exclude malignancy. Regardless of the above frequency of focal TI at 18 F-FDG PET/CT and the not negligible cancer rate among that, there is no evidence on the optimal clinical and cost-effective management of these patients.…”