Systematic review: prevalence of malignant incidental thyroid nodules identified on fluorine-18 fluorodeoxyglucose positron emission tomography

Shie, Philip; Cardarelli, Roberto; Sprawls, Kelly; Fulda, Kimberly; Taur, Alan

doi:10.1097/mnm.0b013e32832ee09d

Cited by 120 publications

(84 citation statements)

References 31 publications

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“…For the FDG uptake pattern, numerous studies found that the malignancy rate for the focal FDG uptake pattern was in the range of 14.0%-68.8% (Table 1). A recent systematic review of Ͼ55,000 patients reported a malignancy risk of 33.2% for focal FDG uptake lesions [19]. Kang et al [20] compared the malignancy rate between the focal and diffuse uptake patterns and found that the focal uptake group had a significantly higher rate than the diffuse uptake group (37.2% versus 4.7%).…”

Section: Significance Of Fdg-pet-detected Thyroid Incidentalomas and mentioning

confidence: 99%

The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in Thyroid Neoplasms

Lang

Law

2011

The Oncologist

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Section: Significance Of Fdg-pet-detected Thyroid Incidentalomas and mentioning

confidence: 99%

The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in Thyroid Neoplasms

Lang

Law

2011

The Oncologist

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“…The reason for this wide range might be variability of the population characteristics and background risk of thyroid disease related to geographic area (Bertagna et al 2013). The high risk of malignancy in incidentalomas warrants further evaluation when detected (Shie et al 2009), which might be explained in two ways. First, as increased FDG uptake indicates either accelerated production of GLUT or enhanced glycolysis related to malignancy, incidentalomas detected by PET might have a higher risk of malignancy (Van den Bruel et al 2002).…”

Section: Incidentalomas Detected By Fdg Petmentioning

confidence: 99%

The role of 18F-fluorodeoxyglucose positron emission tomography in differentiated thyroid cancer before surgery

Pak¹,

Kim²,

Kim³

et al. 2013

Endocrine-Related Cancer

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The incidence of thyroid cancer in both men and women is increasing faster than that of any other cancer. Although positron emission tomography (PET) using 18 F-fluorodeoxyglucose (FDG) has received much attention, the use of FDG PET for the management of thyroid cancer is limited primarily to postoperative follow-up. However, it might have a role in selected, more aggressive pathologies, and so patients at a high risk of distant metastasis may benefit from PET before surgery. As less FDG-avid thyroid cancers may lower the diagnostic accuracy of PET in preoperative assessment, an understanding of FDG avidity is important for the evaluation of thyroid cancer. FDG avidity has been shown to be associated with tumor size, lymph node metastasis, and glucose transporter expression and differentiation. As PET is commonly used in clinical practice, the detection of incidentalomas by PET is increasing. However, incidentalomas detected by PET have a high risk of malignancy. Clinicians handling cytologically indeterminate nodules face a dilemma regarding a procedure for a definitive diagnosis, usually lobectomy. With 'nondiagnostic (ND)' fine-needle biopsy (FNA), PET has shown a negative predictive value (NPV) of 100%, which indicates that negative uptake in a ND FNA procedure accurately excludes malignancy. With 'atypia of undetermined significance' or 'follicular neoplasm', the sensitivity and NPV of PET are 84 and 88%. PET does not provide additional information for the preoperative assessment of thyroid cancer. However, factors associated with FDG positivity are related to a poor prognosis; therefore, FDG PET scans before surgery may facilitate the prediction of the prognosis of differentiated thyroid cancer.

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“…The PET positive thyroid abnormalities that are associated with an increased risk of thyroid malignancy include focal lesions, unilateral involvement and a palpable nodule on clinical examination 2,3 . This patient displayed all of these features.…”

Section: Discussionmentioning

confidence: 63%

Positron emission tomography detected thyroid incidentaloma

Goddard

Gaunt

Markham

2013

annals

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We describe the case of a 48-year-old woman who presented with a thyroid lesion incidentally detected on positron emission tomography/computed tomography for a suspicious lung lesion. Subsequent clinical examination and investigations revealed a 3cm nodule in the left lower pole of the thyroid. Fine needle aspiration was indeterminate for malignancy. A left hemithyroidectomy was performed and histology confirmed a benign thyroid adenoma with an incidental micropapillary carcinoma. The literature regarding the best management for thyroid incidentalomas remains uncertain and, as such, each patient must be managed on an individual basis.

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Systematic review: prevalence of malignant incidental thyroid nodules identified on fluorine-18 fluorodeoxyglucose positron emission tomography

Abstract: The high prevalence of malignancy associated with focal hypermetabolic thyroid nodules found on F-FDG-PET warrants further evaluation when detected.

Cited by 120 publications

References 31 publications

The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in Thyroid Neoplasms

The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in Thyroid Neoplasms

The role of 18F-fluorodeoxyglucose positron emission tomography in differentiated thyroid cancer before surgery

Positron emission tomography detected thyroid incidentaloma

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