The incidence of 18F-FDG PET/CT thyroid incidentalomas andthe prevalence of malignancy: a prospective study

Eren, Mine Şencan; Özdoğan, Özhan; Gedik, Arzu; Ceylan, Mehmet; Durak, Merih Güray; Seçil, Mustafa; Koçdor, Mehmet Ali; Çömlekçi, Abdurrahman; Durak, Hatice

doi:10.3906/sag-1503-26

Cited by 12 publications

(57 citation statements)

References 33 publications

(38 reference statements)

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“…In this regard, 18 FDG-PET/CT for detection of malignancies amongst thyroid focal uptake has a sensitivity of 100%, a specificity of 69%, a positive predictive value (PPV) of 62% and a negative predictive value (NPV) of 100% [1]. Other studies report values ranging from 60 to 80% for sensitivity and from 66.1 to 91.0% for specificity [2]. Iagaru et al , regarding a different patient population with confirmed thyroid carcinoma, stated that 18 FDG-PET/CT has a high sensitivity (88.6%) and specificity (89.3%) when used for follow up [3].…”

Section: Introductionmentioning

confidence: 99%

Thyroid incidentalomas on 18FDG-PET/CT: a metabolico-pathological correlation

Hagenimana

Dallaire

Vallée

et al. 2017

J of Otolaryngol - Head & Neck Surg

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BackgroundThyroid incidentaloma is defined as an unsuspected thyroid lesion found on imaging study or while performing a surgery non-related to the thyroid gland. Most recent scientific literature tends to demonstrate a detection rate of 0.1–4.3% for incidental findings of thyroid focal uptake identified by 18F-fluorodeoxyglugose Positron Emission Tomography with computed tomography (18FDG-PET/CT) initially prescribed for nonthyroid disease. From 10.3 to 80.0% of patients who underwent further evaluation are diagnosed with malignant lesions.Our first objective is to determine the risk of malignancy confined in thyroid incidentalomas(IT) detected on 18FDG-PET/CT in patients treated in a tertiary care center (Centre Hospitalier Universitaire de Sherbrooke). Second, we want to identify a cut-off value for SUVmax in order to distinguish benign from malignant IT. Third, we look for predictive criterion that can be outlined to help in their management.MethodsWe retrospectively reviewed 40 914 charts of patients who had a 18FDG-PET/CT done in a tertiary center from 2004 to 2014. For each patient where a thyroid incidentaloma has been identified, Maximum Standardized Uptake Value (SUVmax), ultrasound report, cytology and histopathological results as well as oncologic outcomes were compiled and analyzed.ResultsIn this study, the incidence for thyroid incidentaloma detected with 18FDG-PET/CT is 0.74%. The rate of malignancy present in IT is 8.2% based on histopathological results. Of the patients who underwent surgery, thyroid malignancy was identified in 54.3% of them. Cytoponction showed a strong correlation with final histopathological results (p = 0.009).ConclusionThyroid incidentalomas detected with 18FDG-PET/CT are relatively infrequent, but the potential risk of malignancy remains elevated. Fine needle aspiration biopsy is the investigation of choice to rule out a malignant incidentaloma when there is no other element in the clinical portrait to preclude such additional work up.

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Section: Introductionmentioning

confidence: 99%

Thyroid incidentalomas on 18FDG-PET/CT: a metabolico-pathological correlation

Hagenimana

Dallaire

Vallée

et al. 2017

J of Otolaryngol - Head & Neck Surg

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“…One of the first uses of nuclear medicine techniques occurred in the 1930s to demonstrate the physiology of radioiodine uptake by using the concentration of radioiodine in the thyroid, followed by the use of radioiodine for the treatment of hyperthyroidism and thyroid carcinoma in the 1940s. These investigations began a new era in the management of thyroid disease with nuclear imaging techniques and 131 I radioiodine therapy (1). Although management has evolved since the 1940s, the basic principles have remained, including the use of radiopharmaceuticals to identify and localize disease, radioiodine 123 I and 131 I to test for iodine avidity, and radioiodine 131 I for radioiodine therapy.…”

Section: Executive Summarymentioning

confidence: 99%

“…These investigations began a new era in the management of thyroid disease with nuclear imaging techniques and 131 I radioiodine therapy (1). Although management has evolved since the 1940s, the basic principles have remained, including the use of radiopharmaceuticals to identify and localize disease, radioiodine 123 I and 131 I to test for iodine avidity, and radioiodine 131 I for radioiodine therapy.…”

Section: Executive Summarymentioning

confidence: 99%

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Appropriate Use Criteria for Nuclear Medicine in the Evaluation and Treatment of Differentiated Thyroid Cancer

Donohoe

Aloff

Avram³

et al. 2020

J Nucl Med

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of Recommendations 99m Tc-pertechnetate imaging of a suspected thyroid remnant after total or near-total thyroidectomy may be appropriate if 123 I or 131 I are not available or otherwise contraindicated. Imaging of suspected residual or recurrent DTC after total or near-total thyroidectomy may be appropriate as well; however, 123 I or 131 I is preferred. Imaging of thyroid cancer before total or near-total thyroidectomy is rarely appropriate. Imaging with 99m Tc-pertechnetate in the pregnant or lactating patient is rarely appropriate.

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“…The risk of malignancy increases especially in case of a SUV max value greater than 5.5. Combining the grey-scale, Doppler window and recently elastographic properties in sonography, these nodules are managed successfully with follow-up, biopsy or surgery [6]. Mediastinal extension can be evaluated with MRI and CT better than US.…”

Section: Situations In Which Scintigraphy Is Advisedmentioning

confidence: 99%

Current Radiological Approach in Thyroid Nodules

Yıldırım¹,

Alış²,

Şirolu³

et al. 2017

JCT

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The aim of this paper is to review the radiological evaluation of thyroid nodules detected with ultrasonography (US), thoroughly and in harmony with the clinical-endocrinological-surgical management. In this review, we tried to summarize the radiological evaluation of nodules detected in the thyroid in compliance with recently published and accepted guidelines, including the most advanced sonographic protocols, emphasizing the indications of crosssectional imaging when needed. In this review important aspects were demonstrated with tables, illustrations and take-home points and technical aspects were emphasized with images and diagrams. We believe that this review, which is concluded with an extensive summary with the support of most recent sources, is an up-to-date and comprehensive evaluation of the broad spectrum of thyroid nodule radiology. We think that the management of any kind of nodule that can be encountered during the US examination can be done successfully by going through the paths described in the pictures, tables and texts in this article.

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The incidence of 18F-FDG PET/CT thyroid incidentalomas andthe prevalence of malignancy: a prospective study

Cited by 12 publications

References 33 publications

Thyroid incidentalomas on 18FDG-PET/CT: a metabolico-pathological correlation

Thyroid incidentalomas on 18FDG-PET/CT: a metabolico-pathological correlation

Appropriate Use Criteria for Nuclear Medicine in the Evaluation and Treatment of Differentiated Thyroid Cancer

Current Radiological Approach in Thyroid Nodules

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