Vol 66, No 3 (2015)
Original paper
Published online: 2015-07-01

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How often do we see incidental 68Ga-DOTATATE thyroid uptake in PET/CT in patients with neuroendocrine tumours?

Jolanta Kunikowska, Renata Matyskiel, Anna Zemczak, Janusz Strzelczyk, Dariusz Pawlak, Leszek Królicki, Beata Kos-Kudła
DOI: 10.5603/EP.2015.0030
Pubmed: 26136132
Endokrynol Pol 2015;66(3):231-236.

Abstract

Introduction: Thyroid diseases, which may occur as focal or diffuse changes in thyroid parenchyma, are most often observed in women.

Aim: Our aim was to assess the prevalence of incidental thyroid uptake of 68Ga-DOTATATE PET/CT in patients referred to the Nuclear Medicine Department for evaluation of neuroendocrine neoplasia (NEN).

Material and methods: We retrospectively evaluated 1150 68Ga-DOTATATE PET/CT images. Clinical history, serum TSH and thyroid antibody (TAb) concentrations, ultrasonography, and cytological assessment of the material from fine-needle aspiration biopsy (FNA) of the thyroid lesion were investigated.

Results: We found incidental abnormalities in 46/1150 (4.1%) patients (12 men, 34 women). 34/46 patients (8 men, 26 women) showed diffuse 68Ga-DOTATATE thyroid uptake, with mean SUVmax 4.6 ± 1.6. Based on laboratory tests and ultrasound, we found: 38% of patients with an active autoimmune thyroiditis, 27% with benign goitre, and 6% with multinodular goitre with autoimmune thyroiditis. The remaining 29% of patients did not show any pathology. In 12/47 patients (4 men, 8 women) focal uptake in the thyroid with SUVmax 7.3 ± 3.3 was found. During one-year follow-up, category II and category III lesions (according to Bethesda classification) were revealed in 9/12 (75%) patients and in one patient, respectively. Histopathological examination after surgery revealed papillary thyroid carcinoma in one patient and benign multinodular goitre in another patient.

Conclusions: Patients with focal 68Ga-DOTATATE uptake should undergo further examination (FNA) due to potential risk of malignancy. Diffuse 68Ga-DOTATATE uptake was predominantly associated with active autoimmune thyroiditis or benign goitre. The focal lesions and diffuse pathology diseases were frequently seen in women. (Endokrynol Pol 2015; 66 (3): 231–236)