Vol 14, No 2 (2011)
Research paper
Published online: 2012-01-04
Incidental 18F-FDG uptake in the thyroid in patients diagnosed with PET/CT for other malignancies
Nucl. Med. Rev 2011;14(2):68-72.
Abstract
BACKGROUND: The value of PET/CT imaging in diagnosis
of different cancers has been widely described. PET/CT may
contribute to visualization of additional findings that were not
the indication to the study and did not refer to initial diagnosis.
In a small number of PET/CT scans an incidentally found focal
18F-FDG uptake in the thyroid gland is found.
The goal of the study was to estimate the prevalence
and evaluate the clinical significance of incidental thyroid
18F-FDG uptake in a cohort of patients diagnosed for different
malignancies.
MATERIAL AND METHODS: 2478 PET/CT scans using 18F-FDG were performed in 1925 subjects for evaluation of different, non-thyroid malignancies. For PET/CT examination, a Discovery ST (General Electric) PET/CT scanner was used. Patients with focal 18F-FDG activity were further evaluated by means of fine needle aspiration biopsy (FNAB). If cytological examination disclosed malignancy or suspicion of malignancy, thyroidectomy was performed. Both cytological and histopathological results were then analyzed.
RESULTS: Focal increased 18F-FDG uptake was found in 71 patients (3.7%), and cytological or histopathological results were evaluable in 20 of them. In general, 8 cases of thyroid cancer were found, which accounts for 40% probability of malignancy. The predominant histopathological diagnosis was papillary thyroid carcinoma (5 out of 8 cases). Additionally, in one case (5%) thyroid metastasis of lung cancer was detected. Diffused 18F-FDG activity in both thyroid lobes was observed in 120 subjects (6.2%) — in most cases chronic thyroiditis was confirmed.
CONCLUSIONS: The probability of malignancy of focal thyroid incidentalomas in 18F-FDG PET/CT scans is rather high. Therefore, thorough evaluation of such lesions is highly recommended in each case. Most thyroid malignancies incidentally detected in PET/CT are papillary carcinomas.
Nuclear Med Rev 2011; 14, 2: 68–72
MATERIAL AND METHODS: 2478 PET/CT scans using 18F-FDG were performed in 1925 subjects for evaluation of different, non-thyroid malignancies. For PET/CT examination, a Discovery ST (General Electric) PET/CT scanner was used. Patients with focal 18F-FDG activity were further evaluated by means of fine needle aspiration biopsy (FNAB). If cytological examination disclosed malignancy or suspicion of malignancy, thyroidectomy was performed. Both cytological and histopathological results were then analyzed.
RESULTS: Focal increased 18F-FDG uptake was found in 71 patients (3.7%), and cytological or histopathological results were evaluable in 20 of them. In general, 8 cases of thyroid cancer were found, which accounts for 40% probability of malignancy. The predominant histopathological diagnosis was papillary thyroid carcinoma (5 out of 8 cases). Additionally, in one case (5%) thyroid metastasis of lung cancer was detected. Diffused 18F-FDG activity in both thyroid lobes was observed in 120 subjects (6.2%) — in most cases chronic thyroiditis was confirmed.
CONCLUSIONS: The probability of malignancy of focal thyroid incidentalomas in 18F-FDG PET/CT scans is rather high. Therefore, thorough evaluation of such lesions is highly recommended in each case. Most thyroid malignancies incidentally detected in PET/CT are papillary carcinomas.
Nuclear Med Rev 2011; 14, 2: 68–72
Keywords: thyroid nodulePET18F-fluorine-deoxyglucosethyroid carcinoma
