Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-23T08:13:19.516Z Has data issue: false hasContentIssue false

Diagnosis of incidental thyroid nodules on 18F-fluorodeoxyglucose positron emission tomography imaging: are these significant?

Published online by Cambridge University Press:  15 December 2014

S D Sharma*
Affiliation:
Department of Otolaryngology, Southend Hospital, UK
T Jacques
Affiliation:
Department of Otolaryngology, Southend Hospital, UK
S Smith
Affiliation:
Department of Otolaryngology, Southend Hospital, UK
G Watters
Affiliation:
Department of Otolaryngology, Southend Hospital, UK
*
Address for correspondence: Mr Sunil D Sharma, Department of Otolaryngology, Southend Hospital, Prittlewell Chase, Southend-on-Sea SS0 0RY, UK Fax:, + 44 (0)1702 385856 E-mail: [email protected]

Abstract

Objective:

To determine the prevalence of thyroid malignancy in the first UK case series of patients with incidentally detected thyroid lesions on 18F-fluorodeoxyglucose positron emission tomography imaging.

Methods:

A total of 235 patients were evaluated with 18F-fluorodeoxyglucose positron emission tomography imaging. Incidental focal uptake in the thyroid gland was identified in nine patients (3.8 per cent). A retrospective review of their case notes was conducted.

Results:

The rate of malignancy was 55 per cent. The mean and standard deviation of the maximum standardised uptake value was 13.1 ± 7.3 in those patients with malignancy and a nodule identified as positive on positron emission tomography. This value was 2.8 ± 1.2 in those patients without malignancy but with a nodule identified as positive on positron emission tomography (p = 0.01). A palpable thyroid nodule was more likely in those with malignant lesions (p = 0.14).

Conclusion:

The prevalence of incidental thyroid lesions found on 18F-fluorodeoxyglucose positron emission tomography in patients with other primary malignancies is low, but the incidence of malignancy in these patients is high. Patients with a palpable thyroid nodule, focal uptake on 18F-fluorodeoxyglucose positron emission tomography and an increased maximum standardised uptake value require further investigation.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Bae, JS, Chae, BJ, Park, WC, Kim, JS, Kim, SH, Jung, SS et al. Incidental thyroid lesions detected by FDG-PET/CT: prevalence and risk of thyroid cancer. World J Surg Oncol 2009;7:63Google Scholar
2Kim, TY, Kim, WB, Ryu, JS, Gong, G, Hong, SJ, Shong, YK. 18F-fluorodeoxyglucose uptake in thyroid from positron emission tomogram (PET) for evaluation in cancer patients: high prevalence of malignancy in thyroid PET incidentaloma. Laryngoscope 2005;115:1074–8Google Scholar
3Cohen, MS, Arslan, N, Dehdashti, F, Doherty, G, Lairmore, TC, Brunt, M et al. Risk of malignancy in thyroid incidentalomas identified by fluorodeoxyglucose-positron emission tomography. Surgery 2001;130:941–6CrossRefGoogle ScholarPubMed
4Chen, YK, Ding, HJ, Chen, KT, Chen, YL, Liao, AC, Shen, YY et al. Prevalence and risk of cancer of focal thyroid incidentalomas identified by 18F-fluorodeoxyglucose positron emission tomography for cancer screening in healthy subjects. Anticancer Res 2005;25:1421–6Google ScholarPubMed
5Van den Bruel, A, Maes, A, De Potter, T, Mortelmans, L, Drijkoningen, M, Van Damme, B et al. Clinical relevance of thyroid fluorodeoxyglucose-whole body positron emission tomography incidentaloma. J Clin Endocrinol Metab 2005;87:1517–20Google Scholar
6de Groot, JW, Links, TP, Jager, PL, Kahraman, T, Plukker, JT. Impact of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in patients with biochemical evidence of recurrent or residual medullary thyroid cancer. Ann Surg Oncol 2004;11:786–94Google Scholar
7Are, C, Hsu, JF, Schoder, H, Shah, JP, Larson, SM, Shaha, AR. FDG-PET detected thyroid incidentalomas: need for further investigation? Ann Surg Oncol 2006;14:239–47CrossRefGoogle ScholarPubMed
8Eloy, JA, Brett, EM, Fatterpekar, GM, Kostakoglu, L, Som, PM, Desai, SC et al. The significance and management of incidental [18F]fluorodeoxyglucose-positron-emission tomography uptake in the thyroid gland in patients with cancer. AJNR Am J Neuroradiol 2009;30:1431–4CrossRefGoogle ScholarPubMed
9GraphPad Software QuickCalcs: Analyze a 2 × 2 contingency table. In: http://www.graphpad.com/quickcalcs/contingency1.cfm [16 June 2013]Google Scholar
10Kim, EK, Park, CS, Chung, WY, Oh, KK, Kim, DI, Lee, JT et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 2002;178:687–91Google Scholar
11Nixon, IJ, Ganly, I, Hann, LE, Lin, O, Yu, C, Brandt, S et al. Nomogram for predicting malignancy in thyroid nodules using clinical, biochemical, ultrasonographic, and cytologic features. Surgery 2010;148:1120–7; discussion 1127–8CrossRefGoogle ScholarPubMed
12Ramos, CD, Chisin, R, Yeung, HWD, Larson, SM, Macapinlac, HA. Incidental focal thyroid uptake on FDG positron emission tomographic scans may represent a secondary primary tumor. Clin Nucl Med 2001;26:193–7Google Scholar
13Kang, KW, Kim, SK, Kang, HS. Prevalence and risk of cancer of focal thyroid incidentalomas identified by 18F-fluorodeoxyglucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab 2005;88:4100–4CrossRefGoogle Scholar