FDG-PET detected thyroid incidentalomas: Need for further investigation? Journal Article
| Authors: | Are, C.; Hsu, J. F.; Schoder, H.; Shah, J. P.; Larson, S. M.; Shaha, A. R. |
| Article Title: | FDG-PET detected thyroid incidentalomas: Need for further investigation? |
| Abstract: | Background: Incidental thyroid abnormalities are increasingly detected in patients undergoing PET scans. The aim of this study was to review our experience with the management of PET detected thyroid incidentalomas in a large single institution series. Methods: All PET scans performed from May 2003 to July 2005 were reviewed and patients with incidental thyroid abnormalities were identified. From this group, patients that underwent further investigation were analyzed. Data relating to PET scan findings, FNA diagnoses, operative details, and histopathology was reviewed. Results: In 8,800 patients, 16,300 PET scans were performed of whom 263 patients (2.9% of patients and 1.6% of PET scans) had findings positive for thyroid abnormality. Thyroid malignancy was noted in 42% (24 patients) of the 57 patients that underwent FNA. In the group of 27 patients that were subjected to operative intervention, 74% (20 patients) were noted to have a malignant diagnosis. The final histopathology revealed primary thyroid carcinoma in all these 20 patients (19 patients with papillary carcinoma and one patient with primary thyroid lymphoma). The factors that correlated with an increased risk of malignancy were the presence of physical finding (p = 0.01) and focal (p < 0.01) or unilateral uptake (p < 0.01) on PET scan. The average SUV was not useful in differentiating benign (9.2) from malignant lesions (8.2, p = 0.7). Conclusions: PET detected incidental thyroid abnormalities are rare. In patients with positive PET scan findings and suspicious features, the incidence of primary thyroid malignancy is very high. These patients warrant further investigation followed by possible operative intervention. © 2006 Society of Surgical Oncology. |
| Keywords: | middle aged; major clinical study; histopathology; review; cancer risk; cancer patient; positron emission tomography; radiopharmaceuticals; intervention study; correlation analysis; incidental findings; biopsy, fine-needle; fluorodeoxyglucose f18; positron-emission tomography; carcinoma; thyroid carcinoma; thyroid neoplasms; papillary carcinoma; aspiration biopsy; thyroid; fluorodeoxyglucose; thyroid disease; thyroid incidentaloma; fdg-pet scan; incidentalomas; risk of malignancy |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 14 |
| Issue: | 1 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2007-01-01 |
| Start Page: | 239 |
| End Page: | 247 |
| Language: | English |
| DOI: | 10.1245/s10434-006-9181-y |
| PUBMED: | 17024553 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 55" - "Export Date: 17 November 2011" - "CODEN: ASONF" - "Source: Scopus" |
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