Incidental focal thyroid uptake on FDG positron emission tomographic scans may represent a second primary tumor Journal Article


Authors: Ramos, C. D.; Chisin, R.; Yeung, H. W. D.; Larson, S. M.; Macapinlac, H. A.
Article Title: Incidental focal thyroid uptake on FDG positron emission tomographic scans may represent a second primary tumor
Abstract: Purpose: This article discusses the value of incidental thyroid uptake of fluorodeoxyglucose (FDG) on whole-body positron emission tomography (PET) scans performed in patients with cancer. This issue has been reported diversely in the literature. Materials and Methods: Whole-body PET scans of four patients with cancer (two of them women; age, 49 to 78 years) in whom focal thyroid uptake was visualized and subsequently correlated with thyroid carcinoma based on cytologic or histopathologic data were reviewed. The clinical outcomes of these patients were analyzed retrospectively. Maximum and average standardized uptake values (SUVs) of thyroid accumulation were recalculated in all patients. Results: Two of the four patients referred for FDG PET scans had lung adenocarcinomas, one had prostrate carcinoma, and one had an unknown primary tumor. Focal thyroid uptake was visualized, with maximum and average SUVs ranging from 3.7 and 2.3 to 53 and 34, respectively. These findings were correlated with cytologic (two patients) or histopathologic data (two patients) that indicated thyroid carcinoma. In two patients, their treatment was changed and total thyroidectomy was performed; in one of them the SUVs of the focal thyroid accumulation (maximum and average values of 7.9 and 4.8, respectively) were less than the cutoff values for thyroid cancer noted in the literature. The clinical condition of the other two patients did not permit additional investigation or treatment for thyroid carcinoma. Conclusion: increased focal thyroid uptake on whole-body FDG PET scans should not be overlooked, even when it is not marked, and should prompt further investigation to rule out cancer.
Keywords: adult; controlled study; human tissue; aged; aged, 80 and over; middle aged; retrospective studies; histopathology; case report; positron emission tomography; radiopharmaceuticals; adenocarcinoma; cytology; lung neoplasms; carcinoma, papillary; standard; diagnostic value; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; thyroidectomy; thyroid carcinoma; thyroid neoplasms; neoplasms, second primary; second cancer; thyroid gland; tomography, emission-computed; radioisotope distribution; standardized uptake value; whole body tomography; fluorine-18; humans; human; male; female; article; fluorodeoxyglucose positron emission tomography; fluorodeoxyglucose thyroid uptake
Journal Title: Clinical Nuclear Medicine
Volume: 26
Issue: 3
ISSN: 0363-9762
Publisher: Lippincott Williams & Wilkins  
Date Published: 2001-03-01
Start Page: 193
End Page: 197
Language: English
DOI: 10.1097/00003072-200103000-00002
PUBMED: 11245108
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 21 May 2015 -- Source: Scopus
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  1. Henry W D Yeung
    126 Yeung
  2. Steven M Larson
    958 Larson