Diagnostic and Clinical Significance of F-18-FDG-PET/CT Thyroid Incidentalomas

Bertagna, Francesco; Treglia, Giorgio; Piccardo, Arnoldo; Giubbini, Raffaele

doi:10.1210/jc.2012-2390

Cited by 156 publications

(133 citation statements)

References 66 publications

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“…By contrast, as expected, we found a low PPV of 18 F-FDG PET/CT (38%) confirming previous data (23,24). All in all, a negative 18 F-FDG PET/CT significantly reduces inappropriate thyroidectomies while positive nodules deserve lobectomy and histological examination.…”

Section: F-fdg Pet/ct Mpus and 99msupporting

confidence: 91%

Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology

Piccardo

Puntoni

Treglia

et al. 2016

European Journal of Endocrinology

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Purpose: To evaluate the role of 18 F-flurodeoxiglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) in predicting malignancy of thyroid nodules with indeterminate cytology. Patients and methods:We analysed 87 patients who have been scheduled to undergo surgery for thyroid nodule with indeterminate cytology. All patients underwent 18 F-FDG-PET/CT, multiparametric neck ultrasonography (MPUS), and 99m Tc-methoxyisobutylisonitrile scintigraphy ( 99m Tc-MIBI-scan). Histopathology was the standard of reference.We compared the sensitivity (SE), specificity (SP), accuracy (AC), positive (PPV) and negative predictive (

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Section: F-fdg Pet/ct Mpus and 99msupporting

confidence: 91%

Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology

Piccardo

Puntoni

Treglia

et al. 2016

European Journal of Endocrinology

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“…These facts have relevance in terms of imaging diagnosis. Imaging by FDG-PET has the potential to reveal unsuspected tumours, including thyroid tumours, commonly indicated as 'incidentaloma' because of their accidental discovery (Bogsrud et al 2010, Hsiao et al 2011, Pagano et al 2011, Bertagna et al 2012. Novel non-radioactive methods for imaging the glucose internalisation by cancer cells are being developed (Walker-Samuel et al 2013), underscoring the importance of glucose uptake as a diagnostic readout of cancer proliferation.…”

Section: Discussionmentioning

confidence: 99%

PTEN regulates plasma membrane expression of glucose transporter 1 and glucose uptake in thyroid cancer cells

Morani

Phadngam

Follo

et al. 2014

Journal of Molecular Endocrinology

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Glucose represents an important source of energy for the cells. Proliferating cancer cells consume elevated quantity of glucose, which is converted into lactate regardless of the presence of oxygen. This phenomenon, known as the Warburg effect, has been proven to be useful for imaging metabolically active tumours in cancer patients by 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET). Glucose is internalised in the cells by glucose transporters (GLUTs) belonging to the GLUT family. GLUT1 (SLC2A1) is the most prevalent isoform in more aggressive and less differentiated thyroid cancer histotypes. In a previous work, we found that loss of expression of PTEN was associated with increased expression of GLUT1 on the plasma membrane (PM) and probability of detecting thyroid incidentalomas by FDG-PET. Herein, we investigated the molecular pathways that govern the expression of GLUT1 on the PM and the glucose uptake in WRO (expressing WT PTEN) and FTC133 (PTEN null) follicular thyroid cancer cells cultured under glucose-depleted conditions. The membrane expression of GLUT1 was enhanced in glucose-deprived cells. Through genetic manipulations of PTEN expression, we could demonstrate that the lack of this oncosuppressor has a dominant effect on the membrane expression of GLUT1 and glucose uptake. We conclude that loss of function of PTEN increases the probability of cancer detection by FDG-PET or other glucose-based imaging diagnosis.

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“…A proportion meta-analysis performed by Bertagna et al (92) with a total of 147 505 subjects from 27 studies revealed a pooled incidence and a malignancy ratio of 2.46% (95% CI 1.68, 3.39%) and 34.6% (95% CI 29.3, 40.2%) respectively. Soelberg et al (91) calculated the prevalence and the risk of malignancy of thyroid incidentalomas reported in 22 selected studies involving 125 754 subjects.…”

Section: Clinical Significance Of Thyroid Pet Incidentalomamentioning

confidence: 99%

“…These studies show that the incidence of thyroid incidentalomas, although low as a percentage, is not negligible, and that about one-third of clinically asymptomatic patients would have had a late diagnosis of thyroid cancer had they not undergone a PET scan. In these cases, the most frequent malignant histological type that was responsible for FDG-PET/CT thyroid incidentaloma was papillary thyroid cancer, and there is no safe SUV cutoff for which it is certain or reasonably safe to either suspect or rule out malignancies (92).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

IMAGING IN ENDOCRINOLOGY: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up

Salvatori

Biondi

Rufini

2015

European Journal of Endocrinology

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In recent years, 2-[ 18 F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) has emerged as an important tool for the postoperative management of patients with differentiated thyroid cancer (DTC) and it is widely used in selected clinical situations. The most valuable role that FDG-PET/CT plays in clinical practice is that it can be used to obtain prognostic information in patients with increasing thyroglobulin (Tg) levels and negative 131 I whole-body scan post-thyroidectomy and radioiodine (RAI) ablation. FDG-PET/CT may also have a potential role in the initial staging and follow-up of high-risk patients with aggressive histological subtypes, in the identification of patients who are at the highest risk of disease-specific mortality, in the management of patients with RAI-refractory disease, in clinical trials of novel targeted therapies in patients with advanced metastatic disease, and in the evaluation of thyroid nodules with indeterminate fineneedle aspiration for cytology. However, several controversies remain to be resolved, namely: the cutoff value of Tg in the selection of DTC patients for FDG-PET/CT, whether FDG-PET/CT scanning should be performed under thyrotropin stimulation or suppression, and the clinical significance of thyroid FDG-PET/CT incidentalomas. The aim of the present article is to provide an overview of the data about the molecular basis for, clinical indications of, and controversies related to the use of FDG-PET/CT in patients with DTC.

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Diagnostic and Clinical Significance of F-18-FDG-PET/CT Thyroid Incidentalomas

Cited by 156 publications

References 66 publications

Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology

Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology

PTEN regulates plasma membrane expression of glucose transporter 1 and glucose uptake in thyroid cancer cells

IMAGING IN ENDOCRINOLOGY: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up

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