Frecuencia de malignidad en incidentalomas tiroideos detectados con tomografía por emisión de positrones/tomografía computada (PET/CT) con F18-FDG de cuerpo entero

Abstract

Frecuencia de malignidad en incidentalomas tiroideos detectados con tomografía por emisión de positrones/ tomografía computada (PET/CT) con F18-FDG de cuerpo entero DaviD LaDrón De guevara h. 1 , cLauDia munizaga m. a , naTaLia garcía s. a , caroLina LeTeLier B. 2 , aLex wash F. 1 Frequency of malignancy in thyroid incidentalomas detected by whole body 18F-FDg PEt/Ct Background: Thyroid incidentalomas detected by 18 F-Fludeoxyglucose (FDG) PET/CT are defined as an incidental and unexpected thyroid focus present in a patient studied for a non-thyroid disease. Aim: To assess the frequency of malignancy of nodular thyroid incidentalomas, and their association with 18 F-FDG avidity (standard uptake value (SUV) max). Material and Methods: Whole body PET/CT performed from December 2008 to December 2017 were reviewed selecting those that showed nodular thyroid foci. Glands with diffuse increased uptake were excluded. Thyroid ultrasonography and fine-needle aspiration cytology (FNAC) performed after PET/CT were reviewed. Bethesda score and SUVmax were correlated. Results: Of 5,100 whole body 18F-FDG PET/CT, 119 showed a thyroid nodular uptake (2.3%). Forty eight percent of these patients were studied with FNAC or surgery, 50% of which (29/58) were confirmed as malignant. Benign nodules showed significantly lower 18 F-FDG uptake (n = 20,

The dilemma of 18F-FDG PET/CT thyroid incidentaloma: what we should expect from FNA. A systematic review and meta-analysis

“…The 15 studies were published between 2012 and 2020. All studies but one [ 29 ] were reported in the English language. Nine studies were performed by Asian/Eastern [ 17 – 20 , 22 – 24 , 27 , 31 ] and six by Western [ 21 , 25 , 26 , 28 – 30 ] authors.…”

“…1. Of these, 289 were screened, 84 were assessed as eligible, and 15 [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] were included in the final systematic review and meta-analysis. Table 1 summarizes the quality assessment of the 15 included studies.…”

“…All studies but one [29] were reported in the English language. Nine studies were performed by Asian/ Eastern [17-20, 22-24, 27, 31] and six by Western [21,25,26,[28][29][30] authors. They were single-center or observational cohort studies.…”

“…The prevalence in the BETHESDA subcategories was substantially unchanged (I 12%, II 47%, III 6%, IV 4%, V 6%, and VI 21%) and the inconsistency remained high (detailed data not shown). A second analysis was performed considering separately the nine studies from Asian/Eastern countries [17-20, 22-24, 27, 31] and the six studies from Western authors [21,25,26,[28][29][30] as shown in Table 4. There was a significantly different prevalence in the BETHESDA category IV between Asian/Eastern and Western studies.…”

2022 Taiwan clinical multicenter expert consensus and recommendations for thyroid radiofrequency ablation

“…18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is non-invasive, and a nodule with a maximum standardized uptake value (SUVmax) ≥5 is highly indicative of malignancy, with a sensitivity of 76% and specificity of 85% [ 83 ]. There is increasing evidence noting the differentiation between Hürthle cell carcinoma and follicular adenomas on PET [ 84 , 85 ].…”