The relationship between positron emission tomography-computed tomography imaging and histopathological features of thyroid incidentalomas detected during follow-up for primary malignancy

Öven, Bala Başak; Kılıçoğlu, Zeynep Gamze; Bılıcı, Ahmet; Tatoğlu, Mehmet Tarık; Canberk, Şule; Tilki, Metin; Vardar, Fugen Aker

doi:10.4103/jcrt.jcrt_889_16

Cited by 1 publication

(4 citation statements)

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“…In the patient selection domain, 17 studies were considered as high risk due to inappropriate exclusion criteria ( 27 , 39 , 42 , 46 , 54 , 56 , 58 , 59 , 62 , 63 , 67 , 69 , 70 , 72 , 76 , 80 , 83 ). We considered another 6 studies to be of high risk because a non-consecutive sample of patients was enrolled ( 24 , 28 , 29 , 31 , 66 , 79 ). One study included only patients with a history of cervical cancer and was therefore classified as high risk ( 38 ).…”

Section: Resultsmentioning

confidence: 99%

“…In the index test domain, 16 studies were classified as being of unclear risk of bias as it was not described how 18 F-FDG PET/CTs were assessed ( 24 , 30 , 32 , 35 , 39 , 45 , 47 , 51 , 52 , 61 , 65 , 66 , 73 – 75 , 79 ).…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-six studies did not use the Bethesda classification to report FNAC results and were therefore classified as high risk in the reference test domain ( 23 – 29 , 31 – 37 , 39 – 41 , 44 , 45 , 47 , 48 , 50 – 54 , 57 , 59 , 60 , 67 , 70 , 74 , 79 – 81 , 83 ).…”

Section: Resultsmentioning

confidence: 99%

“…(3) missing separate data of BIII and BIV or THY3a and THY3b categories (N = 6) ( 31 , 47 , 57 , 70 , 75 , 76 ). (4) description of either non-diagnostic or indeterminate FNAC results and not both subgroups (N = 7) ( 34 , 38 , 46 , 48 , 50 , 78 , 79 ).…”

Section: Resultsmentioning

confidence: 99%

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Focal Thyroid Incidentalomas on 18F-FDG PET/CT: A Systematic Review and Meta-Analysis on Prevalence, Risk of Malignancy and Inconclusive Fine Needle Aspiration

et al. 2021

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BackgroundThe rising demand for 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) has led to an increase of thyroid incidentalomas. Current guidelines are restricted in giving options to tailor diagnostics and to suit the individual patient.ObjectivesWe aimed at exploring the extent of potential overdiagnostics by performing a systematic review and meta-analysis of the literature on the prevalence, the risk of malignancy (ROM) and the risk of inconclusive FNAC (ROIF) of focal thyroid incidentalomas (FTI) on 18F-FDG PET/CT.Data SourcesA literature search in MEDLINE, Embase and Web of Science was performed to identify relevant studies.Study SelectionStudies providing information on the prevalence and/or ROM of FTI on 18F-FDG PET/CT in patients with no prior history of thyroid disease were selected by two authors independently. Sixty-one studies met the inclusion criteria.Data AnalysisA random effects meta-analysis on prevalence, ROM and ROIF with 95% confidence intervals (CIs) was performed. Heterogeneity and publication bias were tested. Risk of bias was assessed using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool.Data SynthesisFifty studies were suitable for prevalence analysis. In total, 12,943 FTI were identified in 640,616 patients. The pooled prevalence was 2.22% (95% CI = 1.90% - 2.54%, I2 = 99%). 5151 FTI had cyto- or histopathology results available. The pooled ROM was 30.8% (95% CI = 28.1% - 33.4%, I2 = 57%). 1308 (83%) of malignant nodules were papillary thyroid carcinoma (PTC). The pooled ROIF was 20.8% (95% CI = 13.7% - 27.9%, I2 = 92%).LimitationsThe main limitations were the low to moderate methodological quality of the studies and the moderate to high heterogeneity of the results.ConclusionFTI are a common finding on 18F-FDG PET/CTs. Nodules are malignant in approximately one third of the cases, with the majority being PTC. Cytology results are non-diagnostic or indeterminate in one fifth of FNACs. These findings reveal the potential risk of overdiagnostics of FTI and emphasize that the workup of FTI should be performed within the context of the patient’s disease and that guidelines should adopt this patient tailored approach.

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