TY - JOUR
T1 - Risk of malignancy in thyroid incidentalomas identified by fluorodeoxyglucose-positron emission tomography
AU - Cohen, Mark S.
AU - Arslan, Nuri
AU - Dehdashti, Farrokh
AU - Doherty, Gerard M.
AU - Lairmore, Terry C.
AU - Brunt, L. Michael
AU - Moley, Jeffrey F.
PY - 2001
Y1 - 2001
N2 - Background. Thyroid tumors often exhibit increased metabolic activity, as evidenced by enhanced glucose uptake on positron emission tomography (PET) with use of 18F-fluorodeoxyglucose (FDG). The incidence of new thyroid lesions found on routine FDG-PET has not been previously reported. Methods. A retrospective review of all patients who underwent FDG-PET imaging at our institution from June 1, 1996, through March 15, 2001, identified patients with a newly diagnosed thyroid lesion. Thyroid incidentaloma was defined as a thyroid lesion seen initially on FDG-PET in a patient without a history of thyroid disease. Available follow-up data were documented. Results. One hundred and two of 4525 FDG-PET examinations (2.3%) demonstrated thyroid incidentalomas. Eighty-seven of 102 patients had no thyroid histology because of other malignancies. Fifteen patients had thyroid biopsy: 7 (47%) with thyroid cancer, 6 (40%) with nodular hyperplasia, 1 with thyroiditis, and 1 with atypical cells of indeterminate origin. The average standardized uptake values were higher for malignant compared with benign lesions. Conclusions. Thyroid incidentaloma identified by FDG-PET occurred with a frequency of 2.3%. Of the thyroid incidentalomas that underwent biopsy, 47% were found to be malignant. Given the risk of malignancy, patients with new thyroid lesions on PET scan should have a tissue diagnosis if it will influence outcome and management. Standardized uptake values may be helpful in predicting benign versus malignant histology.
AB - Background. Thyroid tumors often exhibit increased metabolic activity, as evidenced by enhanced glucose uptake on positron emission tomography (PET) with use of 18F-fluorodeoxyglucose (FDG). The incidence of new thyroid lesions found on routine FDG-PET has not been previously reported. Methods. A retrospective review of all patients who underwent FDG-PET imaging at our institution from June 1, 1996, through March 15, 2001, identified patients with a newly diagnosed thyroid lesion. Thyroid incidentaloma was defined as a thyroid lesion seen initially on FDG-PET in a patient without a history of thyroid disease. Available follow-up data were documented. Results. One hundred and two of 4525 FDG-PET examinations (2.3%) demonstrated thyroid incidentalomas. Eighty-seven of 102 patients had no thyroid histology because of other malignancies. Fifteen patients had thyroid biopsy: 7 (47%) with thyroid cancer, 6 (40%) with nodular hyperplasia, 1 with thyroiditis, and 1 with atypical cells of indeterminate origin. The average standardized uptake values were higher for malignant compared with benign lesions. Conclusions. Thyroid incidentaloma identified by FDG-PET occurred with a frequency of 2.3%. Of the thyroid incidentalomas that underwent biopsy, 47% were found to be malignant. Given the risk of malignancy, patients with new thyroid lesions on PET scan should have a tissue diagnosis if it will influence outcome and management. Standardized uptake values may be helpful in predicting benign versus malignant histology.
UR - http://www.scopus.com/inward/record.url?scp=0035659497&partnerID=8YFLogxK
U2 - 10.1067/msy.2001.118265
DO - 10.1067/msy.2001.118265
M3 - Article
C2 - 11742321
AN - SCOPUS:0035659497
SN - 0039-6060
VL - 130
SP - 941
EP - 946
JO - Surgery
JF - Surgery
IS - 6
ER -