Frecuencia de malignidad en incidentalomas tiroideos detectados con tomografía por emisión de positrones/tomografía computada (PET/CT) con F18-FDG de cuerpo entero / Frequency of malignancy in thyroid incidentalomas detected by whole body 18F-FDG PET/CT
Rev. méd. Chile
;
148(1): 10-16, Jan. 2020. tab, graf
Article
in Spanish
| LILACS
| ID: biblio-1094201
ABSTRACT
Background:
Thyroid incidentalomas detected by 18F-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 18F-FDG avidity (standard uptake value (SUV) max). Material andMethods:
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 18F-FDG uptake (n = 20, SUVmax 3.5 ± 1.7) than Bethesda V-VI (n=24, SUVmax 8.2 ± 5.2) and thyroid metastases (n=5, SUVmax 6.3 ± 2.1). The best cut-off value to distinguish between benign and malignant nodules was a SUVmax of 5.0, with a sensitivity of 76% (95% confidence intervals (CI) 56-90%), a specificity of 85% (95% CI 62 - 97%), and positive likelihood ratio of 5 (95% CI 1.8 - 14.6). The size of the thyroid nodule was not predictive of malignancy.Conclusions:
Half of nodular thyroid incidentalomas detected by 18F-FDG PETC/CT are malignant. A nodule with a SUVmax ≥ 5,0 is highly suggestive of malignancy, regardless of its size.
Full text:
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Index:
LILACS (Americas)
Main subject:
Thyroid Neoplasms
/
Thyroid Nodule
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2020
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Clínica Las Condes/CL
/
Unidad de Endocrinología/CL
/
Universidad de Chile/CL
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