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CC BY-NC-ND 4.0 · World J Nucl Med 2020; 19(01): 36-40
DOI: 10.4103/wjnm.WJNM_33_19
Original Article

Positron emission tomography–computed tomography-associated incidental neoplasms of the thyroid gland

K Kamakshi
Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
,
Arvind Krishnamurthy
Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
,
V Karthik
Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
,
Preetha Vinodkumar
1   Department of Clinical Research, Cancer Institute (WIA), Chennai, Tamil Nadu, India
,
R Kumar
2   Department of Nuclear Medicine, Cancer Institute (WIA), Chennai, Tamil Nadu, India
,
K Lakshmipathy
3   HCG PET-CT Centre, Chennai, Tamil Nadu
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Abstract

With the increasing use of 18F-fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET-CT) scans in oncology, the finding of thyroid incidentalomas, also popularly described as PET-associated incidental neoplasms (PAINs) of the thyroid gland is not unusual. The 18F-FDG PET-CT scans of all patients who underwent imaging for indications other than thyroid malignancy at our tertiary care center between January 1 and December 31, 2017, were retrospectively reviewed for PAINs of the thyroid. A total of 173718F-FDG PET-CT scans were done at our center in the year 2017. 288 thyroid incidentalomas were detected in the said period; the rate of PET-CT-detected thyroid incidentalomas being 16.58%, focal incidentalomas among them being 11.7%. Only 29 out of 204 patients (14.21%) with focal thyroid incidentalomas in our cohort underwent an aspiration cytology and/or ultrasound. The rate of malignancy among the PET detected focal thyroid incidentalomas in the cohort of patients with a proven diagnosis was 10.34%. Our study highlights the challenges in the evaluation and management of PAIN in a tertiary care oncology setting. None of the factors studied including nodule size and standardized uptake value predicted the risk of malignancy. Clinicians specializing in the management of thyroid nodules need to understand the clinical significance of the PAIN, and we hope that our unique experience adds to the limited clinical information available in this regard.

Keywords

Positron emission tomography - positron emission tomography associated incidental neoplasms - prognosis - thyroid incidentalomas

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 26. April 2019

Angenommen: 29. Mai 2019

Artikel online veröffentlicht:
19. April 2022

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Lumbreras B, Donat L, Hernández-Aguado I. Incidental findings in imaging diagnostic tests: A systematic review. Br J Radiol 2010;83:276-89.
  • 2 Uppal A, White MG, Nagar S, Aschebrook-Kilfoy B, Chang PJ, Angelos P, et al. Benign and malignant thyroid incidentalomas are rare in routine clinical practice: A review of 97,908 imaging studies. Cancer Epidemiol Biomarkers Prev 2015;24:1327-31.
  • 3 Asmar A, Simonsen L, Bülow J, Asmar M. Work-up of thyroid incidentalomas identified by 18F-fluorodeoxyglucose PET/CT. Ugeskr Laeger 2017;179. pii: V12160893.
  • 4 Guth S, Theune U, Aberle J, Galach A, Bamberger CM. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest 2009;39:699-706.
  • 5 Tomimori E, Pedrinola F, Cavaliere H, Knobel M, Medeiros-Neto G. Prevalence of incidental thyroid disease in a relatively low iodine intake area. Thyroid 1995;5:273-6.
  • 6 Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas. Prevalence by palpation and ultrasonography. Arch Intern Med 1994;154:1838-40.
  • 7 Liu Y, Ghesani NV, Zuckier LS. Physiology and pathophysiology of incidental findings detected on FDG-PET scintigraphy. Semin Nucl Med 2010;40:294-315.
  • 8 Demir Ö, Köse N, Özkan E, Ünlütürk U, Aras G, Erdoǧan MF. Clinical significance of thyroid incidentalomas identified by 18F-FDG PET/CT: Correlation of ultrasonograpy findings with cytology results. Nucl Med Commun 2016;37:715-20.
  • 9 Soelberg KK, Bonnema SJ, Brix TH, Hegedüs L. Risk of malignancy in thyroid incidentalomas detected by 18F-fluorodeoxyglucose positron emission tomography: A systematic review. Thyroid 2012;22:918-25.
  • 10 Shie P, Cardarelli R, Sprawls K, Fulda KG, Taur A. Systematic review: Prevalence of malignant incidental thyroid nodules identified on fluorine-18 fluorodeoxyglucose positron emission tomography. Nucl Med Commun 2009;30:742-8.
  • 11 Kang KW, Kim SK, Kang HS, Lee ES, Sim JS, Lee IG, et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18F-fluorodeoxyglucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab 2003;88:4100-4.
  • 12 Are C, Hsu JF, Schoder H, Shah JP, Larson SM, Shaha AR. FDG-PET detected thyroid incidentalomas: Need for further investigation? Ann Surg Oncol 2007;14:239-47.
  • 13 Hagenimana N, Dallaire J, Vallée É, Belzile M. Thyroid incidentalomas on 18FDG-PET/CT: A metabolico-pathological correlation. J Otolaryngol Head Neck Surg 2017;46:22.
  • 14 Gavriel H, Tang A, Eviatar E, Chan SW. Unfolding the role of PET FDG scan in the management of thyroid incidentaloma in cancer patients. Eur Arch Otorhinolaryngol 2015;272:1763-8.
  • 15 Kim TY, Kim WB, Ryu JS, Gong G, Hong SJ, Shong YK.18F-fluorodeoxyglucose uptake in thyroid from positron emission tomogram (PET) for evaluation in cancer patients: High prevalence of malignancy in thyroid PET incidentaloma. Laryngoscope 2005;115:1074-8.
  • 16 Vaish R, Venkatesh R, Chaukar DA, Deshmukh AD, Purandare NC, D'cruz AK. Positron emission tomography thyroid incidentaloma: Is it different in Indian subcontinent? Indian J Cancer 2016;53:186-9.
  • 17 Achury C, Estorch M, Domènech A, Camacho V, Flotats A, Jaller R, et al. Interpretation of thyroid incidentalomas in (18)F-FDG PET/CT studies. Rev Esp Med Nucl Imagen Mol 2014;33:205-9.
  • 18 Elzein S, Ahmed A, Lorenz E, Balasubramanian SP. Thyroid incidentalomas on PET imaging – Evaluation of management and clinical outcomes. Surgeon 2015;13:116-20.
  • 19 Nayan S, Ramakrishna J, Gupta MK. The proportion of malignancy in incidental thyroid lesions on 18-FDG PET study: A systematic review and meta-analysis. Otolaryngol Head Neck Surg 2014;151:190-200.
  • 20 Pattison DA, Bozin M, Gorelik A, Hofman MS, Hicks RJ, Skandarajah A. 18F-FDG-avid thyroid incidentalomas: The importance of contextual interpretation. J Nucl Med 2018;59:749-55.
  • 21 Gedberg N, Karmisholt J, Gade M, Fisker RV, Iyer V, Petersen LJ. The frequency of focal thyroid incidental findings and risk of malignancy detected by 18F-fluorodeoxyglucose positron emission tomography in an iodine deficient population. Diagnostics (Basel) 2018;8. pii: E46.
  • 22 Schönberger J, Rüschoff J, Grimm D, Marienhagen J, Rümmele P, Meyringer R, et al. Glucose transporter 1 gene expression is related to thyroid neoplasms with an unfavorable prognosis: An immunohistochemical study. Thyroid 2002;12:747-54.
  • 23 Sager S, Vatankulu B, Sahin OE, Cınaral F, Uslu L, Baran A, et al. Clinical significance of standardized uptake values in thyroid incidentaloma discovered by F-18 fluorodeoxyglucose positron emission tomography/computed tomography. J Cancer Res Ther 2018;14:989-93.
  • 24 Brindle R, Mullan D, Yap BK, Gandhi A. Thyroid incidentalomas discovered on positron emission tomography CT scanning – Malignancy rate and significance of standardised uptake values. Eur J Surg Oncol 2014;40:1528-32.
  • 25 Bertagna F, Treglia G, Piccardo A, Giovannini E, Bosio G, Biasiotto G, et al. F18-FDG-PET/CT thyroid incidentalomas: A wide retrospective analysis in three Italian centres on the significance of focal uptake and SUV value. Endocrine 2013;43:678-85.
  • 26 Şencan Eren M, Özdoǧan Ö, Gedik A, Ceylan M, Güray Durak M, Seçil M, et al. The incidence of 18F-FDG PET/CT thyroid incidentalomas and the prevalence of malignancy: A prospective study. Turk J Med Sci 2016;46:840-7.
  • 27 Chun AR, Jo HM, Lee SH, Chun HW, Park JM, Kim KJ, et al. Risk of malignancy in thyroid incidentalomas identified by fluorodeoxyglucose-positron emission tomography. Endocrinol Metab (Seoul) 2015;30:71-7.
  • 28 Yang Z, Shi W, Zhu B, Hu S, Zhang Y, Wang M, et al. Prevalence and risk of cancer of thyroid incidentaloma identified by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography. J Otolaryngol Head Neck Surg 2012;41:327-33.
  • 29 Marques P, Ratão P, Salgado L, Bugalho MJ. Thyroid carcinoma detected by 18F-fluorodeoxyglucose positron emission tomography among individuals without prior evidence of thyroid disease: Relevance and clinicopathologic features. Endocr Pract 2014;20:1129-36.
  • 30 Yoon JH, Cho A, Lee HS, Kim EK, Moon HJ, Kwak JY. Thyroid incidentalomas detected on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography: Thyroid imaging reporting and data system (TIRADS) in the diagnosis and management of patients. Surgery 2015;158:1314-22.
  • 31 Choi JS, Choi Y, Kim EK, Yoon JH, Youk JH, Han KH, et al. Arisk-adapted approach using US features and FNA results in the management of thyroid incidentalomas identified by 18F-FDG PET. Ultraschall Med 2014;35:51-8.