Is there a SUVmax threshold on FDG uptake of thyroid nodules to indicate or avoid fine needle aspiration?

Congress:

ECR 2019

Poster Number:

C-2146

Type:

Scientific Exhibit

Keywords:

Head and neck, PET-CT, Ultrasound, Puncture, Neoplasia

Authors:

C. Alvarez Sánchez¹, S. Merino¹, M. J. Fernández-Aceñero¹, R. Valhondo Rama¹, A. VIDAL GONZÁLEZ¹, E. Bello Martínez¹, T. Ganado Diaz²; ¹Madrid/ES, ²Madrid /ES

DOI:

10.26044/ecr2019/C-2146

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-2146

Fig. 1

Fig. 2: Figure 2. 62-years-old man with bladder carcinoma and multinodular goiter whit...

Fig. 3: Figure 3. 51-years-old woman with breast cancer. A,B. On control PET-TC a focal...

Fig. 4: Figure 4. A. Bar chart showing the distribution of FDG uptake. B. Box plot...

Aims and objectives

Thyroid incidentalomas are nonpalpable thyroid nodules defined as newly identified thyroid lesions encountered during imaging procedures, mainly on PET-CT. The uptake of the FDG in the normal thyroid gland is homogenous and of low intensity and is usually not visualized on a PET-CT. Focal or diffuse FDG uptake in the thyroid gland is often seen as an incidental finding and most thyroid nodules are identified incidentally and less often by palpation. These nonpalpable nodules have approximately the same risk of malignancy as palpable nodules. The...

Methods and materials

Patients: We retrospectively reviewed 3224 explorations of PET-TC performed at our hospital between 2013 and 2018. The inclusion criteria were FDG uptake of unless 2 (SUVmax), focal uptake defined as well-defined FDG uptake in less than one lobe of the thyroid gland and cytological or histological results after ultrasound guided FNA or surgery. The main exclusion criteria were diffuse FDG uptake, known previous thyroid disease and different studies from same patients. Of all these studies one-hundred and fifty-two cases (152) had incidental and focal FDG...

Results

One-hundred and fifty two focal thyroid FDG uptakes were observed (103 women and 49 men). Cytopathological results following Bethesda classification were as follows: Bethesda I (unsatisfactory material) in only one of the 59 nodules (US-guided FNA was repeated three times with same results and the nodule remained stable in consecutive US exams along 36 months), Bethesda II (benign) in 32 nodules, Bethesda III (uncertain significance atypia) in one nodule, Bethesda IV (follicular neoplasm or suspicious for follicular neoplasm including follicular variant of papillary thyroid carcinoma)...

Conclusion

Irregular margins, marked hypoechogenicity and high SUVmax are associated with higher risk of malignancy with statistical significance with a cut-off value of SUVmax with acceptable values of specificity and sensitivity. However more randomized and prospective researchs are nedeed to confirm the results of our study.

Personal information

References

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