18 F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography May Exclude Malignancy in Sonographically Suspicious and Scintigraphically Hypofunctional Thyroid Nodules and Reduce Unnecessary Thyroid Surgeries
The aim of this study was to evaluate whether F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful in the further characterization of sonographically suspicious and scintigraphically hypofunctional thyroid nodules. Sixty-five patients with sonographically susp...
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| Veröffentlicht in: | Thyroid (New York, N.Y.) N.Y.), 2017-10, Vol.27 (10), p.1300-1306 |
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| creator | Ruhlmann, Marcus Ruhlmann, Jürgen Görges, Rainer Herrmann, Ken Antoch, Gerald Keller, Hans-Wilhelm Ruhlmann, Verena |
| description | The aim of this study was to evaluate whether
F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful in the further characterization of sonographically suspicious and scintigraphically hypofunctional thyroid nodules.
Sixty-five patients with sonographically suspicious thyroid nodules that were hypofunctional on 99m-Tc-pertechnetate scintigraphy (diameter >1 cm) were retrospectively analyzed. All patients underwent evaluation with FDG-PET/CT. Thyroid nodules were sonographically categorized by Thyroid Image Reporting and Data System (TIRADS) criteria. FDG uptake in the thyroid nodules was visually compared to the remainder of the thyroid tissue and categorized as pathological or non-pathological. In cases of pathologically increased uptake, maximum standardized uptake values (SUVmax) of the suspicious nodule and the perinodular thyroid tissue were determined. Depending on the results of the FDG-PET/CT, patients underwent thyroid surgery (pathological FDG uptake) or follow-up examinations (non-pathological FDG uptake). The endpoints for comparison with the FDG uptake were either histological results or sonographic follow-up examinations of at least five years.
In 18/65 (28%) patients, PET/CT showed visually pathological FDG uptake in the suspicious thyroid nodules (SUVmax 7.1 ± 4.6). Of these nodules, 3/18 (17%) were sonographically categorized as TIRADS 4a, 11/18 (61%) nodules as TIRADS 4b, 3/18 (17%) nodules as TIRADS 4c, and 1/18 (6%) nodule as TIRADS 5. The other nodules without pathological FDG uptake were categorized as TIRADS 4a in 24/47 (51%) patients, as TIRADS 4b in 18/47 (38%), and as TIRADS 4c in 5/47 (11%) patients. Twenty-three patients (18 FDG positive, 5 FDG negative) underwent surgery. The other patients underwent follow-up examinations with stability on observation over at least five years as a surrogate endpoint. Taking into consideration that FDG-PET/CT was rated as true negative in 42/47 patients with stability on sonographic follow-up, sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET/CT in detecting malignancy in the suspicious thyroid nodules were 100%, 87%, 61%, and 100%, respectively.
FDG-PET/CT allows stratification of patients with sonographically suspicious and scintigraphically hypofunctional thyroid nodules with a positive predictive value of 61% and negative predictive value of 100%. The absence of visually pathological FDG uptake in suspicious t |
| doi_str_mv | 10.1089/thy.2017.0026 |
| format | Article |
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F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful in the further characterization of sonographically suspicious and scintigraphically hypofunctional thyroid nodules.
Sixty-five patients with sonographically suspicious thyroid nodules that were hypofunctional on 99m-Tc-pertechnetate scintigraphy (diameter >1 cm) were retrospectively analyzed. All patients underwent evaluation with FDG-PET/CT. Thyroid nodules were sonographically categorized by Thyroid Image Reporting and Data System (TIRADS) criteria. FDG uptake in the thyroid nodules was visually compared to the remainder of the thyroid tissue and categorized as pathological or non-pathological. In cases of pathologically increased uptake, maximum standardized uptake values (SUVmax) of the suspicious nodule and the perinodular thyroid tissue were determined. Depending on the results of the FDG-PET/CT, patients underwent thyroid surgery (pathological FDG uptake) or follow-up examinations (non-pathological FDG uptake). The endpoints for comparison with the FDG uptake were either histological results or sonographic follow-up examinations of at least five years.
In 18/65 (28%) patients, PET/CT showed visually pathological FDG uptake in the suspicious thyroid nodules (SUVmax 7.1 ± 4.6). Of these nodules, 3/18 (17%) were sonographically categorized as TIRADS 4a, 11/18 (61%) nodules as TIRADS 4b, 3/18 (17%) nodules as TIRADS 4c, and 1/18 (6%) nodule as TIRADS 5. The other nodules without pathological FDG uptake were categorized as TIRADS 4a in 24/47 (51%) patients, as TIRADS 4b in 18/47 (38%), and as TIRADS 4c in 5/47 (11%) patients. Twenty-three patients (18 FDG positive, 5 FDG negative) underwent surgery. The other patients underwent follow-up examinations with stability on observation over at least five years as a surrogate endpoint. Taking into consideration that FDG-PET/CT was rated as true negative in 42/47 patients with stability on sonographic follow-up, sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET/CT in detecting malignancy in the suspicious thyroid nodules were 100%, 87%, 61%, and 100%, respectively.
FDG-PET/CT allows stratification of patients with sonographically suspicious and scintigraphically hypofunctional thyroid nodules with a positive predictive value of 61% and negative predictive value of 100%. The absence of visually pathological FDG uptake in suspicious thyroid nodules may be useful for avoiding unnecessary thyroid surgery.</description><identifier>ISSN: 1050-7256</identifier><identifier>EISSN: 1557-9077</identifier><identifier>DOI: 10.1089/thy.2017.0026</identifier><identifier>PMID: 28793848</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography ; Retrospective Studies ; Thyroid Gland - diagnostic imaging ; Thyroid Gland - surgery ; Thyroid Neoplasms - diagnostic imaging ; Thyroid Neoplasms - surgery ; Thyroid Nodule - diagnostic imaging ; Thyroid Nodule - surgery ; Ultrasonography</subject><ispartof>Thyroid (New York, N.Y.), 2017-10, Vol.27 (10), p.1300-1306</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1058-a93c056a50892e4ea4b0bfaf42826452a1967f912127a98277d0e2b1f28784193</citedby><cites>FETCH-LOGICAL-c1058-a93c056a50892e4ea4b0bfaf42826452a1967f912127a98277d0e2b1f28784193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28793848$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ruhlmann, Marcus</creatorcontrib><creatorcontrib>Ruhlmann, Jürgen</creatorcontrib><creatorcontrib>Görges, Rainer</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Antoch, Gerald</creatorcontrib><creatorcontrib>Keller, Hans-Wilhelm</creatorcontrib><creatorcontrib>Ruhlmann, Verena</creatorcontrib><title>18 F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography May Exclude Malignancy in Sonographically Suspicious and Scintigraphically Hypofunctional Thyroid Nodules and Reduce Unnecessary Thyroid Surgeries</title><title>Thyroid (New York, N.Y.)</title><addtitle>Thyroid</addtitle><description>The aim of this study was to evaluate whether
F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful in the further characterization of sonographically suspicious and scintigraphically hypofunctional thyroid nodules.
Sixty-five patients with sonographically suspicious thyroid nodules that were hypofunctional on 99m-Tc-pertechnetate scintigraphy (diameter >1 cm) were retrospectively analyzed. All patients underwent evaluation with FDG-PET/CT. Thyroid nodules were sonographically categorized by Thyroid Image Reporting and Data System (TIRADS) criteria. FDG uptake in the thyroid nodules was visually compared to the remainder of the thyroid tissue and categorized as pathological or non-pathological. In cases of pathologically increased uptake, maximum standardized uptake values (SUVmax) of the suspicious nodule and the perinodular thyroid tissue were determined. Depending on the results of the FDG-PET/CT, patients underwent thyroid surgery (pathological FDG uptake) or follow-up examinations (non-pathological FDG uptake). The endpoints for comparison with the FDG uptake were either histological results or sonographic follow-up examinations of at least five years.
In 18/65 (28%) patients, PET/CT showed visually pathological FDG uptake in the suspicious thyroid nodules (SUVmax 7.1 ± 4.6). Of these nodules, 3/18 (17%) were sonographically categorized as TIRADS 4a, 11/18 (61%) nodules as TIRADS 4b, 3/18 (17%) nodules as TIRADS 4c, and 1/18 (6%) nodule as TIRADS 5. The other nodules without pathological FDG uptake were categorized as TIRADS 4a in 24/47 (51%) patients, as TIRADS 4b in 18/47 (38%), and as TIRADS 4c in 5/47 (11%) patients. Twenty-three patients (18 FDG positive, 5 FDG negative) underwent surgery. The other patients underwent follow-up examinations with stability on observation over at least five years as a surrogate endpoint. Taking into consideration that FDG-PET/CT was rated as true negative in 42/47 patients with stability on sonographic follow-up, sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET/CT in detecting malignancy in the suspicious thyroid nodules were 100%, 87%, 61%, and 100%, respectively.
FDG-PET/CT allows stratification of patients with sonographically suspicious and scintigraphically hypofunctional thyroid nodules with a positive predictive value of 61% and negative predictive value of 100%. The absence of visually pathological FDG uptake in suspicious thyroid nodules may be useful for avoiding unnecessary thyroid surgery.</description><subject>Aged</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Retrospective Studies</subject><subject>Thyroid Gland - diagnostic imaging</subject><subject>Thyroid Gland - surgery</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroid Nodule - diagnostic imaging</subject><subject>Thyroid Nodule - surgery</subject><subject>Ultrasonography</subject><issn>1050-7256</issn><issn>1557-9077</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkctuGyEUhlHVqrm0y24rXmAcYC4wy8qym0rpRbWzHmE4Y1MxMIJBCs_alymW0ygrfqGPc9D_IfSJkhUlor9bTnnFCOUrQlj3Bl3TtuVVTzh_WzJpScVZ212hmxj_EEI7wev36IoJ3teiEdfoLxV4W21t8sFr8E_5aJPyEfAvH80SvMObycRoStj7yR-DnE_5bu2nOS2gX93h7zLjzZOySUPJ1hyddCpj4_DOuwtklLQ2412Ks1HGp4il03injFvMa-A-z35MTi1lrbR4f8rBG41_eJ0sXB79Bp0U4EfnQEGMMuQXbJfCEYKB-AG9G6WN8PH5vEWP281-fV89_Pz6bf3loVKlIFHJvlak7WRb6mTQgGwO5DDKsWGCdU3LJO07PvaUUcZlLxjnmgA70LG0KBra17eousxVwccYYBzmYKbypYGS4SxpKJKGs6ThLKnwny_8nA4T6Bf6v5X6H4TNlCA</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Ruhlmann, Marcus</creator><creator>Ruhlmann, Jürgen</creator><creator>Görges, Rainer</creator><creator>Herrmann, Ken</creator><creator>Antoch, Gerald</creator><creator>Keller, Hans-Wilhelm</creator><creator>Ruhlmann, Verena</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201710</creationdate><title>18 F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography May Exclude Malignancy in Sonographically Suspicious and Scintigraphically Hypofunctional Thyroid Nodules and Reduce Unnecessary Thyroid Surgeries</title><author>Ruhlmann, Marcus ; Ruhlmann, Jürgen ; Görges, Rainer ; Herrmann, Ken ; Antoch, Gerald ; Keller, Hans-Wilhelm ; Ruhlmann, Verena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1058-a93c056a50892e4ea4b0bfaf42826452a1967f912127a98277d0e2b1f28784193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Positron Emission Tomography Computed Tomography</topic><topic>Retrospective Studies</topic><topic>Thyroid Gland - diagnostic imaging</topic><topic>Thyroid Gland - surgery</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>Thyroid Neoplasms - surgery</topic><topic>Thyroid Nodule - diagnostic imaging</topic><topic>Thyroid Nodule - surgery</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ruhlmann, Marcus</creatorcontrib><creatorcontrib>Ruhlmann, Jürgen</creatorcontrib><creatorcontrib>Görges, Rainer</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Antoch, Gerald</creatorcontrib><creatorcontrib>Keller, Hans-Wilhelm</creatorcontrib><creatorcontrib>Ruhlmann, Verena</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Thyroid (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ruhlmann, Marcus</au><au>Ruhlmann, Jürgen</au><au>Görges, Rainer</au><au>Herrmann, Ken</au><au>Antoch, Gerald</au><au>Keller, Hans-Wilhelm</au><au>Ruhlmann, Verena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>18 F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography May Exclude Malignancy in Sonographically Suspicious and Scintigraphically Hypofunctional Thyroid Nodules and Reduce Unnecessary Thyroid Surgeries</atitle><jtitle>Thyroid (New York, N.Y.)</jtitle><addtitle>Thyroid</addtitle><date>2017-10</date><risdate>2017</risdate><volume>27</volume><issue>10</issue><spage>1300</spage><epage>1306</epage><pages>1300-1306</pages><issn>1050-7256</issn><eissn>1557-9077</eissn><abstract>The aim of this study was to evaluate whether
F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful in the further characterization of sonographically suspicious and scintigraphically hypofunctional thyroid nodules.
Sixty-five patients with sonographically suspicious thyroid nodules that were hypofunctional on 99m-Tc-pertechnetate scintigraphy (diameter >1 cm) were retrospectively analyzed. All patients underwent evaluation with FDG-PET/CT. Thyroid nodules were sonographically categorized by Thyroid Image Reporting and Data System (TIRADS) criteria. FDG uptake in the thyroid nodules was visually compared to the remainder of the thyroid tissue and categorized as pathological or non-pathological. In cases of pathologically increased uptake, maximum standardized uptake values (SUVmax) of the suspicious nodule and the perinodular thyroid tissue were determined. Depending on the results of the FDG-PET/CT, patients underwent thyroid surgery (pathological FDG uptake) or follow-up examinations (non-pathological FDG uptake). The endpoints for comparison with the FDG uptake were either histological results or sonographic follow-up examinations of at least five years.
In 18/65 (28%) patients, PET/CT showed visually pathological FDG uptake in the suspicious thyroid nodules (SUVmax 7.1 ± 4.6). Of these nodules, 3/18 (17%) were sonographically categorized as TIRADS 4a, 11/18 (61%) nodules as TIRADS 4b, 3/18 (17%) nodules as TIRADS 4c, and 1/18 (6%) nodule as TIRADS 5. The other nodules without pathological FDG uptake were categorized as TIRADS 4a in 24/47 (51%) patients, as TIRADS 4b in 18/47 (38%), and as TIRADS 4c in 5/47 (11%) patients. Twenty-three patients (18 FDG positive, 5 FDG negative) underwent surgery. The other patients underwent follow-up examinations with stability on observation over at least five years as a surrogate endpoint. Taking into consideration that FDG-PET/CT was rated as true negative in 42/47 patients with stability on sonographic follow-up, sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET/CT in detecting malignancy in the suspicious thyroid nodules were 100%, 87%, 61%, and 100%, respectively.
FDG-PET/CT allows stratification of patients with sonographically suspicious and scintigraphically hypofunctional thyroid nodules with a positive predictive value of 61% and negative predictive value of 100%. The absence of visually pathological FDG uptake in suspicious thyroid nodules may be useful for avoiding unnecessary thyroid surgery.</abstract><cop>United States</cop><pmid>28793848</pmid><doi>10.1089/thy.2017.0026</doi><tpages>7</tpages></addata></record> |
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| ispartof | Thyroid (New York, N.Y.), 2017-10, Vol.27 (10), p.1300-1306 |
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| subjects | Aged Female Fluorodeoxyglucose F18 Humans Male Middle Aged Positron Emission Tomography Computed Tomography Retrospective Studies Thyroid Gland - diagnostic imaging Thyroid Gland - surgery Thyroid Neoplasms - diagnostic imaging Thyroid Neoplasms - surgery Thyroid Nodule - diagnostic imaging Thyroid Nodule - surgery Ultrasonography |
| title | 18 F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography May Exclude Malignancy in Sonographically Suspicious and Scintigraphically Hypofunctional Thyroid Nodules and Reduce Unnecessary Thyroid Surgeries |
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