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The Medical Journal of Cairo University
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Volume Volume 88 (2020)
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Volume Volume 87 (2019)
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AYMAN M.A. OSMAN, M.D., M.R.C.S., D. (2020). Fluorine-18-Fluorodeoxyglucose-Avid Thyroid Incidentalomas on Positron Emission Tomography/Computed Tomography in Patients with Non-Thyroid Malignancy: Incidence and Possible Nature. The Medical Journal of Cairo University, 88(December), 2131-2138. doi: 10.21608/mjcu.2020.125163
DALIA K. SEROUR, M.D.; AYMAN M.A. OSMAN, M.D., M.R.C.S.. "Fluorine-18-Fluorodeoxyglucose-Avid Thyroid Incidentalomas on Positron Emission Tomography/Computed Tomography in Patients with Non-Thyroid Malignancy: Incidence and Possible Nature". The Medical Journal of Cairo University, 88, December, 2020, 2131-2138. doi: 10.21608/mjcu.2020.125163
AYMAN M.A. OSMAN, M.D., M.R.C.S., D. (2020). 'Fluorine-18-Fluorodeoxyglucose-Avid Thyroid Incidentalomas on Positron Emission Tomography/Computed Tomography in Patients with Non-Thyroid Malignancy: Incidence and Possible Nature', The Medical Journal of Cairo University, 88(December), pp. 2131-2138. doi: 10.21608/mjcu.2020.125163
AYMAN M.A. OSMAN, M.D., M.R.C.S., D. Fluorine-18-Fluorodeoxyglucose-Avid Thyroid Incidentalomas on Positron Emission Tomography/Computed Tomography in Patients with Non-Thyroid Malignancy: Incidence and Possible Nature. The Medical Journal of Cairo University, 2020; 88(December): 2131-2138. doi: 10.21608/mjcu.2020.125163

Fluorine-18-Fluorodeoxyglucose-Avid Thyroid Incidentalomas on Positron Emission Tomography/Computed Tomography in Patients with Non-Thyroid Malignancy: Incidence and Possible Nature

Article 19, Volume 88, December, December 2020, Page 2131-2138  XML PDF (127.28 K)
Document Type: Original Article
DOI: 10.21608/mjcu.2020.125163
Author
DALIA K. SEROUR, M.D.; AYMAN M.A. OSMAN, M.D., M.R.C.S.
The Departments of Diagnostic & Interventional Radiology* and General Surgery**, Faculty of Medicine, Cairo University, Egypt
Abstract
Abstract Background: Incidental thyroid lesions carry the risk of being malignant. Hence, they present a potential challenge for clinicians that necessitates careful management. Aim of Study: The aim of this retrospective cohort study was to assess the thyroid incidentalomas detected on fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/ Computed Tomography (18F-FDG PET/CT), as well as to determine a maximal standardized uptake value (SUVmax) cutoff that could potentially help in the diagnostic process. Patients and Methods: Medical records of 1526 patients who performed 18F-FDG PET/CT as part of the diagnostic work up for non-thyroid malignancy were retrospectively reviewed. Patients with thyroid incidentalomas who fulfilled the eligibility criteria were enrolled into the study. The SUV-max of the lesions and the results of histopathological exam-ination were recorded. Receiver-Operating Characteristic (ROC) curve analysis was carried out. Results: Thyroid incidentalomas were detected in 112/1526 patients (7.3%). Of those, only 46 patients (41%) fulfilled the eligibilty criteria. Histopathological examinations [FNAC (n=46), surgery (n=19)] revealed that 11/46 lesions (23.9%) were malignant, whereas 35/46 lesions (76.1%) were benign. The mean SUVmax of malignant lesions (7.05±1.51) was significantly higher than that of benign lesions (3.18±1.74); p=0.001. An SUVmax cutoff value of 5.5 was the most accurate for discriminating between benign and malignant incidenta-lomas, with 90.91% sensitivity and 82.86% specificity; p=0.001. Conclusion: The incidence of 18F-FDG-avid thyroid incidentalomas is relatively high among patients who undergo PET/CT as part of the diagnostic work up for non-thyroid malignancy. The SUVmax values are higher in malignant incidentalomas, yet with a noticeable overlap in the values between benign and malignant lesions. An SUVmax cutoff value of 5.5 can potentially be utilized to predict the nature of incidental thyroid lesions.

Keywords
Incidental thyroid lesions; Thyroid incidentalomas; Positron emission tomography/computed tomog-raphy; Maximal standardized uptake value; Cutoff value
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