Abstract
BackgroundIncidentally found thyroid lesions are frequently detected in patients undergoing FDG-PET/CT. The aim of this study was to investigate the prevalence of incidentally found thyroid lesions in patients undergoing FDG-PET/CT and determine the risk for thyroid cancer.MethodsFDG-PET/CT was performed on 3,379 patients for evaluation of suspected or known cancer or cancer screening without any history of thyroid cancer between November 2003 and December 2005. Medical records related to the FDG-PET/CT findings including maximum SUV(SUVmax) and pattern of FDG uptake, US findings, FNA, histopathology received by operation were reviewed retrospectively.ResultsTwo hundred eighty five patients (8.4%) were identified to have FDG uptake on FDG-PET/CT. 99 patients with focal or diffuse FDG uptake underwent further evaluation. The cancer risk of incidentally found thyroid lesions on FDG-PET/CT was 23.2% (22/99) and the cancer risks associated with focal and diffuse FDG uptake were 30.9% and 6.4%. There was a significant difference in the SUVmax between the benign and malignant nodules (3.35 ± 1.69 vs. 6.64 ± 4.12; P < 0.001). There was a significant correlation between the SUVmax and the size of the cancer.ConclusionThe results of this study suggest that incidentally found thyroid lesions by FDG-PET/CT, especially a focal FDG uptake and a high SUV, have a high risk of thyroid malignancy. Further diagnostic work-up is needed in these cases.
Highlights
Found thyroid lesions are frequently detected in patients undergoing FDG-Positron emission tomography (PET)/computed tomography (CT)
Incidentalomas of the thyroid are defined as thyroid lesions identified by radiological imaging, such as ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) for nonthyroid disease
The prevalence of incidentally found thyroid lesions on FDG-PET/CT was higher in women than in men (11.7% vs. 4.3%; odds ratio = 2.9, 95% CI 2.2–3.9, p < 0.0001)
Summary
Found thyroid lesions are frequently detected in patients undergoing FDG-PET/CT. The aim of this study was to investigate the prevalence of incidentally found thyroid lesions in patients undergoing FDG-PET/CT and determine the risk for thyroid cancer. Incidentalomas of the thyroid are defined as thyroid lesions identified by radiological imaging, such as ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) for nonthyroid disease [1,2]. While a number of incidentally found thyroid nodules have been identified, the risk of thyroid cancer in these nodules is not well known. Some studies have reported that the incidence of thyroid incidentalomas with increased FDG uptake is 1.2% – 2.3% on PET examinations [5,7,8,9]. The risk of malignancy in these studies ranged from 26.7% to 50%
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