Abstract
Background: We performed a systematic review of the literature to provide an overview of the application of PET-based radiomics of [18F]FDG-avid thyroid incidentalomas and to discuss the additional value of PET volumetric parameters and radiomic features over clinical data. Methods: The most relevant databases were explored using an algorithm constructed based on a combination of terms related to our subject and English-language articles published until October 2021 were considered. Among the 247 identified articles, 19 studies were screened for eligibility and 11 met the criteria, with 4 studies including radiomics analyses. Results: We summarized the available literature based on a study of PET volumetric parameters and radiomics. Ten articles provided accurate details about volumetric parameters and their prospective value in tumour assessment. We included the data provided by these articles in a sub-analysis, but could not obtain statistically relevant results. Four publications analyzed the diagnostic potential of radiomics and the possibility of creating precise predictive models, their corresponding quality score being assessed. Conclusions: The use of PET volumetric parameters and radiomics analysis in patients with [18F]FDG-avid thyroid incidentalomas outlines a great prospect in diagnosis and stratification of patients with malignant nodules and may represent a way of limiting the need for unnecessary invasive procedures; however, further studies need to be performed for a standardization of the method.
Highlights
Our review is aimed at describing the utility of a correlation between PET/CT volumetric parameters and radiomics features, with the objective of creating an algorithm that could be introduced in routine medical practice and may have an impact on patient management in the near future; we focused our research on studies performed in clinical settings
The results showed that the SUVmax, MTV and total lesion glycolysis (TLG) measured by 18 F-FDG PET/CT were significantly associated with lateral lymph node metastases (LNM) in patients with incidentally detected malignant nodules, with a higher predictive value of MTV and TLG in comparison to the one of SUVmax
The results revealed that SUVmax and TLG could be useful in determining the risk of malignancy in nodules with FNAB indication based on EU-TIRADS
Summary
We performed a systematic review of the literature to provide an overview of the application of PET-based radiomics of [18 F]FDG-avid thyroid incidentalomas and to discuss the additional value of PET volumetric parameters and radiomic features over clinical data. Results: We summarized the available literature based on a study of PET volumetric parameters and radiomics. Conclusions: The use of PET volumetric parameters and radiomics analysis in patients with [18 F]FDG-avid thyroid incidentalomas outlines a great prospect in diagnosis and stratification of patients with malignant nodules and may represent a way of limiting the need for unnecessary invasive procedures; further studies need to be performed for a standardization of the method
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