Abstract
BackgroundThe aim of this study was to investigate whether the maximum standardized uptake value (SUVmax) measured on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) could be used as the primary means of differential diagnosis of thyroid nodules when tumor volume is assessed.MethodsWe studied 192 patients who underwent preoperative 18F-FDG PET/CT followed by thyroidectomy. We evaluated the correlation between the volume of thyroid nodules, 18F-FDG uptake on visual analysis, and the mean SUVmax measured on 18F-FDG PET/CT.ResultsWhen stratified by tumor volume, the mean SUVmax was higher in malignant than in benign nodules in nodules ≥1 cm3 (p < 0.001). However, it did not differ between benign and malignant nodules smaller than 1 cm3. At a cut-off value of SUVmax of 6, the respective sensitivities of 18F-FDG PET/CT, ultrasonography, and fine needle aspiration cytology were 60.8, 96.4, and 99.1 %, and the respective specificities were 95.9, 98.2, and 96.8 %.Conclusions18F-FDG PET/CT is limited as a primary modality in the differential diagnosis of benign and malignant thyroid nodules because of its low sensitivity.
Highlights
The aim of this study was to investigate whether the maximum standardized uptake value (SUVmax) measured on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) could be used as the primary means of differential diagnosis of thyroid nodules when tumor volume is assessed
The mean SUVmax was significantly higher in malignant than in benign nodules (5.11 ± 0.49 vs. 2.32 ± 0.25; p < 0.001)
The SUVmax of 18F-FDG PET/CT might be useful in the differential diagnosis of thyroid nodule detected incidentally by 18F-FDG PET/CT scan which was performed for the purpose of routine health examination or evaluation of metastasis from other malignancy
Summary
The aim of this study was to investigate whether the maximum standardized uptake value (SUVmax) measured on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) could be used as the primary means of differential diagnosis of thyroid nodules when tumor volume is assessed. There is a paucity of data regarding the role of 18F-FDG PET/CT in the differential diagnosis of thyroid nodules; the few studies that exist were conducted in small series of patients [4,5,6] or in patients whose nodules were identified incidentally during routine health checks [7–9] While these studies estimated the mean maximum standardized uptake value (SUVmax) of 18F-FDG, they failed to consider the effect of nodule size. Other studies have enrolled patients with metastatic thyroid cancer or those with diffuse thyroid uptake of 18F-FDG
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