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World Journal of Surgical Oncology

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Open Access 01-12-2015 | Research

SUVmax of ¹⁸F-FDG PET/CT in the differential diagnosis of benign and malignant thyroid nodules according to tumor volume

Authors: Tae Heon Kim, Yong Bae Ji, Chang Myeon Song, Ji Young Kim, Yun Young Choi, Jeong Seon Park, Kyung Tae

Published in: World Journal of Surgical Oncology | Issue 1/2015

Abstract

Background

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.

Methods

We 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.

Results

When 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 %.

Conclusions

¹⁸F-FDG PET/CT is limited as a primary modality in the differential diagnosis of benign and malignant thyroid nodules because of its low sensitivity.

Feine U, Lietzenmayer R, Hanke JP, Held J, Wohrle H, Muller-Schauenburg W. Fluorine-18-FDG and iodine-131-iodide uptake in thyroid cancer. J Nucl Med. 1996;37:1468–72.PubMed

Wang W, Macapinlac H, Larson SM, Yeh SD, Akhurst T, Finn RD, et al. [18F]2-Fluoro-2-deoxy-D glucose positron emission tomography localizes residual thyroid cancer in patients with negative diagnostic (131)I whole body scans and elevated serum thyroglobulin levels. J Clin Endocrinol Metab. 1999;84:2291–302.PubMedCrossRef

Dietlein M, Scheidhauer K, Voth E, Theissen P, Schicha H. Fluorine-18 fluorodeoxyglucose positron emission tomography and iodine-131 whole-body scintigraphy in the follow up of differentiated thyroid cancer. Eur J Nucl Med. 1997;24:1342–8.PubMedCrossRef

Kresnik E, Gallowitsch HJ, Mikosch P, Stettner H, Igerc I, Gomez I, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography in the preoperative assessment of thyroid nodules in an endemic goiter area. Surgery. 2003;133:294–9.PubMedCrossRef

Bloom AD, Adler LP, Shuck JM. Determination of malignancy of thyroid nodules with positron emission tomography. Surgery. 1993;114:728–34.PubMed

Mitchell JC, Grant F, Evenson AR, Parker JA, Hasselgren PO, Parangi S. Preoperative evaluation of thyroid nodules with ¹⁸FDG-PET/CT. Surgery. 2005;138:1166–74.PubMedCrossRef

Cohen MS, Arslan N, Dehdashti F, Doherty GM, Lairmore TC, Brunt LM, et al. Risk of malignancy in thyroid incidentalomas identified by fluorodeoxyglucose-positron emission tomography. Surgery. 2001;130:941–6.PubMedCrossRef

Kang KW, Kim SK, Kang HS, Lee ES, Sim JS, Lee IG, et al. Prevalence and risk of cancer of focal thyroid incidentaloma identified by 18-F-fluorodeoxyglucose positron emission tomography for metastasis evaluation and cancer screening in healthy subjects. J Clin Endocrinol Metab. 2003;88:4100–4.PubMedCrossRef

Choi JY, Lee KS, Kim HJ, Shim YM, Kwon OJ, Park K, et al. Focal thyroid lesions incidentally identified by integrated ¹⁸F-FDG PET/CT: clinical significance and improved characterization. J Nucl Med. 2006;47:609–15.PubMed

10.

Hoffman EJ, Huang SC, Phelps ME. Quantitation in positron emission computed tomography: 1. Effect of object size. J Comput Assist Tomogr. 1979;3:299–308.PubMedCrossRef

11.

Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, et al. Management of thyroid nodules detected at US: society of radiologists in ultrasound consensus conference statement. Radiology. 2005;237:794–800.PubMedCrossRef

12.

Kim EK, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR. 2002;178:687–91.PubMedCrossRef

13.

Regina CM, Gharib H. Continuing controversies in the management of thyroid nodules. Ann Intern Med. 2005;142:926–31.CrossRef

14.

Gardner HAR, Ducatman BS, Wang HH. Predictive value of fine-needle aspiration of the thyroid in the classification of follicular lesions. Cancer. 1993;71:2598–603.PubMedCrossRef

15.

Cibas ES, Ali SZNCI, Thyroid FNA. State of the Science Conference 2009: the Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132:658–65.PubMedCrossRef

16.

Kim JM, Ryu JS, Kim TY, Kim WB, Kwon GY, Gong G, et al. ¹⁸F-fluorodeoxyglucose positron emission tomography does not predict malignancy in thyroid nodules cytologically diagnosed as follicular neoplasm. J Clin Endocrinol Metab. 2007;92:1630–4.PubMedCrossRef

17.

Sebastianes FM, Cerci JJ, Zanoni PH, Soares Jr J, Chibana LK, Tomimori EK, et al. Role of ¹⁸F-fluorodeoxyglucose positron emission tomography in preoperative assessment of cytologically indeterminate thyroid nodules. J Clin Endocrinol Metab. 2007;92:4485–8.PubMedCrossRef

18.

Traugott AL, Dehdashti F, Trinkaus K, Cohen M, Fialkowski E, Quayle F, et al. Exclusion of malignancy in thyroid nodules with indeterminate fine-needle aspiration cytology after negative ¹⁸F-fluorodeoxyglucose positron emission tomography: interim analysis. World J Surg. 2010;34:1247–53.PubMedCentralPubMedCrossRef

19.

Deandreis D, Al Ghuzlan A, Auperin A, Vielh P, Caillou B, Chami L, et al. Is ¹⁸F-fluorodeoxyglucose-PET/CT useful for the presurgical characterization of thyroid nodules with indeterminate fine needle aspiration cytology? Thyroid. 2012;22:165–72.PubMedCrossRef

Title: SUVmax of 18F-FDG PET/CT in the differential diagnosis of benign and malignant thyroid nodules according to tumor volume
Authors: Tae Heon Kim
Yong Bae Ji
Chang Myeon Song
Ji Young Kim
Yun Young Choi
Jeong Seon Park
Kyung Tae
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2015
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-015-0635-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

SUVmax of ¹⁸F-FDG PET/CT in the differential diagnosis of benign and malignant thyroid nodules according to tumor volume

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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