Article

Thyroid incidentalomas identified by 18F-FDG PET: sonographic correlation.

Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 250 Seongsanno (134 Sinchon-dong), Seodaemun-gu, Seoul 120-752, Korea.
American Journal of Roentgenology (impact factor: 2.78). 08/2008; 191(2):598-603. DOI:10.2214/AJR.07.3443 pp.598-603
Source: PubMed

ABSTRACT The purpose of this study was to evaluate the risk of malignancy of thyroid incidentalomas detected on (18)F-FDG PET and the diagnostic accuracy of sonography for differentiating benign from malignant focal thyroid incidentalomas that were detected on FDG PET.
Retrospective review was performed of a database of 87 focal thyroid lesions seen on FDG PET and sonography. Forty-two focal lesions were malignant. We compared the accuracy of the maximum standard uptake value (SUV) to differentiate benign from malignant thyroid lesions. We classified the thyroid nodules as probably benign or suspicious for malignancy by the sonographic features. Statistical analyses compared two subgroups by sonographic classifications between benign and malignant thyroid lesions.
The maximum SUV of the malignant nodules was not significantly higher than that of benign lesions. Thirty-seven (75.5%) of 49 lesions with suspicious sonographic findings revealed malignancy on cytopathology, compared with five (13.2%) of 38 lesions that showed probably benign sonographic findings. These differences were statistically significant using a kappa test (kappa = 0.675, p = 0.001) and logistic regression (odds ratio = 26.2, p = 0.001).
The probability (48.3%) of malignancy of focal thyroid incidentalomas seen on FDG PET is high. The maximum SUV of thyroid cancer is not significantly higher than that of benign lesions. The probability (13.2%) of malignancy is much lower when the sonographic findings appear benign, as compared with a significantly higher probability (75.5%) of malignancy when the sonographic findings are suspicious for malignancy.

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Keywords

38 lesions
 
49 lesions
 
87 focal thyroid lesions
 
benign lesions
 
benign sonographic findings
 
diagnostic accuracy
 
differentiate benign
 
focal lesions
 
focal thyroid incidentalomas
 
higher probability
 
logistic regression
 
malignant focal thyroid incidentalomas
 
malignant nodules
 
malignant thyroid lesions
 
maximum standard uptake value
 
maximum SUV
 
odds ratio
 
sonographic findings
 
suspicious sonographic findings
 
thyroid nodules
 

Jin Young Kwak