Thyroid incidentalomas on fluorine-18-fluorodeoxyglucose positron emission tomography-computed tomography: incidence, malignancy risk, and comparison of standardized uptake values

Yung H Kao, Siew S Lim, Seng C Ong, Ajit K Padhy
Canadian Association of Radiologists Journal 2012, 63 (4): 289-93

INTRODUCTION: To determine the incidence of fluorine-18-fluorodeoxyglucose (FDG) avid thyroid incidentalomas detected on positron emission tomography (PET) with integrated computed tomography (CT), and correlate the FDG-PET-CT findings to cytology.

METHODS: A total of 942 FDG-PET-CT reports were retrospectively reviewed. Patients with FDG-avid thyroid incidentalomas were further reviewed for correlative cytology.

RESULTS: The incidence of FDG-avid thyroid incidentalomas is 2.2%. Thyroid malignancies were identified in 3 of 6 patients who underwent cytologic correlation, with a positive predictive value of 50% (95% confidence interval, 14%-86%). The mean maximum standardized uptake values of benign and malignant FDG-avid thyroid incidentalomas were 5.6 and 6.6, respectively.

CONCLUSION: A FDG-avid thyroid incidentaloma may predict underlying malignancy. Cytologic assessment should be considered for FDG-avid thyroid incidentalomas.

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