JOURNAL ARTICLE

Diagnostic value of metabolic tumor volume assessed by 18F-FDG PET/CT added to SUVmax for characterization of thyroid 18F-FDG incidentaloma

Bo Hyun Kim, Seong-Jang Kim, Heeyoung Kim, Yun Kyung Jeon, Sang Soo Kim, In Joo Kim, Yong Ki Kim
Nuclear Medicine Communications 2013, 34 (9): 868-76
23797273

BACKGROUND: The objective of the study was to investigate whether metabolic tumor volume (MTV) measured by fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (PET/CT) after stratification of serum thyroid stimulating hormone (TSH) levels could predict malignancy in patients with thyroid F-FDG incidentaloma.

MATERIALS AND METHODS: A total 262 patients with focal thyroid F-FDG incidentaloma undergoing cancer evaluation for nonthyroid cancer or a health checkup were enrolled in this study. We retrospectively evaluated the relationship of the maximum standardized uptake value (SUVmax) and MTV in the prediction of malignant thyroid F-FDG incidentaloma.

RESULTS: The prevalence of malignancy was 20.9% (37/177). Malignant thyroid incidentaloma had a statistically significant higher value of SUVmax (malignant: median 4.6, range 1.9-34.9; benign: median 4.1, range 0-28; P=0.030). The value of MTV4 in malignant thyroid incidentaloma was significantly higher than that of benign thyroid incidentaloma (malignant: median 0.16, range 0.02-1.19; benign: median 0.10, range 0-0.65; P=0.032). However, the values of MTV3.5, MTV3, and MTV2.5 did not differ significantly between the groups. After stratification of serum TSH levels (an SUVmax>5 was used as the cutoff point) the sensitivity and specificity for prediction of malignancy were found to be 61.1% [95% confidence interval (CI): 35.7-82.7%] and 68.7% (95% CI: 56.2-79.4%), respectively. The area under the curve (AUC) was 0.655 (95% CI: 0.545-0.755; P=0.0239). When MTV4 greater than 0.07 cm was used as the cutoff point, the sensitivity and specificity for prediction of malignancy were 81.2% (95% CI: 54.4-96.0%) and 50.0% (95% CI: 37.0-63.0%), respectively. The AUC was 0.650 (95% CI: 0.534-0.755; P=0.0451). On comparison receiver operating characteristic curve analysis, no significant difference was found between SUVmax and MTV4 in the prediction of thyroid carcinoma (P=0.4346). However, a combination of SUVmax and MTV4 resulted in an AUC of 0.669 (95% CI: 0.554-0.772; P=0.0183).

CONCLUSION: The SUVmax and MTV4 measured by F-FDG PET/CT after stratification of serum TSH levels could predict thyroid cancer in patients with thyroid F-FDG incidentaloma. A combination of SUVmax and MTV4 may be more useful for the differentiation of malignant from benign thyroid incidentaloma.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23797273
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"