Clinical Meaning of Incidental Thyroid Uptake on F-18 FDG PET-CT

PET-CT상 우연히 발견된 갑상선 병변의 임상적 의미

  • Hahm, Jong-Ryeal (Department of Internal Medicine and Institute of Health Science, Gyeongsang National University School of Medicine)
  • 함종열 (경상대학교 의과대학 내과학교실)
  • Published : 2011.11.01

Abstract

Thyroid nodular lesions and thyroiditis are commonly observed in population over thirties. Since the whole-body F18-fluorodeoxyglucose positron emission tomography (PET-CT) system is widely utilized in clinical application, the detection of incidental thyroid uptake has increased significantly. Unexpected thyroid uptake on PET-CT can be divided into three distinguishable patterns: focal, diffuse, or diffuse plus focal. Focal uptake, incidentaloma, is clinically significant because of its high risk of malignancy at the range of 25-50%. Therefore, the cytologic diagnosis should be additionally performed in these patients. Diffuse pattern of thyroid uptake is very likely secondary to thyroiditis and/or hypothyroidism. Although the clinical meaning of diffuse plus focal uptake of thyroid observed on PET-CT is not clear, the risk of malignancy was increased when it compared with diffuse uptake pattern only. However, further evaluation is required to define its clinical significance.

Keywords

References

  1. Liu Y. Clinical significance of thyroid uptake on F18- fluorodeoxyglucose positron emission tomography. Ann Nucl Med 2009;23:17-23. https://doi.org/10.1007/s12149-008-0198-0
  2. Kwak JY, Kim EK, Yun M, et al. Thyroid incidentalomas identified by F18-FDG PET: sonographic correlation. AJR Am J Roentgenol 2008;191:598-603. https://doi.org/10.2214/AJR.07.3443
  3. Are C, Hsu JF, Schoder H, Shah JP, Larson SM, Shaha AR. FDG-PET detected thyroid incidentalomas: need for further investigation? Ann Surg Oncol 2007;14:239-247.
  4. Sebastianes FM, Cerci JJ, Zanoni PH, et al. Role of 18Ffluorodeoxyglucose positron emission tomography in preoperative assessment of cytologically indeterminate thyroid nodules. J Clin Endocrinol Metab 2007;92:4485-4488. https://doi.org/10.1210/jc.2007-1043
  5. Yasuda S, Shohtsu A, Ide M, et al. Chronic thyroiditis: diffuse uptake of FDG at PET. Radiology 1998;207:775-778.
  6. Karantanis D, Bogsrud TV, Wiseman GA, et al. Clinical significance of diffusely increased 18F-FDG uptake in the thyroid gland. J Nucl Med 2007;48:896-901. https://doi.org/10.2967/jnumed.106.039024
  7. Chen YK, Chen YL, Cheng RH, Yeh CL, Lee CC, Hsu CH. The significance of FDG uptake in bilateral thyroid glands. Nucl Med Commun 2007;28:117-122. https://doi.org/10.1097/MNM.0b013e328013eaf7
  8. Kim HK, Yoon JH, Kim SJ, Kang HC. Clinical meaning of diffuse $^{18}F$-FDG at PET thyroid uptake. Korean J Med 2011;81:595-601.
  9. Kurata S, Ishibashi M, Hirromatsu Y, et al. Diffuse and diffuse-plus-focal uptake in the thyroid gland identified by using FDG-PET: prevalence of thyroid cancer and Hashimoto"s thyroiditis. Ann Nucl Med 2007;21:325-330. https://doi.org/10.1007/s12149-007-0030-2