[Preoperative evaluation of cytologically indeterminate thyroid nodules with 18F-FDG PET].
The aim of this article is to discuss the role of 18F-FDG Positron Emission Tomography (PET) in the preoperative evaluation of patients with cytologically indeterminate thyroid nodules. All studies with patients with thyroid cancer were selected to the calculation of sensitivity. Only studies aiming to evaluate patients with thyroid nodules whose cytological result was indeterminate were selected to establish the specificity. The finding of focal 18F-FDG uptake at PET was associated with the presence of thyroid malignancy in most of the studies. The sensitivity of the exam to the detection of thyroid malignancy was extremely high, but the specificity varied from 0 to 66%. In our experience, the specificity was 39%. In conclusion, the studies suggest that 18F-FDG PET can reduce the number of unnecessary thyroidectomies performed in patients with cytologically indeterminate thyroid nodules. However, the relatively high percentage of false positive results, the high costs, the low availability of this exam in developing countries and the low clinical experience still restrict the use of 18F-FDG PET when recommended with this aim.
Sebastianes
Fernando M
FM
Divisão de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil. fernandosebastianes@gmail.com
Cerci
Juliano J
JJ
Soares Júnior
José
J
Zanoni
Patrícia H
PH
Tomimori
Eduardo K
EK
Camargo
Rosalinda Y A de
RY
Meneghetti
José Cláudio
JC
Pereira
Maria Adelaide A
MA
D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D019788:Fluorodeoxyglucose F18; D006801:Humans; D049268:Positron-Emission Tomography / Q000379:methods*; D011300:Preoperative Care; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000601:surgery; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18