Incidental thyroid lesions detected by FDG-PET/CT: prevalence and risk of thyroid cancer.
BACKGROUND
Incidentally found thyroid lesions are frequently detected in patients undergoing FDG-PET/CT. The aim of this study was to investigate the prevalence of incidentally found thyroid lesions in patients undergoing FDG-PET/CT and determine the risk for thyroid cancer.


METHODS
FDG-PET/CT was performed on 3,379 patients for evaluation of suspected or known cancer or cancer screening without any history of thyroid cancer between November 2003 and December 2005. Medical records related to the FDG-PET/CT findings including maximum SUV(SUVmax) and pattern of FDG uptake, US findings, FNA, histopathology received by operation were reviewed retrospectively.


RESULTS
Two hundred eighty five patients (8.4%) were identified to have FDG uptake on FDG-PET/CT. 99 patients with focal or diffuse FDG uptake underwent further evaluation. The cancer risk of incidentally found thyroid lesions on FDG-PET/CT was 23.2% (22/99) and the cancer risks associated with focal and diffuse FDG uptake were 30.9% and 6.4%. There was a significant difference in the SUVmax between the benign and malignant nodules (3.35 +/- 1.69 vs. 6.64 +/- 4.12; P < 0.001). There was a significant correlation between the SUVmax and the size of the cancer.


CONCLUSIONS
The results of this study suggest that incidentally found thyroid lesions by FDG-PET/CT, especially a focal FDG uptake and a high SUV, have a high risk of thyroid malignancy. Further diagnostic work-up is needed in these cases.
Bae
Ja Seong
JS
Department of Surgery, The Catholic University of Korea, Seoul, Korea. drbae@catholic.ac.kr
Chae
Byung Joo
BJ
Park
Woo Chan
WC
Kim
Jeong Soo
JS
Kim
Sung Hoon
SH
Jung
Sang Seol
SS
Song
Byung Joo
BJ
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods*
D019788:Fluorodeoxyglucose F18