title: Incidental ¹⁸F-FDG uptake in the thyroid in patients diagnosed with PET/CT for other malignancies.
abstract: BACKGROUND
  The value of PET/CT imaging in diagnosis of different cancers has been widely described. PET/CT may contribute to visualization of additional findings that were not the indication to the study and did not refer to initial diagnosis. In a small number of PET/CT scans an incidentally found focal ¹⁸F-FDG uptake in the thyroid gland is found. The goal of the study was to estimate the prevalence and evaluate the clinical significance of incidental thyroid ¹⁸F-FDG uptake in a cohort of patients diagnosed for different malignancies.
  
  
  METHODS
  2478 PET/CT scans using ¹⁸F-FDG were performed in 1925 subjects for evaluation of different, non-thyroid malignancies. For PET/CT examination, a Discovery ST (General Electric) PET/CT scanner was used. Patients with focal ¹⁸F-FDG activity were further evaluated by means of fine needle aspiration biopsy (FNAB). If cytological examination disclosed malignancy or suspicion of malignancy, thyroidectomy was performed. Both cytological and histopathological results were then analyzed.
  
  
  RESULTS
  Focal increased ¹⁸F-FDG uptake was found in 71 patients (3.7%), and cytological or histopathological results were evaluable in 20 of them. In general, 8 cases of thyroid cancer were found, which accounts for 40% probability of malignancy. The predominant histopathological diagnosis was papillary thyroid carcinoma (5 out of 8 cases). Additionally, in one case (5%) thyroid metastasis of lung cancer was detected. Diffused ¹⁸F-FDG activity in both thyroid lobes was observed in 120 subjects (6.2%)--in most cases chronic thyroiditis was confirmed.
  
  
  CONCLUSIONS
  The probability of malignancy of focal thyroid incidentalomas in ¹⁸F-FDG PET/CT scans is rather high. Therefore, thorough evaluation of such lesions is highly recommended in each case. Most thyroid malignancies incidentally detected in PET/CT are papillary carcinomas.
authors.affiliation: Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland. rafal.czepczynski@euromedic.pl
authors.forename: Rafał
authors.initials: R
authors.lastname: Czepczyński
authors.forename: Adam
authors.initials: A
authors.lastname: Stangierski
authors.forename: Robert
authors.initials: R
authors.lastname: Oleksa
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Janicka-Jedyńska
authors.forename: Agata
authors.initials: A
authors.lastname: Czarnywojtek
authors.forename: Marek
authors.initials: M
authors.lastname: Ruchała
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sowiński
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D033162:Incidental Findings; D007223:Infant; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18