title: Thyroid incidentalomas on PET imaging--evaluation of management and clinical outcomes.
abstract: OBJECTIVE
  1. To determine the incidence of 'thyroid incidentaloma' in patients undergoing PET/CT in Sheffield. 2. To assess the distribution of cancer type, stage and short term outcomes of incidentally detected thyroid cancer in this cohort.
  
  
  METHODS
  Patients with an unexpected thyroid radio-isotope uptake on reports of whole body nuclear imaging performed in Sheffield Teaching Hospitals NHS Foundation Trust for 'non-thyroid' indications from April 2008 to March 2011 were identified. Patients who have undergone PET imaging were then selected. The management, clinical and pathology details and short term 'thyroid-related' outcomes of patients with thyroid incidentaloma on PET scans were analysed.
  
  
  RESULTS
  1730 PET nuclear imaging studies were performed in this period. Thyroid incidentalomas were detected in 65 (3.8%)of these scans. Two thyroid cancers were detected in this cohort, both demonstrated focal uptake on the PET scan. Histology showed papillary thyroid cancer (TNM classification; pT1N1Mx and pT1bNxMx).
  
  
  CONCLUSIONS
  The risk of cancer in PET detected thyroid incidentaloma in this series (3%) is low compared to published literature (5-50%). Potential reasons are discussed. The low rate of thyroid cancer in our incidentaloma cohort will influence decision making regarding management of these lesions. Only two thyroid cancers were detected in our cohort, limiting the narrative on type, stage of PET detected thyroid cancer and outcomes. Further observational research is required to study the natural history of these lesions in settings where there is a clear protocol for imaging, biopsy and treatment.
authors: Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK. Electronic address: Redelmo_81@yahoo.com.
authors: Sahar
authors: S
authors: Elzein
authors: Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK.
authors: Abdulkhaled
authors: A
authors: Ahmed
authors: Department of Medical Imaging and Medical Physics, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK.
authors: Eleanor
authors: E
authors: Lorenz
authors: Department of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK.
authors: Sabapathy Prakash
authors: SP
authors: Balasubramanian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: Incidentaloma; Nuclear imaging; PET CT; Thyroid