title: Positron emission tomography thyroid incidentaloma: Is it different in Indian subcontinent?
abstract: BACKGROUND
  Positron emission tomography (PET) forms an integral part in work-up and follow-up of various malignancies. With the increased use of PET in oncology, finding of an incidental focal thyroid uptake (incidentaloma) is not unusual and presents a diagnostic challenge.
  
  
  OBJECTIVE
  The aim of the following study is to evaluate the frequency and radio-pathologic correlation of focal 18-fluoro deoxyglucose uptake (FDG) on PET within the thyroid from a large series.
  
  
  METHODS
  Retrospective review of 37,000 consecutive patients who underwent FDG-PET at tertiary cancer center in India. Radiological, pathological, PET scan and follow-up details were evaluated. Statistical analyzes were carried out using Mann Whitney test and Pearson correlation.
  
  
  RESULTS
  Abnormal thyroid uptake was seen in 78 (0.2%) patients. Nearly 61 (0.16%) scans had focal and 17 (0.04%) had diffuse FDG uptake. A total of 57 patients with focal uptake were available for further evaluation. No further evaluation was done in 24 (42.1%) patients who had advanced index malignancy. Of the remaining 33 patients 26 were benign and seven were a cause for concern (four primary thyroid cancers, one follicular neoplasm with hurthle cell change and two metastatic cancers). There was no significant correlation in Standardized uptake value (SUV) max of benign and malignant lesion (P = 0.5 on Mann Whitney) or size (r = 0.087 Pearson correlation co-efficient P= 0.667).
  
  
  CONCLUSIONS
  Incidence of PET incidentaloma is low in this large cohort of Indian patients. Nearly 27% of focal incidentaloma were malignant. There was no correlation between the SUVmax, size and malignancy.
authors.forename: R
authors.initials: R
authors.lastname: Vaish
authors.forename: R
authors.initials: R
authors.lastname: Venkatesh
authors.forename: D A
authors.initials: DA
authors.lastname: Chaukar
authors.forename: A D
authors.initials: AD
authors.lastname: Deshmukh
authors.forename: N C
authors.initials: NC
authors.lastname: Purandare
authors.affiliation: Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: A K
authors.initials: AK
authors.lastname: D'cruz
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods