Incidental Thyroid Carcinoma by FDG-PET/CT: a Study of Clinicopathological Characteristics

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 2010 Aug 27

PMID 20740320

Citations 6

Authors

T T Law

Brian Hung-Hin Lang

Affiliations

Soon will be listed here.

Abstract

Background: The rising incidence of incidental thyroid carcinoma (ITC) detected during fluoro-2-deoxy-D: -glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) scanning poses a challenge to clinicians. The present study aims to critically evaluate the clinicopathological characteristics of ITC detected by FDG-PET/CT.

Methods: Among the 557 patients managed at our institution, 40 (7.2%) patients were identified as having ITC. Of these, 22 patients had their tumor detected by FDG-PET/CT (PET group) and 11 by ultrasonography (USG group). Additional bedside ultrasonography ± fine-needle aspiration (FNA) was done in all patients at their clinic visit. The clinicopathological characteristics were compared between the PET and USG groups.

Results: The PET group had significantly more patients with history of nonthyroidal malignancy (P < 0.001). Papillary carcinoma was the most common histological type in both groups. Despite having similar histological and prognostic features including tumor size, tumor multifocality, capsular invasion, extrathyroidal extension, and lymph node metastases, tumor bilaterality (or presence of contralateral tumor focus) was significantly more frequent in the PET than the USG group (P = 0.04). The tumors were also more advanced by the tumor-node-metastasis (TNM) staging system in the PET group (P = 0.021). None of the contralateral tumor foci were evident preoperatively. One patient in the USG group developed metastatic thyroid carcinoma in neck lymph nodes 28 months after thyroid resection.

Conclusion: ITC by FDG-PET/CT had higher incidence of tumor bilaterality than those detected by ultrasonography. Total thyroidectomy should be considered for ITC detected by FDG-PET/CT even for tumor size <10 mm.

Citing Articles

Definitions of Incidental [F]FDG PET/CT Findings in the Literature: A Systematic Review and Definition Proposal.

Molstrom J, Lange N, Pareek M, Thomassen A, Nielsen A, Hoilund-Carlsen P Diagnostics (Basel). 2024; 14(23).

PMID: 39682672 PMC: 11639948. DOI: 10.3390/diagnostics14232764.

Diagnostic accuracy of single-source dual-energy computed tomography and ultrasonography for detection of lateral cervical lymph node metastases of papillary thyroid carcinoma.

Li L, Cheng S, Zhao Y, Wang X, Luo D, Wang Y J Thorac Dis. 2020; 11(12):5032-5041.

PMID: 32030219 PMC: 6988027. DOI: 10.21037/jtd.2019.12.45.

Risk stratification of 282 differentiated thyroid cancers found incidentally in 1369 total thyroidectomies according to the 2015 ATA guidelines; implications for management and treatment.

Christakis I, Dimas S, Kafetzis I, Roukounakis N Ann R Coll Surg Engl. 2018; 100(5):357-365.

PMID: 29484944 PMC: 5956592. DOI: 10.1308/rcsann.2018.0017.

Differentiated thyroid cancer incidentally detected by ¹⁸F-FDG PET/CT: patient's future in a hot-spot?.

Morbelli S, Bagnasco M Eur J Nucl Med Mol Imaging. 2014; 41(8):1479-81.

PMID: 24824461 DOI: 10.1007/s00259-014-2794-7.

The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography in the Prognostication, Diagnosis, and Management of Thyroid Carcinoma.

Lang B J Thyroid Res. 2011; 2012:198313.

PMID: 22007340 PMC: 3189566. DOI: 10.1155/2012/198313.

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