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The significance and management of incidental [18f]fluorodeoxyglucose–positron-emission tomography uptake in the thyroid gland in patients with cancer
American Journal of Neuroradiology, 04/07/09

Eloy JA et al. - In a study to determine the significance of incidental fluorodeoxyglucose (FDG) uptake in the thyroid gland on [18F]FDG–positron-emission tomography (FDG-PET/CT) in pts being initially staged for lymphomas and/or cancers other than of thyroid origin, it was found that incidental FDG-PET uptake in these pts is associated with a 27.8% risk for well-differentiated thyroid carcinoma; however, there seems to be no correlation between intensity of FDG uptake and risk for a malignant process.

Methods

A retrospective review was conducted on pts who were incidentally found to have focal FDG uptake in the thyroid bed on initial staging for cancer.
Pt records were assessed for age, sex, clinical presentation, standard uptake values (SUVmax), on FDG-PET/CT, and CT findings in those pts undergoing FDG-PET/CT, fine-needle aspiration (FNA) cytology, and surgical pathologic examination.

Results

30 pts were identified with incidental FDG-PET uptake in the thyroid bed from 630 studies performed for evaluation of cancer.
Complete records were available for 18 pts (6 men, 12 women).
5 (27.8%) of 18 pts with incidental focal FDG-PET/CT uptake in the thyroid gland demonstrated papillary thyroid carcinoma on final pathologic findings.
Mean and SD of SUVmax was 3.0 ± 1.8 overall, 2.9 ± 1.6 in pts without malignant growth, and 3.4 ± 2.6 in 5 pts with papillary thyroid carcinoma.
No statistical difference in SUVmax was noted between pts with papillary thyroid carcinoma and pts with benign pathologic findings.

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