Literature DB >> 20140435

Exclusion of malignancy in thyroid nodules with indeterminate fine-needle aspiration cytology after negative 18F-fluorodeoxyglucose positron emission tomography: interim analysis.

Amber L Traugott1, Farrokh Dehdashti, Kathryn Trinkaus, Mark Cohen, Elizabeth Fialkowski, Frank Quayle, Hameda Hussain, Rosa Davila, Lourdes Ylagan, Jeffrey F Moley.   

Abstract

BACKGROUND: In all, 20% of fine-needle aspiration (FNA) biopsies of thyroid nodules have an indeterminate diagnosis; of these, 80% are found to be benign after thyroidectomy. Some previous reports indicate that positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) imaging may predict malignancy status. We now report results on the first 51 patients in the largest prospective study of FDG-PET in patients with an indeterminate thyroid nodule FNA.
METHODS: Eligible patients had a dominant thyroid nodule that was palpable or >or=1 cm in greatest dimension as seen by ultrasonography, and indeterminate histology of the FNA biopsy specimen. Participants underwent preoperative neck FDG-PET alone or FDG-PET with computed tomography (FDG-PET/CT). Images were evaluated qualitatively and semiquantitatively using the maximum standardized uptake value (SUV(max)). Final diagnosis was determined by histopathologic analysis after thyroidectomy. Descriptive statistical analysis was performed.
RESULTS: A total of 51 patients underwent preoperative FDG-PET or FDG-PET/CT. Studies without focally increased uptake localized to the lesion were considered negative. For all lesions (10 malignant, 41 benign), the sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV) were 80%, 61%, 33%, and 93%, respectively. Postoperatively, two malignant and six benign lesions were found to be <1 cm by pathology examination; one lesion was not measured. When these lesions were excluded, the sensitivity, specificity, PPV, and NPV were 100%, 59%, 36%, and 100%, respectively.
CONCLUSIONS: Based on these preliminary data, FDG-PET may have a role in excluding malignancy in thyroid nodules with an indeterminate FNA biopsy. This finding justifies ongoing accrual to our target population of 125 participants.

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Year:  2010        PMID: 20140435      PMCID: PMC3133809          DOI: 10.1007/s00268-010-0398-3

Source DB:  PubMed          Journal:  World J Surg        ISSN: 0364-2313            Impact factor:   3.352


  16 in total

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2.  Fluorine-18-fluorodeoxyglucose positron emission tomography in the preoperative assessment of thyroid nodules in an endemic goiter area.

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3.  Cervical cystic lymph node metastasis as first manifestation of occult papillary thyroid carcinoma: report of seven cases.

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4.  Papillary microcarcinoma of the thyroid-Prognostic significance of lymph node metastasis and multifocality.

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Journal:  Cancer       Date:  2003-07-01       Impact factor: 6.860

5.  Preoperative FDG-PET imaging to assess the malignant potential of follicular neoplasms of the thyroid.

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6.  Microcarcinoma of the thyroid gland: the Gustave-Roussy Institute experience.

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8.  Role of 18F-fluorodeoxyglucose positron emission tomography in preoperative assessment of cytologically indeterminate thyroid nodules.

Authors:  Fernando M Sebastianes; Juliano J Cerci; Patricia H Zanoni; José Soares; Lilian K Chibana; Eduardo K Tomimori; Rosalinda Y A de Camargo; Marisa Izaki; Maria Clementina P Giorgi; José Eluf-Neto; José Cláudio Meneghetti; Maria Adelaide A Pereira
Journal:  J Clin Endocrinol Metab       Date:  2007-08-07       Impact factor: 5.958

9.  Is there a role for fluorodeoxyglucose positron emission tomography/computed tomography in cytologically indeterminate thyroid nodules?

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  19 in total

1.  Possible role of F18-FDG-PET/CT in differentiating benign lesions versus malignant after indeterminate fine-needle aspiration cytology. a wider and still controversial issue: exclusion of malignancy in thyroid nodules with indeterminate fine-needle aspiration cytology after negative 18F-fluorodeoxyglucose positron emission tomography: interim analysis.

Authors:  Francesco Bertagna; Raffaele Giubbini
Journal:  World J Surg       Date:  2011-05       Impact factor: 3.352

2.  Predictive value of intratumoral heterogeneity of F-18 FDG uptake for characterization of thyroid nodules according to Bethesda categories of fine needle aspiration biopsy results.

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6.  Could 18F-FDG-PET/CT avoid unnecessary thyroidectomies in patients with cytological diagnosis of follicular neoplasm?

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Review 7.  The role of 18F-fluorodeoxyglucose positron emission tomography in thyroid neoplasms.

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9.  PET/CT and prediction of thyroid cancer in patients with follicular neoplasm or atypia.

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10.  F18-FDG-PET/CT thyroid incidentalomas: a wide retrospective analysis in three Italian centres on the significance of focal uptake and SUV value.

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