Jung Hyun Yoon1, Arthur Cho2, Hye Sun Lee3, Eun-Kyung Kim1, Hee Jung Moon1, Jin Young Kwak4. 1. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea. 2. Department of Nuclear Medicine, Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea. 3. Biostatistics Collaboration Unit, Medical Research Center, Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea. 4. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea. Electronic address: docjin@yuhs.ac.
Abstract
BACKGROUND: Our aim was to evaluate the role of the Thyroid Imaging Reporting and Data System (TIRADS) in the risk stratification of thyroid incidentalomas detected on (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG-PET/CT) scans. METHODS: Eighty-seven thyroid nodules in 84 patients showing incidentally detected increased uptake on (18)F-FDG-PET/CT who also had ultrasonography (US)-guided fine needle aspiration performed were included. On review of the US images, a TIRADS category was assigned to each thyroid nodule based on the number of suspicious US features. The correlation between the TIRADS category and the standard uptake values (SUV) on (18)F-FDG-PET/CT were calculated and compared. RESULTS: Of the 87 thyroid nodules, 47 (54%) were benign, and 40 (46%) were malignant. The malignancy rate of the TIRADS categories were as follows: 9% for category 3, 15% for category 4a, 39% for category 4b, 72% for category 4c, and 100.0% for category 5. Combining the TIRADS with the SUV showed increased specificity and positive predictive value but decreased sensitivity and negative predictive value compared with TIRADS alone (all P < .05). The area under the receiver operating characteristics curve value of TIRADS was the greatest, comparable with the combined TIRADS and SUV (0.737 to 0.724, P = .788). CONCLUSION: TIRADS may be applied in the risk stratification of thyroid incidentalomas detected on (18)F-FDG-PET/CT. Considering the high malignancy rate of thyroid incidentalomas showing increased (18)F-FDG uptake, ultrasonography-guided fine needle aspiration is mandatory even if there are no suspicious features present on US.
BACKGROUND: Our aim was to evaluate the role of the Thyroid Imaging Reporting and Data System (TIRADS) in the risk stratification of thyroid incidentalomas detected on (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG-PET/CT) scans. METHODS: Eighty-seven thyroid nodules in 84 patients showing incidentally detected increased uptake on (18)F-FDG-PET/CT who also had ultrasonography (US)-guided fine needle aspiration performed were included. On review of the US images, a TIRADS category was assigned to each thyroid nodule based on the number of suspicious US features. The correlation between the TIRADS category and the standard uptake values (SUV) on (18)F-FDG-PET/CT were calculated and compared. RESULTS: Of the 87 thyroid nodules, 47 (54%) were benign, and 40 (46%) were malignant. The malignancy rate of the TIRADS categories were as follows: 9% for category 3, 15% for category 4a, 39% for category 4b, 72% for category 4c, and 100.0% for category 5. Combining the TIRADS with the SUV showed increased specificity and positive predictive value but decreased sensitivity and negative predictive value compared with TIRADS alone (all P < .05). The area under the receiver operating characteristics curve value of TIRADS was the greatest, comparable with the combined TIRADS and SUV (0.737 to 0.724, P = .788). CONCLUSION: TIRADS may be applied in the risk stratification of thyroid incidentalomas detected on (18)F-FDG-PET/CT. Considering the high malignancy rate of thyroid incidentalomas showing increased (18)F-FDG uptake, ultrasonography-guided fine needle aspiration is mandatory even if there are no suspicious features present on US.
Authors: A Maturo; L Tromba; L De Anna; G Carbotta; G Livadoti; C Donello; F Falbo; G Galiffa; Antonella Esposito; A Biancucci; S Carbotta Journal: G Chir Date: 2017 Mar-Apr
Authors: Lorenzo Scappaticcio; Arnoldo Piccardo; Giorgio Treglia; David N Poller; Pierpaolo Trimboli Journal: Endocrine Date: 2021-03-24 Impact factor: 3.633
Authors: J F de Leijer; M J H Metman; A van der Hoorn; A H Brouwers; S Kruijff; B M van Hemel; T P Links; H E Westerlaan Journal: Front Endocrinol (Lausanne) Date: 2021-10-20 Impact factor: 5.555