Fine-needle aspiration in all thyroid incidentalomas at 18 F-FDG PET/CT: Can EU-TIRADS revise the dogma?

Clinical Endocrinology
Pierpaolo TrimboliLuca Giovanella

Abstract

Focal thyroid incidentalomas (TIs) are observed in 2% of 18 F-FDG PET/CT representing malignancy in one-third of cases. Currently, due to the lack of evidence on their optimal management, guidelines suggest fine-needle aspiration cytology (FNAC). The study aim was to evaluate the role of ultrasound evaluation according to EU-TIRADS to assess the risk of TIs and inform FNAC prescriptions. We retrospectively reviewed 18 F-FDG PET/CT TIs recorded during the period 2014-2017. Enrolled were TIs with histological outcome and autonomous nodules. Cases with uncertain matching between 18 F-FDG PET/CT, ultrasound and histology were excluded. According to the selection criteria, 75 TIs, being 13 (17.3%) malignant and 62 (82.7%) benign, were included. Cancers had significantly higher SUVmax and SUVmax ratio (Mann-Whitney P < 0.01) than benign, and the most accurate cut-offs were >7.1 and >3.65, respectively. At ultrasound, the cancer rate was 0% in EU-TIRADS 2, 2.9% in EU-TIRADS 3, 4.2% in EU-TIRADS 4% and 78.6% in EU-TIRADS 5 (chi-squared P < 0.001). Sensitivity, specificity, PPV, NPV and accuracy for malignancy were 92%, 64%, 35%, 98% and 69% for SUVmax; 85%, 68%, 36%, 96% and 71% for SUVmax ratio; and 85%, 95%, 79%, 97% and 93% for EU-T...Continue Reading

References

Dec 6, 2001·European Radiology·L SolbiatiM Tonolini
Mar 12, 2009·The Journal of Clinical Endocrinology and Metabolism·Eleonora HorvathMiguel Dominguez
Feb 7, 2012·Best Practice & Research. Clinical Endocrinology & Metabolism·Judy Jin, Christopher R McHenry
Aug 21, 2012·The Journal of Clinical Endocrinology and Metabolism·Francesco BertagnaRaffaele Giubbini
Oct 16, 2012·The Journal of Clinical Endocrinology and Metabolism·Pierpaolo TrimboliEnrico Papini
Jan 8, 2013·Thyroid : Official Journal of the American Thyroid Association·Giorgio TregliaMassimo Salvatori
Jul 6, 2014·Clinical Endocrinology·Petros PerrosUNKNOWN British Thyroid Association
Jul 23, 2014·Best Practice & Research. Clinical Endocrinology & Metabolism·Luca GiovanellaGiorgio Treglia
Dec 30, 2014·European Thyroid Journal·Gilles RussLaszlo Hegedüs
May 12, 2016·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Hossein GharibUNKNOWN AACE/ACE/AME Task Force on Thyroid Nodules

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Citations

Jun 11, 2020·Thyroid : Official Journal of the American Thyroid Association·Luca CerianiLuca Giovanella
Aug 11, 2020·Current Opinion in Endocrinology, Diabetes, and Obesity·Katrin Brauckhoff, Martin Biermann
Mar 18, 2019·BMJ Case Reports·Cristian Marco-AlacidCarlos Sánchez-Juan
Apr 10, 2020·Journal of Endocrinological Investigation·P TrimboliL Giovanella
Aug 21, 2021·Annual Review of Medicine·Kristen KobalySusan J Mandel

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