Molecular imaging with (99m)Tc-MIBI and molecular testing for mutations in differentiating benign from malignant follicular neoplasm: a prospective comparison.

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State: Public
Version: Final published version
Serval ID
serval:BIB_A8188DCFF4E7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Molecular imaging with (99m)Tc-MIBI and molecular testing for mutations in differentiating benign from malignant follicular neoplasm: a prospective comparison.
Journal
European journal of nuclear medicine and molecular imaging
Author(s)
Giovanella L., Campenni A., Treglia G., Verburg F.A., Trimboli P., Ceriani L., Bongiovanni M.
ISSN
1619-7089 (Electronic)
ISSN-L
1619-7070
Publication state
Published
Issued date
06/2016
Peer-reviewed
Oui
Volume
43
Number
6
Pages
1018-1026
Language
english
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article
Publication Status: ppublish
Abstract
To compare mutation analysis of cytology specimens and (99m)Tc-MIBI thyroid scintigraphy for differentiating benign from malignant thyroid nodules in patients with a cytological reading of follicular neoplasm.
Patients ≥18 years of age with a solitary hypofunctioning thyroid nodule (≥10 mm), normal thyrotropin and calcitonin levels, and a cytological diagnosis of follicular neoplasm were prospectively enrolled. Mutation analysis and (99m)Tc-MIBI scintigraphy were performed and patients were subsequently operated on to confirm or exclude a malignant lesion. Mutations for KRAS, HRAS and NRAS and for BRAF and translocations of PAX8/PPARγ, RET/PTC1 and RET/PTC3 were investigated. Static thyroid scintigraphic images were acquired 10 and 60 min after intravenous injection of 200 MBq of (99m)Tc-MIBI and visually assessed. Additionally, the MIBI washout index was calculated using a semiquantitative method.
In our series, 26 % of nodules with a follicular pattern on cytology were malignant with a prevalence of follicular carcinomas. (99m)Tc-MIBI scintigraphy was found to be significantly more accurate (positive likelihood ratio 4.56 for visual assessment and 12.35 for semiquantitative assessment) than mutation analysis (positive likelihood ratio 1.74). A negative (99m)Tc-MIBI scan reliably excluded malignancy.
In patients with a thyroid nodule cytologically diagnosed as a follicular proliferation, semiquantitative analysis of (99m)Tc-MIBI scintigraphy should be the preferred method for differentiating benign from malignant nodules. It is superior to molecular testing for the presence of differentiated thyroid cancer-associated mutations in fine-needle aspiration cytology sample material.

Keywords
Adult, Aged, Aged, 80 and over, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Mutation, Prospective Studies, Technetium Tc 99m Sestamibi, Thyroid Epithelial Cells/pathology, Thyroid Nodule/diagnostic imaging, Thyroid Nodule/genetics, Thyroid Nodule/pathology, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
30/12/2015 8:34
Last modification date
20/08/2019 15:12
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