Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology.

Détails

ID Serval
serval:BIB_3834C338ABC5
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology.
Périodique
European journal of endocrinology
Auteur⸱e⸱s
Piccardo A., Puntoni M., Treglia G., Foppiani L., Bertagna F., Paparo F., Massollo M., Dib B., Paone G., Arlandini A., Catrambone U., Casazza S., Pastorino A., Cabria M., Giovanella L.
ISSN
1479-683X (Electronic)
ISSN-L
0804-4643
Statut éditorial
Publié
Date de publication
05/2016
Peer-reviewed
Oui
Volume
174
Numéro
5
Pages
693-703
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Résumé
To evaluate the role of (18)F-flurodeoxiglucose positron emission tomography/computed tomography ((18)F-FDG-PET/CT) in predicting malignancy of thyroid nodules with indeterminate cytology.
We analysed 87 patients who have been scheduled to undergo surgery for thyroid nodule with indeterminate cytology. All patients underwent (18)F-FDG-PET/CT, multiparametric neck ultrasonography (MPUS), and (99m)Tc-methoxyisobutylisonitrile scintigraphy ((99m)Tc-MIBI-scan). Histopathology was the standard of reference. We compared the sensitivity (SE), specificity (SP), accuracy (AC), positive (PPV) and negative predictive (NPV) values of (18)F-FDG-PET/CT with those of (99m)Tc-MIBI-scan and MPUS in detecting cancer. Univariate and multivariate analyses evaluated the association between each diagnostic tool and histopathology.
On histopathology, 69 out of 87 nodules were found to be benign and 18 to be malignant. The SE, SP, AC, PPV and NPV of (18)F-FDG-PET/CT were 94, 58, 66, 37 and 98% respectively. The SE, AC and NPV of (18)F-FDG-PET/CT were significantly higher than those of MPUS and (99m)Tc-MIBI-scan. The association of both positive (18)F-FDG-PET/CT and MPUS (FDG+/MPUS+) showed significantly lower SE (61% vs 94%) and NPV (88% vs 98%) than (18)F-FDG-PET/CT alone, but significantly higher SP (77% vs 58%). On univariate analysis, (18)F-FDG-PET/CT and the combination of FDG+/MPUS+ and of FDG+/MIBI- were all significantly associated with histopathology. On multivariate analysis, only FDG+/MIBI- was significantly associated with histopathology.
The AC of (18)F-FDG-PET /CT in detecting thyroid malignancy is higher than that of (99m)Tc-MIBI-scan and MPUS. A negative (18)F-FDG-PET/CT correctly predicts benign findings on histopathology. The association of FDG+/MPS+ is significantly more specific than (18)F-FDG-PET/CT alone in identifying differentiated thyroid cancer. A positive (18)F-FDG-PET/CT is significantly associated with malignancy when qualitative (99m)Tc-MIBI-scan is rated as negative.

Mots-clé
Aged, Cytodiagnosis/standards, Female, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Multimodal Imaging/standards, Neck/diagnostic imaging, Positron-Emission Tomography/standards, Radionuclide Imaging/standards, Radiopharmaceuticals, Sensitivity and Specificity, Technetium Tc 99m Sestamibi, Thyroid Nodule/diagnosis, Thyroid Nodule/diagnostic imaging, Tomography, X-Ray Computed/standards, Ultrasonography
Pubmed
Web of science
Open Access
Oui
Création de la notice
20/08/2017 16:39
Dernière modification de la notice
20/08/2019 13:27
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