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

Détails

ID Serval
serval:BIB_C51600DCF0E4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Fine-needle aspiration in all thyroid incidentalomas at <sup>18</sup> F-FDG PET/CT: Can EU-TIRADS revise the dogma?
Périodique
Clinical endocrinology
Auteur(s)
Trimboli P., Paone G., Treglia G., Virili C., Ruberto T., Ceriani L., Piccardo A., Giovanella L.
ISSN
1365-2265 (Electronic)
ISSN-L
0300-0664
Statut éditorial
Publié
Date de publication
11/2018
Peer-reviewed
Oui
Volume
89
Numéro
5
Pages
642-648
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Focal thyroid incidentalomas (TIs) are observed in 2% of <sup>18</sup> 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 <sup>18</sup> 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 <sup>18</sup> 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-TIRADS, respectively. The absence of all these three features reached a specificity of 97.1%.
EU-TIRADS, within a clinical careful approach, can discriminate with significant accuracy lesions at high risk of malignancy from those at low risk among TIs at <sup>18</sup> F-FDG PET/CT. Additionally, a centre-based threshold for SUV parameters should be useful for the initial assessment of these lesions during PET/CT reading and reporting.
Mots-clé
18F-FDG-PET/CT, diagnosis, incidental, thyroid cancer, ultrasound, 18F-FDG PET/CT
Pubmed
Web of science
Création de la notice
31/07/2018 15:37
Dernière modification de la notice
06/11/2018 7:26
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