This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Van den Bruel, A. Articles by Bouillon, R. Search for Related Content PubMed PubMed Citation Articles by Van den Bruel, A. Articles by Bouillon, R.

Clinical Relevance of Thyroid Fluorodeoxyglucose-Whole Body Positron Emission Tomography Incidentaloma

Laboratory and Clinic of Experimental Medicine and Endocrinology (A.V.d.B., R.B.), Departments of Nuclear Medicine (A.M., T.D.P., L.M.), Pathology (M.D., B.V.D.), and Head and Neck Surgery (P.D.), Universitaire Ziekenhuizen Gasthuisberg, B-3000 Leuven, Belgium

Address all correspondence and requests for reprints to: R. Bouillon, Laboratory for Experimental Medicine and Endocrinology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium. E-mail: . roger.bouillon{at}med.kuleuven.ac.be

Abstract

Fluorodeoxyglucose (FDG) whole body positron emission tomography (PET) scan is increasingly used in the diagnostic work-up or follow-up of patients. In these conditions, positive PET scans with unexpected hot spots within the thyroid region could be defined as thyroid FDG-PET incidentaloma (in analogy with unexpected sonographic thyroid nodules).

We describe eight consecutive patients referred to the endocrine department because of thyroid "hot spots," incidentally detected by whole body FDG-PET scan (September 1999 to March 2001). Using ultrasound, fine needle aspiration cytology (FNAC), and histology reports, we tried to identify the pathology underlying thyroid FDG-PET incidentaloma. FNAC showed an indication for surgery in all patients. Surgery has been performed in 7 patients. Malignancy was correctly identified in five patients: two medullary thyroid carcinomas, one with lymph node invasion, and three papillary thyroid carcinomas with invasion through the thyroid capsule in two of the PTC cases. In two patients with a positive FDG-PET scan, FNAC pointed to follicular neoplasms, and final histology reports showed follicular adenoma. In the remaining patient, FNAC revealed a follicular lesion, but surgery has not yet been performed.

In conclusion, a small series of consecutive thyroid FDG-PET incidentaloma cases is presented and suggests a high rate of clinically relevant malignancies.

This article has been cited by other articles:

				J. Y. Kwak, E.-K. Kim, M. Yun, A. Cho, M. J. Kim, E. J. Son, and K. K. Oh Thyroid Incidentalomas Identified by 18F-FDG PET: Sonographic Correlation Am. J. Roentgenol., August 1, 2008; 191(2): 598 - 603. [Abstract] [Full Text] [PDF]

				A. S Al-Zahrani, M.-E. M Abouzied, S. A. Salam, G. Mohamed, A. Rifai, A. Al Sugair, and T. Amin The role of F-18-fluorodeoxyglucose positron emission tomography in the postoperative evaluation of differentiated thyroid cancer Eur. J. Endocrinol., May 1, 2008; 158(5): 683 - 689. [Abstract] [Full Text] [PDF]

				M. M. Abouzied, E. S. Crawford, and H. A. Nabi 18F-FDG Imaging: Pitfalls and Artifacts J. Nucl. Med. Technol., September 1, 2005; 33(3): 145 - 155. [Abstract] [Full Text] [PDF]

				J. G. Yi, E. M. Marom, R. F. Munden, M. T. Truong, H. A. Macapinlac, G. W. Gladish, B. S. Sabloff, and D. A. Podoloff Focal Uptake of Fluorodeoxyglucose by the Thyroid in Patients Undergoing Initial Disease Staging with Combined PET/CT for Non-Small Cell Lung Cancer Radiology, July 1, 2005; 236(1): 271 - 275. [Abstract] [Full Text] [PDF]

				N. Pandit-Taskar, H. Schoder, M. Gonen, S. M. Larson, and H. W. D. Yeung Clinical Significance of Unexplained Abnormal Focal FDG Uptake in the Abdomen During Whole-Body PET Am. J. Roentgenol., October 1, 2004; 183(4): 1143 - 1147. [Abstract] [Full Text] [PDF]

				K. Pacak, G. Eisenhofer, and D. S. Goldstein Functional Imaging of Endocrine Tumors: Role of Positron Emission Tomography Endocr. Rev., August 1, 2004; 25(4): 568 - 580. [Abstract] [Full Text] [PDF]

				H. Agress Jr and B. Z. Cooper Detection of Clinically Unexpected Malignant and Premalignant Tumors with Whole-Body FDG PET: Histopathologic Comparison Radiology, February 1, 2004; 230(2): 417 - 422. [Abstract] [Full Text] [PDF]

				K. W. Kang, S.-K. Kim, H.-S. Kang, E. S. Lee, J. S. Sim, I. G. Lee, S.-Y. Jeong, and S. W. Kim Prevalence and Risk of Cancer of Focal Thyroid Incidentaloma Identified by 18F-Fluorodeoxyglucose Positron Emission Tomography for Metastasis Evaluation and Cancer Screening in Healthy Subjects J. Clin. Endocrinol. Metab., September 1, 2003; 88(9): 4100 - 4104. [Abstract] [Full Text] [PDF]