TY - JOUR
T1 - Thyroid incidentalomas detected on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography
T2 - Thyroid Imaging Reporting and Data System (TIRADS) in the diagnosis and management of patients
AU - Yoon, Jung Hyun
AU - Cho, Arthur
AU - Lee, Hye Sun
AU - Kim, Eun Kyung
AU - Moon, Hee Jung
AU - Kwak, Jin Young
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/11
Y1 - 2015/11
N2 - Background Our aim was to evaluate the role of the Thyroid Imaging Reporting and Data System (TIRADS) in the risk stratification of thyroid incidentalomas detected on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) scans. Methods Eighty-seven thyroid nodules in 84 patients showing incidentally detected increased uptake on 18F-FDG-PET/CT who also had ultrasonography (US)-guided fine needle aspiration performed were included. On review of the US images, a TIRADS category was assigned to each thyroid nodule based on the number of suspicious US features. The correlation between the TIRADS category and the standard uptake values (SUV) on 18F-FDG-PET/CT were calculated and compared. Results Of the 87 thyroid nodules, 47 (54%) were benign, and 40 (46%) were malignant. The malignancy rate of the TIRADS categories were as follows: 9% for category 3, 15% for category 4a, 39% for category 4b, 72% for category 4c, and 100.0% for category 5. Combining the TIRADS with the SUV showed increased specificity and positive predictive value but decreased sensitivity and negative predictive value compared with TIRADS alone (all P < .05). The area under the receiver operating characteristics curve value of TIRADS was the greatest, comparable with the combined TIRADS and SUV (0.737 to 0.724, P = .788). Conclusion TIRADS may be applied in the risk stratification of thyroid incidentalomas detected on 18F-FDG-PET/CT. Considering the high malignancy rate of thyroid incidentalomas showing increased 18F-FDG uptake, ultrasonography-guided fine needle aspiration is mandatory even if there are no suspicious features present on US.
AB - Background Our aim was to evaluate the role of the Thyroid Imaging Reporting and Data System (TIRADS) in the risk stratification of thyroid incidentalomas detected on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) scans. Methods Eighty-seven thyroid nodules in 84 patients showing incidentally detected increased uptake on 18F-FDG-PET/CT who also had ultrasonography (US)-guided fine needle aspiration performed were included. On review of the US images, a TIRADS category was assigned to each thyroid nodule based on the number of suspicious US features. The correlation between the TIRADS category and the standard uptake values (SUV) on 18F-FDG-PET/CT were calculated and compared. Results Of the 87 thyroid nodules, 47 (54%) were benign, and 40 (46%) were malignant. The malignancy rate of the TIRADS categories were as follows: 9% for category 3, 15% for category 4a, 39% for category 4b, 72% for category 4c, and 100.0% for category 5. Combining the TIRADS with the SUV showed increased specificity and positive predictive value but decreased sensitivity and negative predictive value compared with TIRADS alone (all P < .05). The area under the receiver operating characteristics curve value of TIRADS was the greatest, comparable with the combined TIRADS and SUV (0.737 to 0.724, P = .788). Conclusion TIRADS may be applied in the risk stratification of thyroid incidentalomas detected on 18F-FDG-PET/CT. Considering the high malignancy rate of thyroid incidentalomas showing increased 18F-FDG uptake, ultrasonography-guided fine needle aspiration is mandatory even if there are no suspicious features present on US.
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U2 - 10.1016/j.surg.2015.03.017
DO - 10.1016/j.surg.2015.03.017
M3 - Article
C2 - 25958065
AN - SCOPUS:84944358146
VL - 158
SP - 1314
EP - 1322
JO - Surgery
JF - Surgery
SN - 0039-6060
IS - 5
M1 - 4105
ER -