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Open AccessArticle

Evaluation of Malignancy Risk in 18F-FDG PET/CT Thyroid Incidentalomas

Prof. Dr. Ion Chiricuță Institute of Oncology, Department of Nuclear Medicine, 400015 Cluj-Napoca, Romania
Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
Author to whom correspondence should be addressed.
Diagnostics 2019, 9(3), 92;
Received: 15 July 2019 / Revised: 4 August 2019 / Accepted: 5 August 2019 / Published: 7 August 2019
(This article belongs to the Section Medical Imaging)
Thyroid incidentalomas detected by 18 fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography/computed tomography (PET/CT) are a real challenge for nuclear medicine physicians and clinicians. This study aimed to evaluate the risk of malignancy for patients with focal thyroid incidentalomas (TIs) diagnosed through FDG PET/CT. Data from 6900 patients, with a known primary tumor, who had an FDG PET/CT investigation performed were analyzed for the presence of incidental thyroid uptake. The focal TIs were reported, and the patients were referred for further investigation to the endocrinology department. There were 126 patients (1.82%) who presented with focal thyroid uptake, and for 87 of them, investigations were completed with ultrasonography (US), and for 29 with a fine needle aspiration biopsy (FNAB) procedure. Malignancy was detected in 7.93% (10/126) of cases. An arbitrary cutoff value of four was established for the standard uptake value lean body mass (SUVlbm Max) to differentiate the malignant nodules from the benign ones, and this value was significantly associated with malignancy (p = 0.0168). TIs are not so frequent, but they have a potential malignancy risk, and a proper evaluation is required. Even though SUVlbm Max is a predictive factor for malignancy, the FNAB remains the main diagnostic method for the therapeutic management of these patients. View Full-Text
Keywords: thyroid incidentalomas; FDG PET/CT; malignancy risk thyroid incidentalomas; FDG PET/CT; malignancy risk
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Larg, M.-I.; Apostu, D.; Peștean, C.; Gabora, K.; Bădulescu, I.C.; Olariu, E.; Piciu, D. Evaluation of Malignancy Risk in 18F-FDG PET/CT Thyroid Incidentalomas. Diagnostics 2019, 9, 92.

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