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18FDG-positron emission tomography/computed tomography (PET/CT) scanning in thyroid nodules with nondiagnostic
Luca Giovanella1, Sergio Suriano, Marco Maffioli
1Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. luca.giovanella@eoc.ch
Objective:
To assess the role of positron emission tomography/computed tomography (PET/CT) scans with (18) FDG ((18)FDG-PET/CT) in the evaluation of thyroid nodules with nondiagnostic cytology.
Subjects And Methods:
Eighty-eight patients with a single euthyroid nodule and repeatedly nondiagnostic ultrasound-guided fine-needle cytology (US-FNC) were enrolled in the present study. Nodules concentrating (18)FDG were considered positive (i.e. suspicious for malignancy). Histological findings were obtained after surgery in all patients.
Results:
None of 41 patients with negative (18)FDG-PET/CT scan had a final histological diagnosis of malignancy (i.e. no false-negative results). Twenty-nine patients with final histological diagnosis of thyroid cancer had positive (18)FDG-PET/CT scan. Eighteen patients with final histological diagnosis of benign lesions (including four with follicular adenomas) also had positive (18)FDG-PET/CT scans. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were 100%, 69%, 79%, 62% and 100%, respectively.
Conclusions:
A negative (18)FDG-PET/CT scan accurately excludes malignancy in thyroid nodules with non-diagnostic US-FNC procedures. Histology is still necessary to distinguish benign from malignant disease in (18)FDG-PET/CT-positive nodules, but unnecessary surgery could have been reduced from 88 to 41 cases (46%) in our series.
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