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18F-FDG PET/CT imaging of atypical subacute thyroiditis in thyrotoxicosis: A case report
Katsuya Yoshida1, Hidetaka Yokoh, Akira Toriihara
1PET Imaging Center, Asahi General Hospital Department of Clinical Cell Biology and Medicine, Graduate School of Medicine, Chiba University, Chiba Department of Diagnostic Radiology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo Department of Radiology, Asahi General Hospital, Chiba, Japan.
Background:
In addition to its established role in oncologic imaging, F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) is useful for the assessment of inflammatory activity. However, subacute thyroiditis (SAT) in thyrotoxicosis is rarely detected during these scans.
Case:
A 66-year-old man with SAT in thyrotoxicosis demonstrated symptoms of transient fatigue, headache, and fever, without typical neck pain. Using F-FDG PET/CT, we found increased F-FDG uptake in the thyroid gland, predominantly in the right side due to SAT. We also observed a coexisting decrease in F-FDG uptake in the liver and increased F-FDG uptake in skeletal muscle due to thyrotoxicosis.
Conclusion:
Using F-FDG PET/CT, the combined observations of increased F-FDG uptake in the thyroid and skeletal muscle, and decreased F-FDG uptake in the liver, even when the typical symptom of neck pain is subtle or absent, may be helpful for the differential diagnosis of SAT in thyrotoxicosis.
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