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FDG-avid thyroid nodules are at a significantly increased risk of malignancy
Brodie D Laurie1, Elizabeth Thomas2, Hieu Nguyen1
1Endocrine Surgical Services Unit, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Australia.
Background:
FDG-avid thyroid incidentalomas pose a diagnostic challenge due to their potential for malignancy. This study evaluated the malignancy rates in FDG-avid thyroid nodules, stratified by fine needle aspiration (FNA) cytology results.
Methods:
A retrospective cohort study was conducted on patients with FDG-avid thyroid incidentalomas who underwent surgical resection between 2012 and 2023. The primary outcome was malignancy rates stratified by pre-operative cytology results. Logistic regression was used to assess the utility of patient age, gender and nodule size for predicting malignancy in FDG-avid thyroid incidentaloma.
Results:
Of 258 patients included, malignancy rates stratified by cytology were: Bethesda I (15.4 %), Bethesda II(11.1 %), Bethesda III(29.1 %), Bethesda IV(34 %), Bethesda V (83.3 %), and Bethesda VI (98.3 %). The overall malignancy rate was 48.1 %, predominantly papillary thyroid carcinoma. No significant differences in malignancy were observed concerning age, gender, or nodule size.
Conclusion:
FDG-avid thyroid nodules exhibit a significantly higher risk of malignancy, particularly in Bethesda categories III to VI.
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