Preoperative evaluation of thyroid nodules with 18FDG-PET/CT

• Published in: Surgery Vol. 138; no. 6; pp. 1166 - 1175
• Main Authors: Mitchell, Jamie C., Grant, Frederick, Evenson, Amy R., Parker, J.A., Hasselgren, Per-Olof, Parangi, Sareh
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.12.2005
• Subjects: Adult; Aged; Female; Fluorodeoxyglucose F18; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Positron-Emission Tomography; Radiopharmaceuticals; Sensitivity and Specificity; Thyroid Nodule - diagnostic imaging; Thyroid Nodule - surgery; Thyroidectomy; Tomography, X-Ray Computed
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2005.08.031

Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18FDG-PET/CT) has become an important tool in the postoperative management of de-differentiated thyroid cancer. The utility of this imaging modality in the preoperative assessment of thyroid nodules is unclear. This study was designed to determine whether 18FDG-PET/CT improves the preoperative diagnosis of thyroid nodules. A total of 31 patients with 48 lesions underwent fine-needle aspiration and 18FDG-PET/CT before surgical resection of thyroid nodules. PET/CT images were obtained 1hour after intravenous administration of 18FDG. Standard uptake values were calculated for regions of increased 18FDG uptake. CT scans were evaluated to identify thyroid pathology. Final pathologic diagnoses were compared with PET/CT findings. Fifteen of 48 lesions were malignant and 33 were benign. Nine of 15 malignant lesions were 18FDG-avid (sensitivity 60%). Thirty of 33 benign lesions were 18FDG-cold (specificity 91%). Positive and negative predictive values were 75% and 83%, respectively. 18FDG-PET/CT provides a high negative predictive value for malignancy, making this a potentially useful tool in the evaluation of thyroid nodules with indeterminate fine-needle aspiration. However further studies with larger sample sizes are needed to determine the true efficacy of this test.