King Deanne L, Stack Brendan C, Spring Paul M, Walker Ronald, Bodenner Donald L
Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Otolaryngol Head Neck Surg. 2007 Sep;137(3):400-4. doi: 10.1016/j.otohns.2007.02.037.
Fluorodeoxyglucose (FDG) whole body positron emission tomography (PET) scan may show clinically occult second lesions. Such lesions in the thyroid are increasingly common. There are several recent reports of a high probability of malignancy in these lesions ranging from 14% to 63%.
This is a retrospective review of 15,711 PET scans at a multi-disciplinary thyroid clinic at a tertiary care university medical center. Twenty-two patients were referred with thyroid PET "incidentalomas." The review included 18 FDG-PET scans, ultrasound guided fine needle aspiration biopsies, and thyroid surgery pathology. Aspiration cytology or pathology were the main outcome measures.
Three patients had malignancy of the PET-positive thyroid lesions. Papillary thyroid micro carcinomas were detected in four of the specimens that showed a benign pathology of the dominant nodule.
Our experience shows a 14% malignancy rate for the dominant (imaged) nodule and a total malignancy rate of 32% when the incidental micro carcinomas are included. Both of these rates are significantly lower than results published previously.
氟脱氧葡萄糖（FDG）全身正电子发射断层扫描（PET）可能显示临床上隐匿的继发性病变。甲状腺中的此类病变越来越常见。最近有几篇报道称这些病变的恶性概率很高，在14%至63%之间。
这是对一所三级护理大学医学中心的多学科甲状腺诊所的15711次PET扫描进行的回顾性研究。22例患者因甲状腺PET“偶发瘤”前来就诊。该回顾包括18次FDG-PET扫描、超声引导下细针穿刺活检以及甲状腺手术病理检查。细针穿刺细胞学检查或病理检查是主要的观察指标。
3例患者的PET阳性甲状腺病变为恶性。在显示主要结节为良性病理的4个标本中检测到甲状腺微小乳头状癌。
我们的经验显示，主要（成像）结节的恶性率为14%，若将偶发微小癌包括在内，总恶性率为32%。这两个比率均显著低于先前发表的结果。
