Chen Wengen, Parsons Molly, Torigian Drew A, Zhuang Hongming, Alavi Abass
Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Nucl Med Commun. 2009 Mar;30(3):240-4. doi: 10.1097/MNM.0b013e328324b431.
To characterize the prevalence and malignancy of thyroid F-flurodeoxyglucose (FDG) uptake incidentally identified on FDG-PET/computed tomography (CT) scan in a relatively large population.
Two thousand five hundred and ninety-four cases of FDG-PET/CT performed at our institute in the past 1 year and a half were retrospectively reviewed. Images with incidental focal or diffuse thyroid FDG uptake were identified. Data of the PET findings, thyroid functional assay, and pathological diagnosis were collected and analyzed. Incidental thyroid FDG uptake was defined as a new thyroid lesion initially identified on PET scan in a patient without a previous known history of thyroid disease.
The prevalence of incidental thyroid FDG uptake (including both focal and diffuse lesions) was 3.8% (99 of 2594) on FDG-PET/CT, of which 1.8% (46 of 2594) were diffuse and 2.0% (53/2594) were focal. Of the 46 cases with diffuse uptake, 21 had thyroid functional assay and/or ultrasound study, and a diagnosis of chronic thyroiditis was made in all of the 21 cases. Eleven of the 53 patients with focal uptake had fine-needle aspiration or postsurgical pathological diagnosis, four benign lesions (four of 11=36.4%: two thyroid adenomas and two hyperplastic lesions); seven malignancies (seven of 11=63.6%: three papillary carcinomas, two follicular carcinoma, and two metastases). There was overlapping of the lesion SUVmax between the benign and malignant cases, with no statistical difference of the mean SUVmax between the two groups.
Thyroid FDG uptake incidentally identified on FDG-PET/CT occurred at a frequency of 3.8%, with about half of focal and half of diffuse lesions. The risk of thyroid malignancy was 63.6% in lesions with focal uptake, whereas the majority of diffuse uptake cases represents chronic thyroiditis. More data are needed to elucidate the role of SUV in the differentiation of benign and malignant lesions.
在相对较大的人群中，描述氟代脱氧葡萄糖（FDG）-正电子发射断层扫描/计算机断层扫描（CT）中偶然发现的甲状腺FDG摄取的患病率及恶性程度。
回顾性分析过去一年半内在我院进行的2594例FDG-PET/CT病例。识别出有偶然局灶性或弥漫性甲状腺FDG摄取的图像。收集并分析PET检查结果、甲状腺功能测定及病理诊断数据。偶然甲状腺FDG摄取定义为在无既往已知甲状腺疾病史的患者中，PET扫描最初发现的新甲状腺病变。
FDG-PET/CT上偶然甲状腺FDG摄取（包括局灶性和弥漫性病变）的患病率为3.8%（2594例中的99例），其中1.8%（2594例中的46例）为弥漫性，2.0%（2594例中的53例）为局灶性。在46例弥漫性摄取病例中，21例进行了甲状腺功能测定和/或超声检查，所有21例均诊断为慢性甲状腺炎。53例局灶性摄取患者中有11例进行了细针穿刺或术后病理诊断，4例为良性病变（11例中的4例=36.4%：2例甲状腺腺瘤和2例增生性病变）；7例为恶性肿瘤（11例中的7例=63.6%：3例乳头状癌、2例滤泡癌和2例转移瘤）。良性和恶性病例之间病变的最大标准摄取值（SUVmax）有重叠，两组之间的平均SUVmax无统计学差异。
FDG-PET/CT上偶然发现的甲状腺FDG摄取发生率为3.8%，局灶性和弥漫性病变各占约一半。局灶性摄取病变的甲状腺恶性风险为63.6%，而大多数弥漫性摄取病例为慢性甲状腺炎。需要更多数据来阐明SUV在鉴别良性和恶性病变中的作用。
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