Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
Otolaryngol Head Neck Surg. 2012 Jun;146(6):906-12. doi: 10.1177/0194599811435770. Epub 2012 Feb 3.
To determine if standardized uptake values (SUV) on positron emission tomography (PET) are predictive of thyroid pathology and the significance of serial SUV measurements of thyroid nodules over time.
Case series with chart review.
Academic health center.
In total, 23,384 PET and PET/computed tomography (CT) scans were performed between December 2001 and April 2011.
Patients with incidental thyroid uptake were identified. SUV(max), age, sex, size of thyroid lesion, indication for PET scan, and cytology/pathology were collected.
Incidental thyroid uptake was noted in 1309 PET scans (5.60%), focal uptake in 690 (2.95%), and diffuse uptake in 619 (2.65%). Complete data were available for 359 PET scans from 103 patients. Malignancy was identified in 28 patients (27%). Twenty-five of the 28 lesions (89%) were primary thyroid malignancies. A significant difference between malignant SUV(max) and benign SUV(max) was found (mean ± SD, 7.04 ± 7.88 for malignancies vs 3.85 ± 3.06 for benign tumors, P = .0292). Receiver operating characteristics curves were constructed on patients with PET data within 3 months of diagnosis and indicated that a SUV(max) of 4.2 differentiated maximally between benign and malignant lesions. Serial SUV uptake had no significant change over time.
All thyroid nodules with focal uptake on (18)F-fluorodeoxyglucose-PET/CT should be considered at higher risk of malignancy than those discovered incidentally by other imaging modalities. Higher SUV(max) values are more indicative of malignant lesions. All lesions should be evaluated with ultrasonography ± fine-needle aspiration if no clinical contraindications exist. Size of the primary nodule does not influence SUV(max) uptake.
确定正电子发射断层扫描(PET)的标准化摄取值(SUV)是否可预测甲状腺病理,以及随时间推移甲状腺结节 SUV 连续测量的意义。
病例系列,病历回顾。
学术医疗中心。
2001 年 12 月至 2011 年 4 月间共进行了 23384 次 PET 和 PET/计算机断层扫描(CT)检查。
确定偶然发现甲状腺摄取的患者。收集 SUV(max)、年龄、性别、甲状腺病变大小、PET 扫描适应证以及细胞学/病理学结果。
1309 次 PET 扫描(5.60%)中发现偶然甲状腺摄取,690 次(2.95%)为局灶摄取,619 次(2.65%)为弥漫摄取。103 例患者的 359 次 PET 扫描有完整数据。28 例患者(27%)确诊为恶性肿瘤。28 个病灶中有 25 个(89%)为原发性甲状腺恶性肿瘤。恶性 SUV(max)与良性 SUV(max)之间有显著差异(均值±标准差,恶性肿瘤为 7.04±7.88,良性肿瘤为 3.85±3.06,P=0.0292)。对诊断后 3 个月内有 PET 数据的患者构建受试者工作特征曲线,表明 SUV(max)为 4.2 时可最大程度地区分良性和恶性病变。随时间推移,SUV 摄取无显著变化。
与通过其他影像学手段偶然发现的甲状腺结节相比,(18)F-氟代脱氧葡萄糖-PET/CT 局灶摄取的所有甲状腺结节恶性风险更高。SUV(max)值越高,提示恶性病变的可能性越大。如果没有临床禁忌证,所有病变均应通过超声检查+细针抽吸活检进行评估。结节大小不影响 SUV(max)摄取。