Rosario Pedro W, Rocha Tiara G, Calsolari Maria R
Santa Casa de Belo Horizonte, Belo Horizonte, Brazil.
Nucl Med Commun. 2019 Feb;40(2):185-187. doi: 10.1097/MNM.0000000000000946.
Up to 20% of thyroid nodules subjected to fine-needle aspiration exhibit indeterminate cytology. The rate of malignancy in these nodules ranges from 10 to 40%. The objective of this prospective study was to evaluate the utility of fluorine-18-fluorodeoxyglucose (F-FDG) PET in nonautonomous thyroid nodules of more than 1 cm whose cytology is indeterminate (Bethesda categories III or IV) and that are not highly suspicious on ultrasonography.
Fifty-nine patients with 63 nodules were studied.
F-FDG PET result was positive in 31 nodules. Of these, 22.6% were malignant, 25.8% were noninvasive follicular thyroid neoplasm with papillary-like nuclear features, 6.5% were tumors of uncertain malignant potential, and 45.1% were benign. F-FDG PET result was negative in 32 nodules. Of these, 3.1% were neoplasm with papillary-like nuclear features, 3.1% were tumors of uncertain malignant potential, and 93.8% were benign.
This study suggests a high negative predictive value of F-FDG PET in thyroid nodules of more than 1 cm whose cytology is indeterminate and that are not highly suspicious on ultrasonography.
接受细针穿刺的甲状腺结节中，高达20%的结节细胞学检查结果为不明确。这些结节的恶性率在10%至40%之间。这项前瞻性研究的目的是评估氟-18-氟脱氧葡萄糖（F-FDG）PET在直径大于1 cm、细胞学检查结果不明确（贝塞斯达分类III或IV类）且超声检查无高度可疑表现的非自主性甲状腺结节中的应用价值。
对59例患者的63个结节进行了研究。
31个结节的F-FDG PET结果为阳性。其中，22.6%为恶性，25.8%为具有乳头状核特征的非侵袭性滤泡性甲状腺肿瘤，6.5%为恶性潜能不确定的肿瘤，45.1%为良性。32个结节的F-FDG PET结果为阴性。其中，3.1%为具有乳头状核特征的肿瘤，3.1%为恶性潜能不确定的肿瘤，93.8%为良性。
本研究表明，F-FDG PET在直径大于1 cm、细胞学检查结果不明确且超声检查无高度可疑表现的甲状腺结节中具有较高的阴性预测价值。
