Nuclear Medicine, Spedali Civili Brescia, Brescia, Italy.
Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy.
Endocrine. 2019 Mar;63(3):531-536. doi: 10.1007/s12020-018-01832-6. Epub 2018 Dec 29.
Thyroid incidental uptake is defined as a thyroid uptake incidentally detected by imaging examinations performed for non-thyroid disease. The aim of this study was to establish the prevalence and the pathological nature of focal thyroid incidental uptake (FTIU) among patients studied with 18F-choline-PET/CT.
We retrospectively evaluated 368 patients who performed 18F-choline-PET/CT between June 2016 and August 2018. The PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax) and the mean SUV (SUVmean) of the thyroid gland and of the FTIU; every focal thyroid uptake deviating from physiological distribution and background was considered FTIU. Final diagnosis of FTIU was obtained by cytological or histological examination after surgery.
The average SUVmax and SUVmean of thyroid gland in population were 3 and 1.8. Among 368 patients, FTIU was identified in nine cases (2.4%) and eight underwent further investigations to determine the nature. Two FTIU were classified as malignant (thyroid carcinoma), whereas five were benign (three nodular hyperplasia, one follicular adenoma, one Hurtle cell adenoma) and one indeterminate at cytological examination. In malignant lesions, average SUVmax was 9.6 and 4.5, respectively, while average SUVmean was 5.3 and 2.9, respectively. Average SUVmax and SUVmean of benign lesions were 4.9 and 3.2 and of the indeterminate lesion 5 and 3, respectively.
18F-choline-PET/CT FTIU may be a relevant diagnostic reality, which requires further investigations and affects management, especially considering that, despite being mainly benign, also malignancy is possible.
甲状腺偶然摄取是指在因非甲状腺疾病而进行的影像学检查中偶然发现的甲状腺摄取。本研究的目的是在使用 18F-胆碱-PET/CT 研究的患者中确定局灶性甲状腺偶然摄取（FTIU）的患病率和病理性质。
我们回顾性评估了 2016 年 6 月至 2018 年 8 月间进行 18F-胆碱-PET/CT 的 368 名患者。通过测量甲状腺的最大标准化摄取值（SUVmax）和平均 SUV（SUVmean），对 PET 图像进行视觉和半定量分析，对甲状腺和 FTIU 的每一个偏离生理分布和背景的局灶性甲状腺摄取都被认为是 FTIU。在手术后通过细胞学或组织学检查获得 FTIU 的最终诊断。
人群中甲状腺的平均 SUVmax 和 SUVmean 分别为 3 和 1.8。在 368 名患者中，有 9 例（2.4%）发现了 FTIU，其中 8 例进一步调查以确定其性质。2 例 FTIU 被归类为恶性（甲状腺癌），而 5 例为良性（3 例结节性增生、1 例滤泡性腺瘤、1 例 Hurthle 细胞腺瘤），1 例细胞学检查不确定。在恶性病变中，SUVmax 分别为 9.6 和 4.5，SUVmean 分别为 5.3 和 2.9。良性病变的 SUVmax 和 SUVmean 分别为 4.9 和 3.2，不确定病变为 5 和 3。
18F-胆碱-PET/CT 的 FTIU 可能是一个相关的诊断现实，需要进一步的调查并影响管理，特别是考虑到尽管主要是良性的，但也有可能是恶性的。
