Kamakshi K, Krishnamurthy Arvind, Karthik V, Vinodkumar Preetha, Kumar R Krishna, Lakshmipathy K M
Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.
Department of Clinical Research, Cancer Institute (WIA), Chennai, Tamil Nadu, India.
World J Nucl Med. 2020 Jan 14;19(1):36-40. doi: 10.4103/wjnm.WJNM_33_19. eCollection 2020 Jan-Mar.
With the increasing use of F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) scans in oncology, the finding of thyroid incidentalomas, also popularly described as PET-associated incidental neoplasms (PAINs) of the thyroid gland is not unusual. The F-FDG PET-CT scans of all patients who underwent imaging for indications other than thyroid malignancy at our tertiary care center between January 1 and December 31, 2017, were retrospectively reviewed for PAINs of the thyroid. A total of 1737 F-FDG PET-CT scans were done at our center in the year 2017. 288 thyroid incidentalomas were detected in the said period; the rate of PET-CT-detected thyroid incidentalomas being 16.58%, focal incidentalomas among them being 11.7%. Only 29 out of 204 patients (14.21%) with focal thyroid incidentalomas in our cohort underwent an aspiration cytology and/or ultrasound. The rate of malignancy among the PET detected focal thyroid incidentalomas in the cohort of patients with a proven diagnosis was 10.34%. Our study highlights the challenges in the evaluation and management of PAIN in a tertiary care oncology setting. None of the factors studied including nodule size and standardized uptake value predicted the risk of malignancy. Clinicians specializing in the management of thyroid nodules need to understand the clinical significance of the PAIN, and we hope that our unique experience adds to the limited clinical information available in this regard.
随着氟脱氧葡萄糖（FDG）正电子发射断层扫描-计算机断层扫描（PET-CT）在肿瘤学领域的使用日益增加，发现甲状腺偶发瘤（也通常被称为甲状腺PET相关偶发肿瘤，即PAINs）并不罕见。对2017年1月1日至12月31日期间在我们三级医疗中心因甲状腺恶性肿瘤以外的指征接受成像检查的所有患者的F-FDG PET-CT扫描进行回顾性分析，以查找甲状腺PAINs。2017年我们中心共进行了1737例F-FDG PET-CT扫描。在上述期间检测到288例甲状腺偶发瘤；PET-CT检测到的甲状腺偶发瘤发生率为16.58%，其中局灶性偶发瘤为11.7%。在我们队列中的204例有局灶性甲状腺偶发瘤的患者中，只有29例（14.21%）接受了细针穿刺细胞学检查和/或超声检查。在经确诊的患者队列中，PET检测到的局灶性甲状腺偶发瘤的恶性率为10.34%。我们的研究突出了在三级医疗肿瘤学环境中评估和管理PAIN的挑战。所研究的因素包括结节大小和标准化摄取值，均无法预测恶性风险。专门从事甲状腺结节管理的临床医生需要了解PAIN的临床意义，我们希望我们的独特经验能为这方面有限的临床信息增添内容。
