Iacovitti Cesare Michele, Albano Domenico, Rizzo Alessio, Piccardo Arnoldo, Cuzzocrea Marco, Paone Gaetano, Trimboli Pierpaolo, Treglia Giorgio
Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland.
Department of Nuclear Medicine, ASST Spedali Civili di Brescia and University of Brescia, 25123 Brescia, Italy.
Pharmaceuticals (Basel). 2025 May 15;18(5):723. doi: 10.3390/ph18050723.
: Meta-analyses on the prevalence and significance of thyroid incidentalomas at PET (TIP) are available only about [F]FDG. Focal TIP at [F]FDG PET is not rare and may be malignant lesions in about one-third of cases. The aim of this study is to perform a meta-analysis on the prevalence and clinical significance of TIP using other PET radiotracers beyond [F]FDG. : A comprehensive literature search of studies about TIP was carried out using four different databases, screened until 31 December 2024. Only original articles about TIP using radiopharmaceuticals other than [F]FDG were selected. A proportion meta-analysis on the prevalence and clinical significance of TIP was carried out on a patient-based analysis using a random-effects model. : 21 studies (29,409 patients) were included in the meta-analysis. PET was performed using radiolabeled somatostatin analogues (SSA) [ = 5], choline [ = 6], prostate-specific membrane antigen (PSMA) [ = 7], or fibroblast activation protein inhibitors (FAPI) [ = 3]. The uptake pattern of TIP was described as focal, diffuse, or mixed/heterogeneous. The pooled prevalence of TIP was 5.6% for SSA-PET, 6.1% for choline-PET, 4.2% for PSMA-PET, and 3.6% for FAPI-PET. The final diagnosis of TIP with a diffuse pattern was a benign condition or represented a physiological uptake. Conversely, TIP with focal or mixed/heterogeneous pattern may represent a benign condition in most cases, but even a malignant lesion in 6-10% of cases. : As for [F]FDG, TIP using other radiopharmaceuticals is not rare. Most of them are benign, but those with focal or heterogeneous uptake patterns may represent a malignant lesion in some cases (even if the risk of malignancy is lower compared to [F]FDG PET), thus requiring further evaluation. Further studies are warranted to better clarify the clinical impact of TIP detection.
关于PET（甲状腺偶发瘤，TIP）的患病率及意义的荟萃分析仅针对[F]FDG。[F]FDG PET上的局灶性TIP并不罕见，约三分之一的病例可能为恶性病变。本研究的目的是对使用[F]FDG以外的其他PET放射性示踪剂的TIP的患病率及临床意义进行荟萃分析。：使用四个不同的数据库对关于TIP的研究进行了全面的文献检索，检索截止至2024年12月31日。仅选择了使用[F]FDG以外的放射性药物的关于TIP的原创文章。使用随机效应模型在基于患者的分析中对TIP的患病率及临床意义进行了比例荟萃分析。：21项研究（29409例患者）纳入了荟萃分析。PET使用放射性标记的生长抑素类似物（SSA）[ = 5]、胆碱[ = 6]、前列腺特异性膜抗原（PSMA）[ = 7]或成纤维细胞活化蛋白抑制剂（FAPI）[ = 3]进行。TIP的摄取模式描述为局灶性、弥漫性或混合/异质性。SSA-PET的TIP汇总患病率为5.6%，胆碱-PET为6.1%，PSMA-PET为4.2%，FAPI-PET为3.6%。弥漫性模式的TIP最终诊断为良性情况或代表生理性摄取。相反，局灶性或混合/异质性模式的TIP在大多数情况下可能代表良性情况，但在6 - 10%的病例中也可能为恶性病变。：至于[F]FDG，使用其他放射性药物的TIP并不罕见。它们大多为良性，但那些具有局灶性或异质性摄取模式的在某些情况下可能代表恶性病变（即使与[F]FDG PET相比恶性风险较低），因此需要进一步评估。有必要进行进一步研究以更好地阐明TIP检测的临床影响。
