Diagnostic Value of Volume-Based Fluorine-18-Fluorodeoxyglucose PET/CT Parameters for Characterizing Thyroid Incidentaloma.
10.3348/kjr.2018.19.2.342
- Author:
Huazheng SHI
1
;
Zuguo YUAN
;
Zheng YUAN
;
Chunshan YANG
;
Jian ZHANG
;
Yi SHOU
;
Wenrui ZHANG
;
Zhaofu PING
;
Xin GAO
;
Shiyuan LIU
Author Information
1. Shanghai Universal Medical Imaging Diagnostic Center, Shanghai 200233, China. yuanzheng0404@163.com
- Publication Type:Original Article
- Keywords:
Fluorine-18-fluorodeoxyglucose;
FDG PET/CT;
Thyroid neoplasms;
Metabolic tumor volume;
Total lesion glycolysis;
Thyroid incidentaloma
- MeSH:
Area Under Curve;
Diagnosis, Differential;
Electrons;
Fluorodeoxyglucose F18*;
Glycolysis;
Humans;
Positron-Emission Tomography and Computed Tomography*;
Retrospective Studies;
ROC Curve;
Sensitivity and Specificity;
Thyroid Gland*;
Thyroid Neoplasms;
Tumor Burden
- From:Korean Journal of Radiology
2018;19(2):342-351
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To assess clinical value of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for differentiation of malignant from benign focal thyroid incidentaloma. MATERIALS AND METHODS: This retrospective study included 99 patients with focal thyroid incidentaloma of 5216 non-thyroid cancer patients that had undergone PET/CT. PET/CT semi-quantitative parameters, volume-based functional parameters, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of thyroid incidentaloma were assessed. Receiver-operating characteristic (ROC) analysis was conducted and areas under the curve (AUC) were compared by Hanley and McNeil test to evaluate usefulness of maximum standardized uptake value (SUVmax), MTV and TLG, as markers for differentiating malignant from benign thyroid incidentalomas. RESULTS: Of 99 thyroid incidentalomas, 64 (64.6%) were malignant and 35 (35.4%) were benign. Malignant thyroid incidentalomas were larger (1.8 cm vs. 1.3 cm, p = 0.006), and had higher SUVmax (11.3 vs. 4.8, p < 0.001), MTV (all p < 0.001) and TLG (all p < 0.001) than benign. TLG 4.0 had the highest performance for differentiation of malignant from benign thyroid incidentaloma in all semi-quantitative parameters with AUC 0.895 by ROC curve analysis. AUC (TLG 4.0) was significantly larger than AUC (SUVmean), AUC (MTV 2.5), AUC (MTV 3.0), AUC (MTV 3.5), AUC (TLG 2.5), and AUC (TLG 3.0), respectively (all, p < 0.05). There was no statistical difference between AUC (TLG 4.0) and AUC (SUVmax) (p > 0.05). A threshold TLG 4.0 of 2.475 had 81.3% sensitivity and 94.3% specificity for identifying malignant thyroid incidentalomas. CONCLUSION: Volume-based PET/CT parameters could potentially have clinical value in differential diagnosis of thyroid incidentaloma along with SUVmax.
