Preoperative FDG-PET imaging to assess the malignant potential of follicular neoplasms of the thyroid

Russell B. Smith; Robert A. Robinson; Henry T. Hoffman; Michael M. Graham

doi:10.1016/j.otohns.2007.09.008

Preoperative FDG-PET imaging to assess the malignant potential of follicular neoplasms of the thyroid

Russell B. Smith, Robert A. Robinson, Henry T. Hoffman, Michael M. Graham

Otolaryngology-Head & Neck Surgery

Research output: Contribution to journal › Article › peer-review

29 Scopus citations

Abstract

Objective: When a fine needle aspiration biopsy of a thyroid nodule suggests follicular neoplasm, surgery is required for diagnosis. Establishing the diagnosis preoperatively would allow the patient to undergo the appropriate initial thyroidectomy. Preoperative [¹⁸F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging may be able to determine malignancy in follicular neoplasms. Study Design: Prospective cases series. Subjects and Methods: Twenty-three patients with a diagnosis of follicular neoplasm underwent presurgical FDG-PET at 60, 90, and 120 minutes after injection of fluorodeoxyglucose (F18). Thyroidectomy was performed with comparison of the histopathologic results with the FDG-PET results. Results: There were 5 malignant conditions and 18 benign conditions identified with the standard uptake valve (SUV) ranging from 0.9 to 44.8. The follicular thyroid cancers that exhibited only capsular invasion had an average SUV of 3.1, whereas those with vascular invasion had an average SUV of 39.9. The SUV increased in 80% of the malignant cases but in only 50% of the benign cases. Conclusion: Despite certain patterns being suggestive of malignancy, FDG-PET can not consistently predict the malignant potential of a follicular neoplasm.

Original language	English (US)
Pages (from-to)	101-106
Number of pages	6
Journal	Otolaryngology - Head and Neck Surgery
Volume	138
Issue number	1
DOIs	https://doi.org/10.1016/j.otohns.2007.09.008
State	Published - Jan 2008

ASJC Scopus subject areas

Surgery
Otorhinolaryngology

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10.1016/j.otohns.2007.09.008

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title = "Preoperative FDG-PET imaging to assess the malignant potential of follicular neoplasms of the thyroid",

abstract = "Objective: When a fine needle aspiration biopsy of a thyroid nodule suggests follicular neoplasm, surgery is required for diagnosis. Establishing the diagnosis preoperatively would allow the patient to undergo the appropriate initial thyroidectomy. Preoperative [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging may be able to determine malignancy in follicular neoplasms. Study Design: Prospective cases series. Subjects and Methods: Twenty-three patients with a diagnosis of follicular neoplasm underwent presurgical FDG-PET at 60, 90, and 120 minutes after injection of fluorodeoxyglucose (F18). Thyroidectomy was performed with comparison of the histopathologic results with the FDG-PET results. Results: There were 5 malignant conditions and 18 benign conditions identified with the standard uptake valve (SUV) ranging from 0.9 to 44.8. The follicular thyroid cancers that exhibited only capsular invasion had an average SUV of 3.1, whereas those with vascular invasion had an average SUV of 39.9. The SUV increased in 80% of the malignant cases but in only 50% of the benign cases. Conclusion: Despite certain patterns being suggestive of malignancy, FDG-PET can not consistently predict the malignant potential of a follicular neoplasm.",

author = "Smith, {Russell B.} and Robinson, {Robert A.} and Hoffman, {Henry T.} and Graham, {Michael M.}",

note = "Funding Information: This project was funded by grant support from the University of Iowa Roy and Lucille Carver College of Medicine. ",

year = "2008",

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doi = "10.1016/j.otohns.2007.09.008",

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T1 - Preoperative FDG-PET imaging to assess the malignant potential of follicular neoplasms of the thyroid

AU - Smith, Russell B.

AU - Robinson, Robert A.

AU - Hoffman, Henry T.

AU - Graham, Michael M.

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PY - 2008/1

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N2 - Objective: When a fine needle aspiration biopsy of a thyroid nodule suggests follicular neoplasm, surgery is required for diagnosis. Establishing the diagnosis preoperatively would allow the patient to undergo the appropriate initial thyroidectomy. Preoperative [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging may be able to determine malignancy in follicular neoplasms. Study Design: Prospective cases series. Subjects and Methods: Twenty-three patients with a diagnosis of follicular neoplasm underwent presurgical FDG-PET at 60, 90, and 120 minutes after injection of fluorodeoxyglucose (F18). Thyroidectomy was performed with comparison of the histopathologic results with the FDG-PET results. Results: There were 5 malignant conditions and 18 benign conditions identified with the standard uptake valve (SUV) ranging from 0.9 to 44.8. The follicular thyroid cancers that exhibited only capsular invasion had an average SUV of 3.1, whereas those with vascular invasion had an average SUV of 39.9. The SUV increased in 80% of the malignant cases but in only 50% of the benign cases. Conclusion: Despite certain patterns being suggestive of malignancy, FDG-PET can not consistently predict the malignant potential of a follicular neoplasm.

AB - Objective: When a fine needle aspiration biopsy of a thyroid nodule suggests follicular neoplasm, surgery is required for diagnosis. Establishing the diagnosis preoperatively would allow the patient to undergo the appropriate initial thyroidectomy. Preoperative [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging may be able to determine malignancy in follicular neoplasms. Study Design: Prospective cases series. Subjects and Methods: Twenty-three patients with a diagnosis of follicular neoplasm underwent presurgical FDG-PET at 60, 90, and 120 minutes after injection of fluorodeoxyglucose (F18). Thyroidectomy was performed with comparison of the histopathologic results with the FDG-PET results. Results: There were 5 malignant conditions and 18 benign conditions identified with the standard uptake valve (SUV) ranging from 0.9 to 44.8. The follicular thyroid cancers that exhibited only capsular invasion had an average SUV of 3.1, whereas those with vascular invasion had an average SUV of 39.9. The SUV increased in 80% of the malignant cases but in only 50% of the benign cases. Conclusion: Despite certain patterns being suggestive of malignancy, FDG-PET can not consistently predict the malignant potential of a follicular neoplasm.

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Preoperative FDG-PET imaging to assess the malignant potential of follicular neoplasms of the thyroid

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