scholarly journals Radiomics analysis improves 18FDG PET/CT-based risk stratification of cytologically indeterminate thyroid nodules

Endocrine ◽  
2021 ◽  
Author(s):  
Luca Giovanella ◽  
Lisa Milan ◽  
Arnoldo Piccardo ◽  
Gianluca Bottoni ◽  
Marco Cuzzocrea ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Predictive Performance ◽  
Final Diagnosis ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Lesion ◽  
Interpretation Criteria ◽  
18Fdg Pet ◽  
Pet Ct ◽  
Risk Of Malignancy ◽  
Fdg Pet Ct

Abstract Purpose As ~25% of cytologically indeterminate thyroid nodules harbour malignancy, diagnostic lobectomy is still performed in many cases. 18FDG PET/CT rules out malignancy in visually negative nodules; however, none of the currently available interpretation criteria differentiates malignant from benign 18FDG-avid nodules. We evaluated the ability of PET metrics and radiomics features (RFs) to predict final diagnosis of 18FDG-avid cytologically indeterminate thyroid nodules. Methods Seventy-eight patients were retrospectively included. After volumetric segmentation of each thyroid lesion, 4 PET metrics and 107 RFs were extracted. A logistic regression was performed including thyroid stimulating hormone, PET metrics, and RFs to assess their predictive performance. A linear combination of the resulting parameters generated a radiomics score (RS) that was matched with cytology classes (Bethesda III and IV) and compared with final diagnosis. Results Two RFs (shape_Sphericity and glcm_Autocorrelation) differentiated malignant from benign lesions. A predictive model integrating RS and cytology classes effectively stratified the risk of malignancy. The prevalence of thyroid cancer increased from 5 to 37% and 79% in accordance with the number (score 0, 1 or 2, respectively) of positive biomarkers. Conclusions Our multiparametric model may be useful for reducing the number of diagnostic lobectomies with advantages in terms of costs and quality of life for patients.

scholarly journals Radiomics analysis improves 18FDG PET/CT-based risk stratification of cytologically indeterminate thyroid nodules

2021 ◽  
Author(s):  
Luca Giovanella ◽  
Lisa Milan ◽  
Arnoldo Piccardo ◽  
Gianluca Bottoni ◽  
Marco Cuzzocrea ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Predictive Performance ◽  
Final Diagnosis ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Lesion ◽  
Interpretation Criteria ◽  
18Fdg Pet ◽  
Pet Ct ◽  
Risk Of Malignancy ◽  
Fdg Pet Ct

Abstract Purpose As ~ 25% of cytologically indeterminate thyroid nodules harbour malignancy, diagnostic lobectomy is still performed in many cases. 18FDG PET/CT rules out malignancy in visually negative nodules; however, none of the currently available interpretation criteria differentiates malignant from benign 18FDG-avid nodules. We evaluated the ability of PET metrics and radiomics features (RFs) to predict final diagnosis of 18FDG-avid cytologically indeterminate thyroid nodules. Methods 78 patients were retrospectively included. After volumetric segmentation of each thyroid lesion, 4 PET metrics and 107 RFs were extracted. A logistic regression was performed including thyroid stimulating hormone, PET metrics and RFs to assess their predictive performance. A linear combination of the resulting parameters generated a radiomics score (RS) that was matched with cytology classes (Bethesda III and IV) and compared with final diagnosis. Results Two RFs (shape_Sphericity and glcm_Autocorrelation) differentiated malignant from benign lesions. A predictive model integrating RS and cytology classes effectively stratified the risk of malignancy. The prevalence of thyroid cancer increased from 5–37% and 79% in accordance with the number (score 0, 1 or 2, respectively) of positive biomarkers. Conclusion Our multiparametric model may be useful for reducing the number of diagnostic lobectomies with advantages in terms of costs and quality of life for patients.

scholarly journals Hürthle Cells on Fine-Needle Aspiration Cytology Are Important for Risk Assessment of Focally PET/CT FDG Avid Thyroid Nodules

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3544
Author(s):  
David N. Poller ◽  
Hakim Megadmi ◽  
Matthew J. A. Ward ◽  
Pierpaolo Trimboli
Keyword(s):  
Fine Needle Aspiration ◽  
Fdg Pet ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Fine Needle ◽  
Hürthle Cell ◽  
Pet Ct ◽  
Risk Of Malignancy ◽  
Fdg Pet Ct

This study assesses the role of [18F] FDG PET/CT, fine needle aspiration (FNA) cytology and ultrasound in the 1–2% of patients with focally positive thyroid nodules on FDG PET/CT. All FDG PET/CT scans with focally increased thyroid FDG PET/CT uptake performed over 37 months in one institution were matched to patients undergoing thyroid FNA. Diffuse FDG PET/CT uptake patients were excluded. A total of 47 patients showed focally increased thyroid uptake. Consistent with previous studies, 18 (38.2%) patients had malignancy—12 primary thyroid carcinoma, 1 parathyroid carcinoma, 3 metastatic carcinoma to the thyroid and 2 lymphoma. A total of 15 (31.9%) lesions categorized as non-malignant contained Hürthle cells/oncocytes. A total of 14 lesions (29.8%) had focally increased FDG PET/CT uptake with no specific cytological or histopathological cause identified. No focally PET avid Hürthle cell/oncocytic lesions were found to be malignant. Exclusion of oncocytic lesions increased the calculated risk of malignancy (ROM) of focally PET avid nodules from 38% to 68%. It may be useful to exclude focally FDG PET/CT avid Hürthle cell/oncocytic lesions, typically reported as follicular neoplasm or suspicious for a follicular neoplasm, Hürthle cell type (Oncocytic) type, RCPath Thy 3F: Bethesda IV or sometimes Thy 3a: Bethesda III FNAs) from ROM calculations. Oncocytic focally PET/CT FDG avid lesions appear of comparatively lower risk of malignancy and require investigation or operation but these lesions should be readily identified by FNA cytology on diagnostic work up of focally PET avid thyroid nodules.

Dedicated neck 18 F‐FDG PET/CT: An additional tool for risk assessment in thyroid nodules at ultrasound intermediate risk

2019 ◽  
Vol 90 (5) ◽  
pp. 737-743 ◽  
Author(s):  
Pierpaolo Trimboli ◽  
Arnoldo Piccardo ◽  
Maria Alevizaki ◽  
Camilla Virili ◽  
Mehrdad Naseri ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Fdg Pet ◽  
Thyroid Nodules ◽  
Intermediate Risk ◽  
Additional Tool ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Hounsfield unit value has null effect on thyroid nodules at 18F-FDG PET/CT scans

2018 ◽  
Vol 62 (4) ◽  
pp. 460-465
Author(s):  
Filiz Eksi Haydardedeoglu ◽  
Gulay Simsek Bagir ◽  
Nese Torun ◽  
Emrah Kocer ◽  
Mehmet Reyhan ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Thyroid Nodules ◽  
Hounsfield Unit ◽  
Ct Scans ◽  
Null Effect ◽  
Unit Value ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Incidental uptake of 18F-fluorodeoxyglucose in the prostate gland

2014 ◽  
Vol 53 (06) ◽  
pp. 249-258 ◽  
Author(s):  
R. Sadeghi ◽  
L. Giovanella ◽  
G. Treglia ◽  
F. Bertagna
Keyword(s):  
Fdg Pet ◽  
Prostate Gland ◽  
Significant Risk ◽  
Published Data ◽  
Pooled Prevalence ◽  
Pet Ct ◽  
Significant Difference ◽  
Risk Of Malignancy ◽  
18F Fdg ◽  
Fdg Pet Ct

SummaryAim: To perform a systematic review and meta-analysis of published data on the prevalence and risk of malignancy of pros- tatic incidental uptake (PIU) detected by flu- orine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) or PET/computed tomography (PET/CT). Patients, material, methods: A comprehensive literature search of studies published up to February 2014 was performed. Pooled prevalence and malignancy risk of PIU were calculated on a per patient-based analysis including 95% confidence interval (95%CI). Furthermore, we assessed some parameters as potential predictors of malignant PIU. Results: Six studies including 47925 patients who underwent 18F-FDG PET/CT were selected. Pooled prevalence of PIU was 1.8% (95%CI: 1.3–2.3%). Overall, 444 patients with PIU were further evaluated and 121 underwent biopsy. The pooled risk of malignancy in patients with PIU further evaluated or verified by biopsy were 17% (95%CI: 12–23%) and 62% (95%CI: 54–71%), respectively. A higher mean age was observed in the group of malignant PIUs compared to benign PIUs. There was a trend towards a higher mean SUVmax in the group of malignant PIUs but without a statistically significant difference compared to benign PIUs. Peripheric site of PIU but not presence or absence of calcification was a predictor of malignancy. Conclusions: PIU is observed in about 1.8% of 18F-FDG PET/CT scans performed in male patients carrying a significant risk of malignancy. Therefore, whenever a PIU is detected further investigation is warranted to exclude malignancy, in particular when PIU is located in the peripheric site of prostate gland.

scholarly journals Prevalence of focal incidental breast uptake on FDG-PET/CT and risk of malignancy: a systematic review and meta-analysis

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Else Marie Aarstad ◽  
Petter Nordhaug ◽  
Mohammad Naghavi-Behzad ◽  
Lisbet Brønsro Larsen ◽  
Oke Gerke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fdg Pet ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Previous History ◽  
Fdg Uptake ◽  
Pooled Prevalence ◽  
Pet Ct ◽  
Risk Of Malignancy ◽  
Fdg Pet Ct

Abstract Background FDG-PET/CT is increasingly used for oncologic and inflammatory diseases. Focal incidental FDG uptake occurs rarely in breast tissue but has often significant consequences. This study aimed to systematically review literature regarding focal incidental breast uptake (FIBU) on FDG-PET/CT in order to yield an update on the prevalence and risk of malignancy for FIBU. Methods A systematic search for relevant articles published between 2012 and 2018 was performed through MEDLINE, Embase, and Cochrane databases. Studies addressing the detection of FIBU in patients without a previous history of breast malignancy were included. The QUADAS-2 was used for quality assessment, and eligible data were pooled using a fixed-effects model. I2 was calculated for the heterogeneity between studies. Results Eight studies containing 180,002 scans were included in the systematic review. The median prevalence of FIBU for both genders was 0.52% (range 0.18–22.5%). Prevalence for women was mentioned separately in five studies and varied from 0.51 to 23.5%. One study reporting a high prevalence was based on patients being staged for known malignancy, and the word “breast” was used in the search, which may have caused selection bias. Data from four studies were eligible for meta-analysis. A high degree of heterogeneity was observed for prevalence data (I2 of 97.5%), while moderate heterogeneity was observed for data on malignancy risk assessment (I2 of 62.8%). The pooled prevalence of FIBU in women was 0.61% (range 0.56–0.66%), and the pooled prevalence of malignancy of FIBUs was 38.7% (range 34.4–43.0%). The most commonly detected malignancy was invasive ductal carcinoma. Conclusion FIBU occurs rarely on FDG-PET/CT for female patients but yields a high risk of malignancy according to the results of published papers. Therefore, it should be considered relevant to further elucidate patients with incidentally detected FDG uptake in breast in clinical practice.

The effects of chemotherapy on arterial inflammation assessed by 18 FDG PET-CT in patients with Lymphoma

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Solomou ◽  
I Koutagiar ◽  
N Ioakimidis ◽  
D Terentes-Printzios ◽  
A Georgakopoulos ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Heart Function ◽  
Specific Treatment ◽  
Chemotherapy Cycle ◽  
Treatment Regimes ◽  
18Fdg Pet ◽  
Pet Ct ◽  
Study Population ◽  
Arterial Inflammation ◽  
Fdg Pet Ct

Abstract Introduction Anti-cancer treatment can lead to increased cardiovascular morbidity among lymphoma survivors. This may be the result of direct effect of treatment on heart function, or indirect acceleration of atherosclerosis. 18F-fluorodeoxyglucose (FDG) uptake is a sensitive and robust marker for assessment of atherosclerotic inflammation. Purpose To investigate the effects of chemotherapy on arterial inflammation using FDG-PET CT in patients with lymphoma. Methods Fifty nine (mean age 58±17 years) patients with Hodgkin (n=39) or non-Hodgkin lymphomas (n=20) underwent 18FDG PET-CT imaging at baseline, interim and after completion of chemotherapy as part of their routine protocol. Arterial inflammation was assessed by arterial target to background ratio (TBR) of the aortic wall along the entire aorta. The index vessel TBR (the vessel with the higher value at baseline) was used for assessment of arterial inflammation. Patients with Hodgkin Lymphomas (HL) underwent therapy with Doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD). The interim of their treatment was set at 1 to 3 days prior to initiating the 3rd chemotherapy cycle. Patients with non Hodgkin Lymphomas (NHL) underwent therapy with cyclophosphamide, doxorubicin, vincristine, and prednisone+rituximab (R-CHOP). The interim of their treatment was set at 2 weeks post the 4th chemotherapy cycle. All patients we reassessed 6 weeks after chemotherapy completion. Results There were no differences in age and atherosclerotic risk factors (hypertension, diabetes, dyslipidemia and smoking), between the two groups (all P>0.05). Similarly, there were no differences in mean (±SD) index vessel TBR between HL and NHL patients (2.4±0.7 vs 2.7±0.9, respectively, P=0.65). In the whole study population the index vessel TBR progressively decreased after the end of therapy (by 0.53±0.11, from baseline to 6 weeks following the end of therapies) (F=10.94, P<0.001, ANOVA). The index vessel TBR decreased in both HL and NHL patients at 6 weeks after therapy compared to baseline level (all P<0.01, ANOVA, figure). The decrease at the interim scan was more pronounced in NHL compared to HL patients, however at 6 weeks after chemotherapy completion the index vessel TBR decreased further in patients with HL, while it increased slightly compared to interim levels in NHL patients (figure 1). Conclusion Arterial inflammation is reduced during and post-chemotherapy in patients with lymphoma. The index vessel TBR changes at the interim phase and 6 weeks after therapy completion indicate a different effect of specific treatment regimes in arterial inflammation between HL and NHL patients. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Evaluation of FDG-PET/CT Use in Children with Suspected Infection or Inflammation

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 715
Author(s):  
Fabienne G. Ropers ◽  
Robin M. P. van Mossevelde ◽  
Chantal P. Bleeker-Rovers ◽  
Floris H. P. van Velden ◽  
Danielle M. E. van Assema ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Final Diagnosis ◽  
Management Decisions ◽  
Multicenter Cohort Study ◽  
Disease Manifestation ◽  
Suspected Infection ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

[18F]-FDG-PET/CT ([18F]-fluoro-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT)) is increasingly used as a diagnostic tool in suspected infectious or inflammatory conditions. Studies on the value of FDG-PET/CT in children are scarce. This study assesses the role of FDG-PET/CT in suspected infection or inflammation in children. In this multicenter cohort study, 64 scans in 59 children with suspected infection or inflammation were selected from 452 pediatric FDG-PET/CT scans, performed in five hospitals between January 2016 and August 2017. Main outcomes were diagnostic information provided by FDG-PET/CT for diagnostic scans and impact on clinical management for follow-up scans. Of these 64 scans, 50 were performed for primary diagnosis and 14 to monitor disease activity. Of the positive diagnostic scans, 23/27 (85%) contributed to establishing a diagnosis. Of the negative diagnostic scans, 8/21 (38%) contributed to the final diagnosis by narrowing the differential or by providing information on the disease manifestation. In all follow-up scans, FDG-PET/CT results guided management decisions. CRP was significantly higher in positive scans than in negative scans (p = 0.004). In 6% of diagnostic scans, relevant incidental findings were identified. In conclusion, FDG-PET/CT performed in children with suspected infection or inflammation resulted in information that contributed to the final diagnosis or helped to guide management decisions in the majority of cases. Prospective studies assessing the impact of FDG-PET/CT results on diagnosis and patient management using a structured diagnostic protocol are feasible and necessary.

scholarly journals Diagnostic Value of 18F-FDG-PET/CT in Patients with FUO

2020 ◽  
Vol 9 (7) ◽  
pp. 2112
Author(s):  
Stamata Georga ◽  
Paraskevi Exadaktylou ◽  
Ioannis Petrou ◽  
Dimitrios Katsampoukas ◽  
Vasilios Mpalaris ◽  
...  
Keyword(s):  
Predictive Value ◽  
Fdg Pet ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Whole Body ◽  
Considerable Proportion ◽  
Clinical Criteria ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Conventional diagnostic imaging is often ineffective in revealing the underlying cause in a considerable proportion of patients with fever of unknown origin (FUO). The aim of this study was to assess the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with FUO. We retrospectively reviewed 18F-FDG-PET/CT scans performed on 50 consecutive adult patients referred to our department for further investigation of classic FUO. Final diagnosis was based on histopathological and microbiological findings, clinical criteria, or clinical follow-up. Final diagnosis was established in 39/50 (78%) of the patients. The cause of FUO was infection in 20/50 (40%), noninfectious inflammatory diseases in 11/50 (22%), and malignancy in 8/50 (16%) patients. Fever remained unexplained in 11/50 (22%) patients. 18F-FDG-PET/CT scan substantially contributed to the diagnosis in 70% of the patients, either by identifying the underlying cause of FUO or by directing to the most appropriate site for biopsy. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG-PET/CT for active disease detection in patients with FUO were 94.7%, 50.0%, 84.0%, 85.7%, and 75.0%, respectively. In conclusion, whole-body 18F-FDG-PET/CT is a highly sensitive method for detection of the underlining cause of FUO or for correctly targeting suspicious lesions for further evaluation.

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