scholarly journals Malignancy Risk in 18F-FDG-Avid Thyroid Incidentalomas: Controversies and Limitations

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A864-A865
Author(s):  
Khulood Bukhari ◽  
Zarah Haleem ◽  
Kashif Munir
Keyword(s):  
Fdg Pet ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
American Thyroid Association ◽  
Clinicopathologic Characteristics ◽  
Malignancy Rate ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
Study Results ◽  
18F Fdg

Abstract Introduction: The prevalence of malignancy in thyroid incidentalomas (TI) discovered on 18F-FDG-PET or PET/CT varies between 0% and 63.6%. The pooled malignancy rate according to three systematic reviews is 33-35%. The 2015 American Thyroid Association (ATA) guidelines recommend that such nodules, when one centimeter or larger in size, should undergo further investigation with thyroid ultrasound (US) and fine-needle aspiration (FNA) cytology. Objectives: The objective of our study was to determine the rate of malignancy amongst TI discovered incidentally on 18F-FDG-PET or PET/CT, examine their clinicopathologic characteristics, and assess the usefulness of maximum standardized uptake values (SUVmax) in differentiating benign and malignant lesions. Methods: We performed an electronic medical record search looking at all 18F-FDG-PET or PET/CT reports during the study period of 12/01/2015 to 05/31/2019 that included the keyword ‘thyroid’ in the impression. Exclusion criteria included a history of thyroid disease or malignancy, known lesion(s) detected on previous clinical or radiological examinations and diffuse radiotracer uptake. Of the 476 reports reviewed, 136 cases were included in the study. Results: Common indications included initial staging or restaging of lymphoma (diffuse large B-cell, mantle-cell, T-cell types) (27.9%), lung adenocarcinoma (18.4%), head and neck cancer (16.9%) and breast cancer (11%). Fifty-eight (42.6%) patients had metabolically inactive lesions; five (8.6%) underwent further investigation with thyroid US and 3 subsequently with FNA (5%). All 3 had benign cytology. Seventy-seven (56.6%) patients had metabolically active lesions and 25 (32.5%) underwent imaging with thyroid US. Twelve (15.6%) had FNA; eight (66.7%) had benign cytology, two (16.7%) revealed atypia of undetermined significance and two (16.7%) were malignant. Biopsy for the two patients with malignant cytology showed follicular cell neoplasm of oncocytic hurtle cell type, and invasive follicular carcinoma with focal insular and papillary features and extensive capsular and vascular invasion. The mean SUVmax in malignant vs benign lesions was 9.05 and 6.41 respectively. Conclusion: The malignancy rate was 2.6% amongst all patients with 18F-FDG-avid TI and 8% amongst patients with metabolically active lesions who were investigated with thyroid US+/- FNA. This is significantly lower than malignancy rates previously reported in the literature. The evident inhomogeneity in the literature is likely multifactorial and may be explained in part by a dissimilarity among studies, and an informed decision by some to avoid invasive testing in the context of poor prognosis from underlying non-thyroidal cancer. Research is needed to determine the cohort of patients who could potentially benefit from further evaluation and treatment.

scholarly journals Value of 18-F-FDG PET/CT and CT in the Diagnosis of Indeterminate Adrenal Masses

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Nathalie Launay ◽  
Stéphane Silvera ◽  
Florence Tenenbaum ◽  
Lionel Groussin ◽  
Frédérique Tissier ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Malignant Tumors ◽  
Apparent Diffusion Coefficient Values ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
Adrenal Masses ◽  
18F Fdg ◽  
Ct Data ◽  
Adrenocortical Carcinomas ◽  
Fdg Pet Ct

The purpose of this paper was to study the value of 18-FDG PET/CT and reassess the value of CT for the characterization of indeterminate adrenal masses. 66 patients with 67 indeterminate adrenal masses were included in our study. CT/MRI images and 18F-FDG PET/CT data were evaluated blindly for tumor morphology, enhancement features, apparent diffusion coefficient values, maximum standardized uptake values, and adrenal-to-liver maxSUV ratio. The study population comprised pathologically confirmed 16 adenomas, 19 metastases, and 32 adrenocortical carcinomas. Macroscopic fat was observed in 62.5% of the atypical adenomas at CT but not in malignant masses. On 18F-FDG PET/CT, SUVmax and adrenal-to-liver maxSUV ratio were significantly lower in adenomas than in malignant tumors. An SUVmax value of less than 3.7 or an adrenal-to-liver maxSUV ratio of less than 1.29 is highly predictive of benignity.

scholarly journals Usefulness of 18F-FDG PET/CT in Patients with Cardiac Implantable Electronic Device Suspected of Late Infection

2020 ◽  
Vol 9 (7) ◽  
pp. 2246
Author(s):  
Giuseppe Rubini ◽  
Cristina Ferrari ◽  
Domenico Carretta ◽  
Luigi Santacroce ◽  
Rossella Ruta ◽  
...  
Keyword(s):  
Predictive Value ◽  
Fdg Pet ◽  
Large Scale ◽  
Electronic Device ◽  
High Sensitivity ◽  
Roc Curves ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

The presence of a cardiovascular implantable electronic device (CIED) can be burdened by complications such as late infections that are associated with significant morbidity and mortality and require immediate and effective treatment. The aim of this study was to evaluate the role of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT) in patients with suspected CIED infection. Fifteen patients who performed a 18F-FDG PET/CT for suspicion of CIED infection were retrospectively analyzed; 15 patients, with CIED, that underwent 18F-FDG PET/CT for oncological reasons, were also evaluated. Visual qualitative analysis and semi-quantitative analysis were performed. All patients underwent standard clinical management regardless 18F-FDG PET/CT results. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) resulted as 90.91%, 75%, 86.67%, 90.91% and 75% respectively. Maximum standardized uptake values (SUVmax) and semi-quantitative ratio (SQR) were collected and showed differences statistically significant between CIED infected patients and those who were not. Exploratory cut-off values were derived from receiver operating characteristic (ROC) curves for SUVmax (2.56) and SQR (4.15). This study suggests the clinical usefulness of 18F-FDG PET/CT in patients with CIED infection due to its high sensitivity, repeatability and non-invasiveness. It can help the clinicians in decision making, especially in patients with doubtful clinical presentation. Future large-scale and multicentric studies should be conducted to establish precise protocols about 18F-FDG PET/CT performance.

Inter-comparison of 18F-FDG PET/CT standardized uptake values in Korea

2011 ◽  
Vol 69 (1) ◽  
pp. 241-246 ◽  
Author(s):  
Hoon Hee Park ◽  
Dae Sung Park ◽  
Dae Cheol Kweon ◽  
Sang Bock Lee ◽  
Ki Baek Oh ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Impact of blood glucose, diabetes, insulin, and obesity on standardized uptake values in tumors and healthy organs on 18F-FDG PET/CT

2013 ◽  
Vol 40 (2) ◽  
pp. 206-213 ◽  
Author(s):  
Karen A. Büsing ◽  
Stefan O. Schönberg ◽  
Joachim Brade ◽  
Klaus Wasser
Keyword(s):  
Blood Glucose ◽  
Fdg Pet ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals CXCR4-Directed PET/CT in Patients with Newly Diagnosed Neuroendocrine Carcinomas

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 605
Author(s):  
Alexander Weich ◽  
Rudolf A. Werner ◽  
Andreas K. Buck ◽  
Philipp E. Hartrampf ◽  
Sebastian E. Serfling ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Cxcr4 Expression ◽  
Reference Standard ◽  
Diagnostic Potential ◽  
Pet Tracer ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Neuroendocrine Carcinomas

We aimed to elucidate the diagnostic potential of the C-X-C motif chemokine receptor 4 (CXCR4)-directed positron emission tomography (PET) tracer 68Ga-Pentixafor in patients with poorly differentiated neuroendocrine carcinomas (NEC), relative to the established reference standard 18F-FDG PET/computed tomography (CT). In our database, we retrospectively identified 11 treatment-naïve patients with histologically proven NEC, who underwent 18F-FDG and CXCR4-directed PET/CT for staging and therapy planning. The images were analyzed on a per-patient and per-lesion basis and compared to immunohistochemical staining (IHC) of CXCR4 from PET-guided biopsies. 68Ga-Pentixafor visualized tumor lesions in 10/11 subjects, while18F-FDG revealed sites of disease in all 11 patients. Although weak to moderate CXCR4 expression could be corroborated by IHC in 10/11 cases, 18F-FDG PET/CT detected significantly more tumor lesions (102 vs. 42; total lesions, n = 107; p < 0.001). Semi-quantitative analysis revealed markedly higher 18F-FDG uptake as compared to 68Ga-Pentixafor (maximum and mean standardized uptake values (SUV) and tumor-to-background ratios (TBR) of cancerous lesions, SUVmax: 12.8 ± 9.8 vs. 5.2 ± 3.7; SUVmean: 7.4 ± 5.4 vs. 3.1 ± 3.2, p < 0.001; and, TBR 7.2 ± 7.9 vs. 3.4 ± 3.0, p < 0.001). Non-invasive imaging of CXCR4 expression in NEC is inferior to the reference standard 18F-FDG PET/CT.

scholarly journals The Link between Cytogenetics/Genomics and Imaging Patterns of Relapse and Progression in Patients with Relapsed/Refractory Multiple Myeloma: A Pilot Study Utilizing 18F-FDG PET/CT

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2399 ◽  
Author(s):  
Xiang Zhou ◽  
Alexander Dierks ◽  
Olivia Kertels ◽  
Samuel Samnick ◽  
Malte Kircher ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Pilot Study ◽  
Fdg Pet ◽  
Progression Free Survival ◽  
Standardized Uptake Values ◽  
Positron Emission ◽  
Pet Ct ◽  
Genomic Markers ◽  
18F Fdg ◽  
Fdg Pet Ct

Utilizing 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT), we performed this pilot study to evaluate the link between cytogenetic/genomic markers and imaging patterns in relapsed/refractory (RR) multiple myeloma (MM). We retrospectively analyzed data of 24 patients with RRMM who were treated at our institution between November 2018 and February 2020. At the last relapse/progression, patients had been treated with a median of three (range 1–10) lines of therapy. Six (25%) patients showed FDG avid extramedullary disease without adjacency to bone. We observed significantly higher maximum standardized uptake values (SUVmax) in patients harboring del(17p) compared with those without del(17p) (p = 0.025). Moreover, a high SUVmax of >15 indicated significantly shortened progression-free survival (PFS) (p = 0.01) and overall survival (OS) (p = 0.0002). One female patient exhibited biallelic TP53 alteration, i.e., deletion and mutation, in whom an extremely high SUVmax of 37.88 was observed. In summary, this pilot study suggested a link between del(17p)/TP53 alteration and high SUVmax on 18F-FDG PET/CT in RRMM patients. Further investigations are highly warranted at this point.

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