Prevalence of Malignancy in Patients with Tyroid Incidentalomas detected by 18F-Fluorodeoxyglucose Positron Emission Tomography

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Title Prevalence of Malignancy in Patients with Tyroid Incidentalomas detected by 18F-Fluorodeoxyglucose Positron Emission Tomography
 
Creator Juan Maria Ibarra O Co; Alumni, Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, St. Luke's Medical Center
Michael L Villa; Chief of Section, Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, St. Luke's Medical Center
Jonas Y Santiago; Chairman, Department of Nuclear Medicine, St. Luke's Medical Center, Head, Positron Emission Tomography Center, St. Luke's Medical Center, Assistant Professor I, St. Luke's College of Medicine William H. Quasha Memorial
 
Subject Endocrinology
Thyroid incidentaloma; thyroid carcinoma; positron emission tomography
 
Description Background: Thyroid incidentalomas detected by 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) have been reported in 1.1 to 2.9% of scans performed. Previous studies have determined the prevalence of thyroid malignancy in these patients to be 14-72%. Objective: We undertook a retrospective study to determine the prevalence of thyroid incidentalomas in our center, and evaluated the corresponding prevalence for malignancy in these patients. Results: A total of 2,912 FDG-PET scans were performed on 1,855 patients, of which 56 (3.0%) presented with a thyroid incidentaloma (40 focal and 16 diffuse). Among the 22 patients who had an ultrasound, 15 presented with solid nodules (10 focal and 5 diffuse), while 5 were negative for any lesions (4 focal and 1 diffuse). Of 13 patients who had a subsequent FDGPET scan, 8 had resolution of the hypermetabolic foci (61.5%), of which 5 were focal and 3 diffuse. Only 1 of 6 incidentalomas whose histological diagnoses were available showed malignancy (papillary carcinoma). Other cytologic diagnoses include colloid goiter and lymphocytic thyroiditis. Conclusion: The prevalence of thyroid malignancy in focal incidentalomas is 1 in 12 (8.3%) and 1 in 17 in all incidentalomas (5.9%). Our experience indicates that the prevalence rates are much lower than that previously reported. Nevertheless, the prevalence rates are significantly elevated to warrant further evaluation, including an imaging procedure and fine needle aspiration biopsy. Keywords: Thyroid incidentaloma; thyroid carcinoma; positron emission tomography DOI: 10.3860/pjim.v47i2.1645   Phil. J. Internal Medicine, 47: 71-75, March-April, 2009  
 
Publisher The Philippine College of Physicians
 
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Date 2010-07-23
 
Type Peer-Reviewed Article

 
Format application/pdf
 
Identifier http://www.philjol.info/index.php/PJIM/article/view/1645
 
Source Philippine Journal of Internal Medicine; Vol 47, No 2 (2009); 71-75
 
Language en
 
Coverage Philippines