PET/CT in thyroid nodule and differentiated thyroid cancer patients. The evidence-based state of the art.
Diagnosis
Differentiated thyroid Cancer
PET/CT
Thyroid nodules
Journal
Reviews in endocrine & metabolic disorders
ISSN: 1573-2606
Titre abrégé: Rev Endocr Metab Disord
Pays: Germany
ID NLM: 100940588
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
pubmed:
23
3
2019
medline:
14
4
2020
entrez:
23
3
2019
Statut:
ppublish
Résumé
A more conservative approach to the clinical management of thyroid nodules and differentiated thyroid cancer has recently been proposed by the 2015 ATA guidelines. In this context, fine-needle aspiration biopsy has been reserved for nodules with particular ultrasound features or dimensions that exclude low-risk thyroid lesions. Accordingly, a less aggressive surgical approach (i.e. lobectomy) has been recommended as the first-choice treatment in nodules with indeterminate cytology or in small cytologically confirmed malignant nodules. At the same time, radioactive remnant ablation has been considered only for DTC patients with concrete risks of disease persistence/relapse after thyroidectomy. In addition, further radioactive iodine therapies (RAI) have been proposed only for patients presenting unresectable and iodine-avid structural relapse. In this complex scenario, which requires attention to each clinical aspect of the patient, the introduction of accurate diagnostic tools is highly warranted. PET/CT is a very sensitive and specific diagnostic procedure that can better characterize the risk of thyroid nodules, identify DTC relapse early and predict the response to RAI. Thus, it seems essential to customize a more conservative approach to thyroid nodules and DTC patients. The aim of this review is to report the principal clinical context in which PET/CT has been used and to evaluate the evidence-based support for each diagnostic indication.
Identifiants
pubmed: 30900067
doi: 10.1007/s11154-019-09491-2
pii: 10.1007/s11154-019-09491-2
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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