The FDG Pattern of Autonomously Functioning Thyroid Nodules Correlates With Thyroid-Stimulating Hormone and Histopathology.


Journal

Clinical nuclear medicine
ISSN: 1536-0229
Titre abrégé: Clin Nucl Med
Pays: United States
ID NLM: 7611109

Informations de publication

Date de publication:
01 Feb 2023
Historique:
pubmed: 20 10 2022
medline: 11 1 2023
entrez: 19 10 2022
Statut: ppublish

Résumé

Whereas the 18 F-FDG PET/CT pattern of malignant thyroid neoplasia is known, the glucose uptake of autonomously functioning thyroid nodules (AFTNs) has not been fully investigated. We aimed to analyze the FDG uptake of AFTNs and its correlation with clinical, laboratory, ultrasonography, and histological features. We retrospectively analyzed the records of all AFTN patients from 2 centers, in which an 18 F-FDG PET/CT, thyroid function tests, and neck ultrasound were available within a 3-month window from the thyroid scintigraphy. Forty-five patients (35 female patients; median age, 65 years) were retrospectively included. The presence of FDG uptake was compared with the laboratory data and, whenever available, the histology. Over a 36-month follow-up, 20 patients underwent surgery; 4 cancers, 10 follicular adenomas, and 6 follicular hyperplasias were found. Twenty-two AFTNs (48.9%) were FDG-positive, whereas the remaining 23 (51.1%) were not. Thyroid-stimulating hormone (TSH) was significantly lower in FDG-positive AFTNs than in negative ones (0.055 [0.02-0.42] vs 0.65 [0.2-0.96] mIU/L, P = 0.0018). On multivariate analysis, only TSH was independently associated with FDG uptake ( P = 0.008). On receiver operating characteristic curve analysis, TSH <0.08 mIU/L indicated FDG-positive AFTNs, with 64% sensitivity, 87% specificity, 4.88 positive likelihood ratio, and 0.42 negative likelihood ratio. In histologically proven benign lesions, TSH was significantly lower in follicular adenomas than in follicular hyperplasias ( P < 0.001). Patients with cancer had TSH in the low-normal range. Autonomously functioning thyroid nodules show heterogeneous uptake FDG pattern, which depends on histopathology and thyroid function. Particularly, follicular adenomas tend to display increased glucose uptake and suppressed TSH.

Identifiants

pubmed: 36260757
doi: 10.1097/RLU.0000000000004396
pii: 00003072-202302000-00003
doi:

Substances chimiques

Thyrotropin 9002-71-5
Fluorodeoxyglucose F18 0Z5B2CJX4D
Glucose IY9XDZ35W2

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

119-125

Informations de copyright

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of interest and sources of funding: none declared.

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Auteurs

Arnoldo Piccardo (A)

From the Nuclear Medicine Department, Ente Ospedaliero "Ospedali Galliera," Genoa.

Francesco Fiz (F)

From the Nuclear Medicine Department, Ente Ospedaliero "Ospedali Galliera," Genoa.

Gianluca Bottoni (G)

From the Nuclear Medicine Department, Ente Ospedaliero "Ospedali Galliera," Genoa.

Michela Massollo (M)

From the Nuclear Medicine Department, Ente Ospedaliero "Ospedali Galliera," Genoa.

Matteo Puntoni (M)

Clinical and epidemiological research unit, University Hospital of Parma, Parma.

Ugo Catrambone (U)

General Surgery Department.

Luca Foppiani (L)

Internal Medicine Department, Ente Ospedaliero "Ospedali Galliera," Genoa.

Francesco Bertagna (F)

Nuclear Medicine Department, University of Brescia and ASST Spedali Civili Di Brescia, P.le Spedali Civili, Brescia, Italy.

Domenico Albano (D)

Nuclear Medicine Department, University of Brescia and ASST Spedali Civili Di Brescia, P.le Spedali Civili, Brescia, Italy.

Pierpaolo Trimboli (P)

Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano.

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