Contribution of Focal 18F-FDG Uptake on Positron Emission Tomography/Computed Tomography to Ultrasonography-Based Malignancy Risk Assessment in Incidentally Detected Thyroid Nodules

IF 2.1 4区医学 Q4 ONCOLOGY

Asia-Pacific journal of clinical oncology Pub Date : 2026-10-22 Epub Date: 2026-08-06 DOI:10.1111/ajco.70154

Yusuf Öztürk, Buğra Kaya, Yusuf Karadeniz, Melia Karaköse

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引用次数: 0

Abstract

Aim

The present study sought to evaluate the incremental contribution of the presence of focal FDG uptake and SUVmax on PET/CT in predicting malignancy in incidentally detected thyroid nodules when assessed in conjunction with ultrasonography-based risk features.

Methods

In this retrospective study, 304 incidentally detected thyroid nodules identified on PET/CT and confirmed by cytology and/or histopathology were analyzed. The clinical, ultrasonographic, and PET/CT findings were meticulously documented. The presence or absence of focal FDG uptake was subsequently visually assessed on PET/CT images, and SUVmax values were also calculated for FDG-avid nodules. The factors associated with malignancy were evaluated using univariate and multivariate logistic regression analyses.

Results

The overall malignancy rate was 12.2%. The analysis revealed that focal FDG uptake was observed in 97.3% of malignant nodules and in 65.9% of benign nodules (p < 0.001). Among FDG-avid nodules, SUVmax values were significantly higher in malignant lesions (p < 0.001). However, in multivariate models incorporating ultrasonography-based risk features, focal FDG uptake demonstrated only borderline statistical significance (p = 0.055), while SUVmax was not independently associated with malignancy (p = 0.360).

Conclusion

The absence of focal FDG uptake on PET/CT was associated with a very low likelihood of malignancy in incidentally detected thyroid nodules. However, focal FDG uptake should be interpreted in conjunction with ultrasonography-based risk features rather than as an independent decision-making criterion. Although SUVmax values were higher in malignant FDG-avid nodules, SUVmax did not provide independent or additional diagnostic value beyond ultrasonography-based risk assessment.

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正电子发射断层扫描/计算机断层扫描中病灶18f - fdg摄取对偶然发现甲状腺结节的超声诊断的贡献

目的：本研究旨在评估局灶性FDG摄取和SUVmax在PET/CT上对偶然发现的甲状腺结节的恶性预测的增量贡献，并结合超声检查为基础的危险特征进行评估。方法：回顾性分析304例经PET/CT检查并经细胞学和/或组织病理学证实的甲状腺结节。临床、超声和PET/CT检查结果被详细记录。随后在PET/CT图像上评估局灶性FDG摄取的存在与否，并计算FDG结节的SUVmax值。使用单变量和多变量logistic回归分析评估与恶性肿瘤相关的因素。结果：总恶性率为12.2%。分析显示，97.3%的恶性结节和65.9%的良性结节局灶性氟脱氧葡萄糖摄取（p < 0.001）。在fdg阳性结节中，SUVmax值在恶性病变中显著升高（p < 0.001）。然而，在结合超声危险特征的多变量模型中，局灶性FDG摄取仅显示边缘性统计学意义（p = 0.055），而SUVmax与恶性肿瘤没有独立相关性（p = 0.360）。结论：在PET/CT上没有局灶性FDG摄取与偶然发现的甲状腺结节的恶性可能性非常低有关。然而，局灶性FDG摄取应与基于超声检查的风险特征一起解释，而不是作为独立的决策标准。虽然SUVmax值在恶性FDG-avid结节中较高，但SUVmax并没有提供独立的或额外的诊断价值，除了基于超声的风险评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia-Pacific journal of clinical oncology 医学-肿瘤学

CiteScore

3.40

自引率

0.00%

发文量

175

审稿时长

6-12 weeks

期刊介绍： Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.