A Nazari, S Sager, S Schenke, L Uslu Beşli, C Samancı, T Öztürk, H B Sayman
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SUVmax and ADC values were correlated with FNAC results.</p><p><strong>Results: </strong>FNAC results revealed 76 (70.4%) benign and 32 (29.6%) malignant nodules among the 108 patients. The mean SUVmax of malignant nodules was significantly higher than that of benign nodules (10.6 ± 8.3 vs. 5.94 ± 5.2, p < 0.001). Similarly, the mean ADC value was lower in malignant nodules compared to benign ones (1.4 ± 0.6 × 10<sup>-3</sup> mm<sup>2</sup>/s vs. 1.8 ± 0.4 × 10<sup>-3</sup> mm<sup>2</sup>/s; p < 0.001). A significant but weak correlation was found between FNAC results and mean SUVmax (r = 0.335), as well as a significant weak negative correlation with mean ADC values (r = -0.355). Using a cut-off value of 6 for SUVmax and 1.56 × 10<sup>-3</sup> mm<sup>2</sup>/s for ADC, the sensitivity, specificity, and accuracy for SUVmax were 68.7%, 73.6%, and 72.1%, respectively, while for ADC, they were 71.8%, 69.7%, and 70.4%, respectively. The PET/MRI system demonstrated a relative sensitivity, specificity, accuracy, PPV, and NPV of 90.62%, 51.32%, 62.96%, 43.94%, and 92.86%.</p><p><strong>Conclusion: </strong>This study is one of the first in the literature to explore the use of FDG PET/MRI, a single-stop device, in distinguishing between benign and malignant thyroid nodules with high sensitivity and NPV.</p>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":" ","pages":"502333"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The contribution of PET/MRI in benign/malignant nodule separation in thyroid incidentalomas detected in FDG PET/CT imaging.\",\"authors\":\"A Nazari, S Sager, S Schenke, L Uslu Beşli, C Samancı, T Öztürk, H B Sayman\",\"doi\":\"10.1016/j.rceng.2025.502333\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction and objectives: </strong>Incidentalomas of the thyroid gland are frequently observed in oncological patients undergoing FDG PET/CT imaging for staging or treatment response assessment. This study aims to investigate the utility of SUVmax and ADC values measured by PET/MRI in distinguishing between benign and malignant thyroid nodules.</p><p><strong>Materials and methods: </strong>We selected 108 patients (72 females, 36 males; mean age 54 ± 12 years) who underwent routine oncological FDG PET/CT scans for staging or treatment response assessment, with nodule sizes greater than 1 cm. A one-bed neck PET/MRI scan followed the whole-body PET/CT. SUVmax values were measured, and ADC maps were created using DWI with b factors of 50 and 1000 s/mm<sup>2</sup>. SUVmax and ADC values were correlated with FNAC results.</p><p><strong>Results: </strong>FNAC results revealed 76 (70.4%) benign and 32 (29.6%) malignant nodules among the 108 patients. The mean SUVmax of malignant nodules was significantly higher than that of benign nodules (10.6 ± 8.3 vs. 5.94 ± 5.2, p < 0.001). Similarly, the mean ADC value was lower in malignant nodules compared to benign ones (1.4 ± 0.6 × 10<sup>-3</sup> mm<sup>2</sup>/s vs. 1.8 ± 0.4 × 10<sup>-3</sup> mm<sup>2</sup>/s; p < 0.001). A significant but weak correlation was found between FNAC results and mean SUVmax (r = 0.335), as well as a significant weak negative correlation with mean ADC values (r = -0.355). Using a cut-off value of 6 for SUVmax and 1.56 × 10<sup>-3</sup> mm<sup>2</sup>/s for ADC, the sensitivity, specificity, and accuracy for SUVmax were 68.7%, 73.6%, and 72.1%, respectively, while for ADC, they were 71.8%, 69.7%, and 70.4%, respectively. 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引用次数: 0
摘要
简介和目的：在接受FDG PET/CT成像进行分期或治疗反应评估的肿瘤患者中经常观察到甲状腺偶发瘤。本研究旨在探讨PET/MRI测量的SUVmax和ADC值在区分良性和恶性甲状腺结节中的应用。材料与方法：选取108例患者，其中女性72例，男性36例；平均年龄54±12岁)，接受常规肿瘤FDG PET/CT扫描进行分期或治疗反应评估，结节大小大于1cm。全身PET/CT扫描后进行单床颈部PET/MRI扫描。测量SUVmax值，并使用b因子为50和1000s/mm²的DWI创建ADC图。SUVmax和ADC值与FNAC结果相关。结果：FNAC结果显示，108例患者中良性结节76例（70.4%），恶性结节32例（29.6%）。恶性结节的平均SUVmax明显高于良性结节（10.6±8.3 vs. 5.94±5.2,p）。结论：本研究是文献中首次探索利用FDG PET/MRI这种单次停止装置来区分高灵敏度和NPV的甲状腺结节的良恶性。
The contribution of PET/MRI in benign/malignant nodule separation in thyroid incidentalomas detected in FDG PET/CT imaging.
Introduction and objectives: Incidentalomas of the thyroid gland are frequently observed in oncological patients undergoing FDG PET/CT imaging for staging or treatment response assessment. This study aims to investigate the utility of SUVmax and ADC values measured by PET/MRI in distinguishing between benign and malignant thyroid nodules.
Materials and methods: We selected 108 patients (72 females, 36 males; mean age 54 ± 12 years) who underwent routine oncological FDG PET/CT scans for staging or treatment response assessment, with nodule sizes greater than 1 cm. A one-bed neck PET/MRI scan followed the whole-body PET/CT. SUVmax values were measured, and ADC maps were created using DWI with b factors of 50 and 1000 s/mm2. SUVmax and ADC values were correlated with FNAC results.
Results: FNAC results revealed 76 (70.4%) benign and 32 (29.6%) malignant nodules among the 108 patients. The mean SUVmax of malignant nodules was significantly higher than that of benign nodules (10.6 ± 8.3 vs. 5.94 ± 5.2, p < 0.001). Similarly, the mean ADC value was lower in malignant nodules compared to benign ones (1.4 ± 0.6 × 10-3 mm2/s vs. 1.8 ± 0.4 × 10-3 mm2/s; p < 0.001). A significant but weak correlation was found between FNAC results and mean SUVmax (r = 0.335), as well as a significant weak negative correlation with mean ADC values (r = -0.355). Using a cut-off value of 6 for SUVmax and 1.56 × 10-3 mm2/s for ADC, the sensitivity, specificity, and accuracy for SUVmax were 68.7%, 73.6%, and 72.1%, respectively, while for ADC, they were 71.8%, 69.7%, and 70.4%, respectively. The PET/MRI system demonstrated a relative sensitivity, specificity, accuracy, PPV, and NPV of 90.62%, 51.32%, 62.96%, 43.94%, and 92.86%.
Conclusion: This study is one of the first in the literature to explore the use of FDG PET/MRI, a single-stop device, in distinguishing between benign and malignant thyroid nodules with high sensitivity and NPV.
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