FDG PET/BT görüntülemede tiroid bezinde rastlantısal saptanan fokal artmış FDG tutulumunun klinik önemi

Amaç: Bu çalışmada tiroid bezinde önceden malignite varlığı bilinmeyen olgularda, FDG PET/BT görüntüleme sırasında rastlantısal saptanan fokal artmış FDG (RSFA-FDG) tutulumunun prevalansı, klinik önemi ve malignite oranlarını araştırmak amaçlandı. Gereç ve Yöntem: Mayıs 2014 – Eylül 2016 tarihleri arasında FDG PET/BT görüntülemesi yapılan 7267 hastada tiroid bezinde RSFA-FDG tutulumu saptanan 193 (%2,6) olgunun klinik takipleri ve SUVmax değerleri retrospektif değerlendirildi. Bulgular: Tiroid bezinde RSFA-FDG tutulumlarının SUVmax değeri 3-71 arasında olup ortalama 9,13±7,4 olarak saptandı. Hastaların %54,4’ünde (105/193) olası tiroid patolojileriyle ilgili inceleme yapıldığı görüldü. Otuz dokuz hastanın (%20,2) patolojik incelemesi mevcut olup, bunların 10’u tiroidektomi materyali, 29 tanesi ise biyopsi sonucuydu. Biyopsi yapılan 29 hastadan iki olgu tiroid papiller karsinomu (TPK), dört olgu TPK yönünden kuşkulu, biri metastatik odak, 22’si ise benign hastalıklar lehine raporlanmıştı. Opere olan 10 hastanın beşinde TPK, ikisinde metastatik odak, kalan üç vakada ise tiroidin benign nodüler hastalıklarıyla uyumlu bulgular saptanmıştı. Malignite tanısı alan 10 tiroid nodülünde SUVmax değeri 3-34,9 arasında olup ortalama SUVmax=12,5±9,1 idi. Serimizde FDG PET/BT görüntülemede RSFA-FDG tutulumu gösteren tiroid nodülü saptanma oranı %2,6 olup, hastaların %20,2’sinde patolojik inceleme yapılmış, malignite oranı %25,6 (10/39) olarak saptanmıştır. Sonuç: FDG PET/BT görüntüleme sırasında saptanan RSFA-FDG tutulumunda malignite oranının yüksek olduğu görülmektedir. Hastaların büyük bölümüne ileri inceleme yapılmamış olması primer maligniteye bağlı sağ kalım beklentisinin kısa olmasına bağlı olabilir.

Clinical significance of random finding of focal increased activity in thyroid gland on FDG PET/CT imaging

Aim: We aimed to investigate prevalence, clinical significance and malignancy rates of incidentally detected focal increased FDG uptake in thyroid gland on FDG PET/CT imaging in cases without known thyroid malignancy. Materials and Methods: Of the 7267 patients who underwent FDG PET/CT imaging between May 2014 and September 2016, 193 (2.6%) patients who had incidentally detected focal increased FDG uptake in thyroid gland were enrolled into the study for retrospective evaluation of clinical follow-up and SUVmax values. Results: The SUVmax values of incidentally detected focal increased FDG foci ranged between 3-71, with an average of 9.13±7.4. Of the 193 patients, 105 (54%) were examined for possible thyroid diseases. A total 39 (20.2%) patients (10 histopathological, 29 cytological) had pathological examination. In cytological examination, two thyroid papillary carcinomas (TPC), one metastasis and 22 benign lesions were reported and four were suspicious for TPC. Five TPC, two primary tumor metastasis and three benign nodular diseases were detected in 10 patients who underwent sugery. In 10 thyroid nodules pathologically confirmed as malignancy, SUVmax values ranged from 3 to 34.9 (mean 12.5±9.1). In our series, incidental thyroid nodules with focal increased FDG uptake were detected in 2.6% of FDG PET/CT examinations. Pathological examination was performed in 20.2% of those patients and malignancy rate was 25.6% (10/39). Conclusion: Rate of malignancy is high in incidentally detected focal increased FDG uptake on FDG PET/CT imaging. The fact that majority of patients have not undergone further examination may be due to the short survival expectancy due to primary malignancy.

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Ege Tıp Dergisi-Cover
  • ISSN: 1016-9113
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1962
  • Yayıncı: Ersin HACIOĞLU
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