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PET/CT and prediction of thyroid cancer in patients with follicular neoplasm or atypia

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Abstract

Purpose

To examine whether addition of 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT) to fine needle aspiration biopsy (FNAB) would improve prediction of thyroid cancer in patients with FNAB-derived follicular neoplasm or atypia, classified according to focal, multifocal, diffuse, or no FDG uptake.

Materials and methods

Consecutive patients with FNAB-derived follicular neoplasm or atypia planned for surgery from September 2013 to March 2016 were prospectively included and considered for analysis. All patients underwent preoperative PET/CT and a clinical head and neck examination, including ultrasound of the neck and the thyroid gland. Patients with obvious signs of thyroid malignancy were excluded from the study. Histology of the surgical specimen was used as reference standard for statistical analysis.

Results

Of the 108 patients included (85 women, median age 53.4 years), 31 (29%) had a thyroid nodule that was histologically verified as malignant. Sensitivity and specificity for PET/CT in detection of thyroid cancer was 79 and 32%, respectively, including a derived positive predictive value (PPV) of 31%, and a negative predictive value (NPV) of 79%. Univariate and multivariate analyses showed no significant increase in the risk of thyroid cancer among patients with focal or multifocal FDG uptake compared to patients with no FDG uptake.

Conclusion

Addition of PET/CT to FNAB did not improve prediction of thyroid cancer in patients with FNAB-derived follicular neoplasm or atypia.

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Author information

Author notes

  1. Thao T. Nguyen and Natascha G. E. Lange shared first authorship. Both authors contributed equally to this work.

Authors and Affiliations

  1. Department of ORL, Head and Neck Surgery, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark

    Thao T. Nguyen, Natascha G. E. Lange, Helle Døssing, Christian Godballe & Max Rohde

  2. Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark

    Anne L. Nielsen & Anders Thomassen

Authors
  1. Thao T. Nguyen
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  2. Natascha G. E. Lange
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  3. Anne L. Nielsen
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  4. Anders Thomassen
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  5. Helle Døssing
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  6. Christian Godballe
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  7. Max Rohde
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Corresponding authors

Correspondence to Thao T. Nguyen or Natascha G. E. Lange.

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Ethical considerations

The diagnostic procedures including FNAB, PET/CT, surgical procedure, and final histology were approved by the Regional Ethics Committee and the Danish Data Protection Agency Region of Southern Denmark.

Conflict of interest

This study received no financial or other compensations. The authors declare that there is no conflict of interests regarding the publication of this article.

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Nguyen, T.T., Lange, N.G.E., Nielsen, A.L. et al. PET/CT and prediction of thyroid cancer in patients with follicular neoplasm or atypia. Eur Arch Otorhinolaryngol 275, 2109–2117 (2018). https://doi.org/10.1007/s00405-018-5030-4

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  • DOI: https://doi.org/10.1007/s00405-018-5030-4

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