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Preoperative stratification of cytologically indeterminate thyroid nodules by [18F]FDG-PET: can Orpheus bring back Eurydice?

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Data availability

The study protocol and datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Data requestors will need to sign a data access agreement and in keeping with patient consent for secondary use and obtain ethical approval for any new analyses.

Notes

  1. For presented RoM’s, NIFTP is counted as malignancy. When NIFTP is considered benign, the RoM for Bethesda III, IV, V and VI is 6-18%, 10-40%, 45-60% and 94-96%, respectively [2].

References

  1. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26:1–133. https://doi.org/10.1089/thy.2015.0020.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Cibas ES, Ali SZ. The 2017 Bethesda system for reporting thyroid cytopathology. Thyroid. 2017;27:1341–6. https://doi.org/10.1089/thy.2017.0500.

    Article  PubMed  Google Scholar 

  3. Strieder DL, Cristo AP, Zanella AB, Faccin CS, Farenzena M, Graudenz MS, et al. Using an ultrasonography risk stratification system to enhance the thyroid fine needle aspiration performance. Eur J Radiol. 2022;150: 110244. https://doi.org/10.1016/j.ejrad.2022.110244.

    Article  PubMed  Google Scholar 

  4. de Koster EJ, de Geus-Oei LF, Dekkers OM, van Engen-van GI, Hamming J, Corssmit EPM, et al. Diagnostic utility of molecular and imaging biomarkers in cytological indeterminate thyroid nodules. Endocr Rev. 2018;39:154–91. https://doi.org/10.1210/er.2017-00133.

    Article  PubMed  Google Scholar 

  5. Joensuu H, Ahonen A, Klemi PJ. 18F-fluorodeoxyglucose imaging in preoperative diagnosis of thyroid malignancy. Eur J Nucl Med. 1988;13:502–6. https://doi.org/10.1007/BF00256624.

    Article  CAS  PubMed  Google Scholar 

  6. Adler LP, Bloom AD. Positron emission tomography of thyroid masses. Thyroid. 1993;3:195–200. https://doi.org/10.1089/thy.1993.3.195.

    Article  CAS  PubMed  Google Scholar 

  7. Bloom AD, Adler LP, Shuck JM. Determination of malignancy of thyroid nodules with positron emission tomography. Surg. 1993;114:728–34 (discussion 34–5).

    CAS  Google Scholar 

  8. de Geus-Oei LF, Pieters GF, Bonenkamp JJ, Mudde AH, Bleeker-Rovers CP, Corstens FH, et al. 18F-FDG PET reduces unnecessary hemithyroidectomies for thyroid nodules with inconclusive cytologic results. J Nucl Med. 2006;47:770–5.

    PubMed  Google Scholar 

  9. Vriens D, de Wilt JH, van der Wilt GJ, Netea-Maier RT, Oyen WJ, de Geus-Oei LF. The role of [18F]-2-fluoro-2-deoxy-d-glucose-positron emission tomography in thyroid nodules with indeterminate fine-needle aspiration biopsy: systematic review and meta-analysis of the literature. Cancer. 2011;117:4582–94. https://doi.org/10.1002/cncr.26085.

    Article  PubMed  Google Scholar 

  10. Vriens D, Adang EM, Netea-Maier RT, Smit JW, de Wilt JH, Oyen WJ, et al. Cost-effectiveness of FDG-PET/CT for cytologically indeterminate thyroid nodules: a decision analytic approach. J Clin Endocrinol Metab. 2014;99:3263–74. https://doi.org/10.1210/jc.2013-3483.

    Article  CAS  PubMed  Google Scholar 

  11. Kim JM, Ryu JS, Kim TY, Kim WB, Kwon GY, Gong G, et al. 18F-fluorodeoxyglucose positron emission tomography does not predict malignancy in thyroid nodules cytologically diagnosed as follicular neoplasm. J Clin Endocrinol Metab. 2007;92:1630–4. https://doi.org/10.1210/jc.2006-2311.

    Article  CAS  PubMed  Google Scholar 

  12. Salvatori M, Biondi B, Rufini V. Imaging in endocrinology: 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up. Eur J Endocrinol. 2015;173:R115–30. https://doi.org/10.1530/EJE-15-0066.

    Article  CAS  PubMed  Google Scholar 

  13. Pak K, Kim SJ, Kim IJ, Kim BH, Kim SS, Jeon YK. The role of 18F-fluorodeoxyglucose positron emission tomography in differentiated thyroid cancer before surgery. Endocr Relat Cancer. 2013;20:R203–13. https://doi.org/10.1530/ERC-13-0088.

    Article  CAS  PubMed  Google Scholar 

  14. Wang N, Zhai H, Lu Y. Is fluorine-18 fluorodeoxyglucose positron emission tomography useful for the thyroid nodules with indeterminate fine needle aspiration biopsy? A meta-analysis of the literature. J Otolaryngol Head Neck Surg. 2013;42:38. https://doi.org/10.1186/1916-0216-42-38.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Castellana M, Trimboli P, Piccardo A, Giovanella L, Treglia G. Performance of (18)F-FDG PET/CT in selecting thyroid nodules with indeterminate fine-needle aspiration cytology for surgery. A systematic review and a meta-analysis. J Clin Med. 2019;8. https://doi.org/10.3390/jcm8091333.

  16. Qichang W, Jinming S, Lu L, Bin J, Renjie W, Xiuying Z. Comparison of 18F-FDG-PET and 18F-FDG-PET/CT for the diagnostic performance in thyroid nodules with indeterminate cytology: a meta-analysis. Medicine (Baltimore). 2020;99: e20446. https://doi.org/10.1097/MD.0000000000020446.

    Article  PubMed  Google Scholar 

  17. Deandreis D, Al Ghuzlan A, Auperin A, Vielh P, Caillou B, Chami L, et al. Is (18)F-fluorodeoxyglucose-PET/CT useful for the presurgical characterization of thyroid nodules with indeterminate fine needle aspiration cytology? Thyroid. 2012;22:165–72. https://doi.org/10.1089/thy.2011.0255.

    Article  CAS  PubMed  Google Scholar 

  18. Hales NW, Krempl GA, Medina JE. Is there a role for fluorodeoxyglucose positron emission tomography/computed tomography in cytologically indeterminate thyroid nodules? Am J Otolaryngol. 2008;29:113–8. https://doi.org/10.1016/j.amjoto.2007.04.006.

    Article  PubMed  Google Scholar 

  19. Traugott AL, Dehdashti F, Trinkaus K, Cohen M, Fialkowski E, Quayle F, et al. Exclusion of malignancy in thyroid nodules with indeterminate fine-needle aspiration cytology after negative 18F-fluorodeoxyglucose positron emission tomography: interim analysis. World J Surg. 2010;34:1247–53. https://doi.org/10.1007/s00268-010-0398-3.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Scappaticcio L, Piccardo A, Treglia G, Poller DN, Trimboli P. The dilemma of (18)F-FDG PET/CT thyroid incidentaloma: what we should expect from FNA. A systematic review and meta-analysis Endocrine. 2021;73:540–9. https://doi.org/10.1007/s12020-021-02683-4.

    Article  CAS  PubMed  Google Scholar 

  21. de Leijer JF, Metman MJH, van der Hoorn A, Brouwers AH, Kruijff S, van Hemel BM, et al. Focal thyroid incidentalomas on (18)F-FDG PET/CT: a systematic review and meta-analysis on prevalence, risk of malignancy and inconclusive fine needle aspiration. Front Endocrinol (Lausanne). 2021;12: 723394. https://doi.org/10.3389/fendo.2021.723394.

    Article  PubMed  Google Scholar 

  22. Pathak KA, Goertzen AL, Nason RW, Klonisch T, Leslie WD. A prospective cohort study to assess the role of FDG-PET in differentiating benign and malignant follicular neoplasms. Ann Med Surg (Lond). 2016;12:27–31. https://doi.org/10.1016/j.amsu.2016.10.008.

    Article  PubMed  Google Scholar 

  23. Nguyen TT, Lange NGE, Nielsen AL, Thomassen A, Dossing H, Godballe C, et al. PET/CT and prediction of thyroid cancer in patients with follicular neoplasm or atypia. Eur Arch Otorhinolaryngol. 2018;275:2109–17. https://doi.org/10.1007/s00405-018-5030-4.

    Article  PubMed  Google Scholar 

  24. de Koster EJ, de Geus-Oei LF, Brouwers AH, van Dam E, Dijkhorst-Oei LT, van Engen-van Grunsven ACH, et al. [(18)F]FDG-PET/CT to prevent futile surgery in indeterminate thyroid nodules: a blinded, randomised controlled multicentre trial. Eur J Nucl Med Mol Imaging. 2022;49:1970–84. https://doi.org/10.1007/s00259-021-05627-2.

    Article  PubMed  PubMed Central  Google Scholar 

  25. de Koster EJ, Noortman WA, Mostert JM, Booij J, Brouwer CB, de Keizer B, et al. Quantitative classification and radiomics of [(18)F]FDG-PET/CT in indeterminate thyroid nodules. Eur J Nucl Med Mol Imaging. 2022;49:2174–88. https://doi.org/10.1007/s00259-022-05712-0.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. de Koster EJ, Vriens D, van Aken MO, Dijkhorst-Oei LT, Oyen WJG, Peeters RP, et al. FDG-PET/CT in indeterminate thyroid nodules: cost-utility analysis alongside a randomised controlled trial. Eur J Nucl Med Mol Imaging. 2022;49:3452–69. https://doi.org/10.1007/s00259-022-05794-w.

    Article  PubMed  PubMed Central  Google Scholar 

  27. de Koster EJ, Husson O, van Dam E, Mijnhout GS, Netea-Maier RT, Oyen WJG, et al. Health-related quality of life following FDG-PET/CT for cytological indeterminate thyroid nodules. Endocr Connect. 2022;11. https://doi.org/10.1530/EC-22-0014.

  28. de Koster EJ, van Engen-van Grunsven ACH, Bussink J, Frielink C, de Geus-Oei LF, Kusters B, et al. [(18)F]FDG uptake and expression of immunohistochemical markers related to glycolysis, hypoxia, and proliferation in indeterminate thyroid nodules. Mol Imaging Biol. 2022. https://doi.org/10.1007/s11307-022-01776-4.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors thank all the patients who participated in the EfFECTS trial, all members of the EfFECTS trial consortium and all others who were involved in any of the study procedures.

Funding

The EfFECTS trial was supported by a project grant from the Dutch Cancer Society (KUN 2014–6514).

Author information

Authors and Affiliations

  1. Department of Radiology, (C2-P-117), Section of Nuclear Medicine, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, the Netherlands

    Dennis Vriens & Lioe-Fee de Geus-Oei

  2. Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands

    Elizabeth J. de Koster, Lioe-Fee de Geus-Oei & Wim J. G. Oyen

  3. Biomedical Photonic Imaging Group, University of Twente, Enschede, the Netherlands

    Lioe-Fee de Geus-Oei

  4. Radiation Science & Technology, Delft University of Technology, Delft, The Netherlands

    Lioe-Fee de Geus-Oei

  5. Department of Radiology and Nuclear Medicine, Rijnstate, Hospital, Arnhem, the Netherlands

    Wim J. G. Oyen

  6. Department of Biomedical Sciences, Department of Nuclear Medicine, Humanitas University, Humanitas Clinical and Research Centre, Milan, Italy

    Wim J. G. Oyen

Authors
  1. Dennis Vriens
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  2. Elizabeth J. de Koster
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  3. Lioe-Fee de Geus-Oei
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  4. Wim J. G. Oyen
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Consortia

For the EfFECTS trial consortium

Contributions

Lioe-Fee de Geus-Oei, Wim J.G. Oyen and Dennis Vriens conceptualised the EfFECTS-study. Lioe-Fee de Geus-Oei was the project leader. Wim J.G. Oyen and Dennis Vriens were principal investigators. Elizabeth J. de Koster was the junior investigator. Dennis Vriens prepared the manuscript of this Editorial. All authors contributed to data acquisition and the interpretation of the data of the EfFECTS-study and critically reviewed this manuscript (and other EfFECTS-related manuscripts). All authors had full access to all the data in the study and approved any manuscript before submission. Dennis Vriens had final responsibility for the decision to submit for publication.

Corresponding author

Correspondence to Dennis Vriens.

Ethics declarations

Ethical approval

The EfFECTS trial was conducted according to the principles of the Declaration of Helsinki (version of the 59th WMA General Assembly, Seoul, October 2008) and in accordance with the Medical Research Involving Human Subjects Act (WMO), the European Union (EU) General Data Protection Regulation (GDPR), the National Thyroid Cancer guideline and the local (hospital) guidelines.

Consent to participate

Written informed consent was obtained from all participants prior to any study activity. The study protocol was approved by the Medical Research Ethics Committee on Research Involving Human Subjects region Arnhem-Nijmegen, Nijmegen, the Netherlands. The trial was overseen by a trial steering committee and an independent study safety committee. The funder of the study had no role in its design, data collection and analysis, or writing of this report.

Competing interests

The authors declare no competing interests.

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Vriens, D., de Koster, E.J., de Geus-Oei, LF. et al. Preoperative stratification of cytologically indeterminate thyroid nodules by [18F]FDG-PET: can Orpheus bring back Eurydice?. Eur J Nucl Med Mol Imaging 50, 975–979 (2023). https://doi.org/10.1007/s00259-022-06093-0

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