18F-Fluorocholine Positron Emission Tomography/Computed Tomography is a Highly Sensitive but Poorly Specific Tool for Identifying Malignancy in Thyroid Nodules with Indeterminate Cytology: The Chocolate Study
| Autor: | Bénédicte Clarisse, Jean-Michel Grellard, Renaud Ciappuccini, Dominique De Raucourt, Idlir Licaj, D. Blanchard, Emmanuel Babin, Justine Lequesne, Damien Peyronnet, Vianney Bastit, Stéphane Bardet, Audrey Lasne-Cardon, Virginie Saguet-Rysanek |
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| Rok vydání: | 2021 |
| Předmět: |
Thyroid nodules
medicine.medical_specialty PET/CT Endocrinology Diabetes and Metabolism indeterminate cytology 030209 endocrinology & metabolism Malignancy 03 medical and health sciences 0302 clinical medicine Endocrinology Cytology Medicine Positron Emission Tomography-Computed Tomography Thyroid Radiology and Nuclear Medicine PET-CT business.industry thyroid nodules fluorocholine PET/CT medicine.disease Highly sensitive 030220 oncology & carcinogenesis Radiology 18F-choline PET/CT Indeterminate business 18F-fluorocholine |
| Zdroj: | Thyroid |
| ISSN: | 1557-9077 1050-7256 |
| DOI: | 10.1089/thy.2020.0555 |
| Popis: | Background: Refining the risk of malignancy in patients presenting with thyroid nodules with indeterminate cytology (IC) is a critical challenge. We investigated the performances of 18F-fluorocholine (FCH) positron emission tomography/computed tomography (PET/CT) to predict malignancy. Methods: Between May 2016 and March 2019, 107 patients presenting with a thyroid nodule ≥15 mm with IC and eligible for surgery were included in this prospective study. Head-and-neck PET/CT acquisitions were performed 20 and 60 minutes after injection of 1.5 MBq/kg of FCH. PET/CT acquisition was scored positive when maximal standardized uptake value in the IC nodule was higher than in the thyroid background. Pathology was the gold standard for diagnosis. Results: At pathology, 19 (18%) nodules were malignant, 87 were benign, and one was a noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Sensitivity, specificity, accuracy, positive-predictive value (PPV), and negative-predictive value (NPV) of FCH PET/CT in detecting cancer or NIFTP were 90%, 50%, 55%, 29%, and 96% at 20 minutes and 85%, 49%, 67%, 28%, and 94% at 60 minutes, respectively. Higher specificity (58% vs. 33%, p = 0.01) was observed in nononcocytic (n = 72) than in oncocytic IC nodules (n = 35). The pre-PET/CT probability of cancer or NIFTP in Bethesda III–IV nodules was 11% and the post-PET/CT probability was 19% in PET-positives and 0% in PET-negatives. In retrospective analysis, 42% of surgeries would have been unnecessary after PET/CT and 81% before (p |
| Databáze: | OpenAIRE |
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