Fine-needle aspiration in all thyroid incidentalomas at 18 F-FDG PET/CT: Can EU-TIRADS revise the dogma?

2018 ◽  
Vol 89 (5) ◽  
pp. 642-648 ◽  
Author(s):  
Pierpaolo Trimboli ◽  
Gaetano Paone ◽  
Giorgio Treglia ◽  
Camilla Virili ◽  
Teresa Ruberto ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Fdg Pet ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Hürthle Cells on Fine-Needle Aspiration Cytology Are Important for Risk Assessment of Focally PET/CT FDG Avid Thyroid Nodules

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3544
Author(s):  
David N. Poller ◽  
Hakim Megadmi ◽  
Matthew J. A. Ward ◽  
Pierpaolo Trimboli
Keyword(s):  
Fine Needle Aspiration ◽  
Fdg Pet ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Fine Needle ◽  
Hürthle Cell ◽  
Pet Ct ◽  
Risk Of Malignancy ◽  
Fdg Pet Ct

This study assesses the role of [18F] FDG PET/CT, fine needle aspiration (FNA) cytology and ultrasound in the 1–2% of patients with focally positive thyroid nodules on FDG PET/CT. All FDG PET/CT scans with focally increased thyroid FDG PET/CT uptake performed over 37 months in one institution were matched to patients undergoing thyroid FNA. Diffuse FDG PET/CT uptake patients were excluded. A total of 47 patients showed focally increased thyroid uptake. Consistent with previous studies, 18 (38.2%) patients had malignancy—12 primary thyroid carcinoma, 1 parathyroid carcinoma, 3 metastatic carcinoma to the thyroid and 2 lymphoma. A total of 15 (31.9%) lesions categorized as non-malignant contained Hürthle cells/oncocytes. A total of 14 lesions (29.8%) had focally increased FDG PET/CT uptake with no specific cytological or histopathological cause identified. No focally PET avid Hürthle cell/oncocytic lesions were found to be malignant. Exclusion of oncocytic lesions increased the calculated risk of malignancy (ROM) of focally PET avid nodules from 38% to 68%. It may be useful to exclude focally FDG PET/CT avid Hürthle cell/oncocytic lesions, typically reported as follicular neoplasm or suspicious for a follicular neoplasm, Hürthle cell type (Oncocytic) type, RCPath Thy 3F: Bethesda IV or sometimes Thy 3a: Bethesda III FNAs) from ROM calculations. Oncocytic focally PET/CT FDG avid lesions appear of comparatively lower risk of malignancy and require investigation or operation but these lesions should be readily identified by FNA cytology on diagnostic work up of focally PET avid thyroid nodules.

False-positive FDG PET/CT uptake in Warthin tumor in head and neck oncological patients confirmed by a fine needle aspiration

2011 ◽  
Vol 40 (3) ◽  
pp. 282-284 ◽  
Author(s):  
Jerzy Klijanienko ◽  
Slavomir Petras ◽  
Lucile De Bosschere ◽  
Benoît Paulmier ◽  
Christophe Le Tourneau ◽  
...  
Keyword(s):  
Head And Neck ◽  
Fine Needle Aspiration ◽  
False Positive ◽  
Fdg Pet ◽  
Needle Aspiration ◽  
Warthin Tumor ◽  
Fine Needle ◽  
Oncological Patients ◽  
Pet Ct ◽  
Fdg Pet Ct

Metastatic Lung Nodule Diagnosed on 18F-FDG PET/CT-Guided Fine Needle Aspiration in a Patient With Renal Cell Carcinoma

2013 ◽  
Vol 38 (1) ◽  
pp. e38-e39 ◽  
Author(s):  
Kuruva Manohar ◽  
Anish Bhattacharya ◽  
Sameer Vyas ◽  
Pranab Dey ◽  
Arup Kumar Mandal ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Fine Needle Aspiration ◽  
Lung Nodule ◽  
Needle Aspiration ◽  
Ct Guided ◽  
Fine Needle ◽  
Pet Ct ◽  
Metastatic Lung ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Performance of 18F-FDG PET/CT in Selecting Thyroid Nodules with Indeterminate Fine-Needle Aspiration Cytology for Surgery. A Systematic Review and a Meta-Analysis.

2019 ◽  
Vol 8 (9) ◽  
pp. 1333 ◽  
Author(s):  
Castellana ◽  
Trimboli ◽  
Piccardo ◽  
Giovanella ◽  
Treglia
Keyword(s):  
Fdg Pet ◽  
Thyroid Nodules ◽  
Meta Analysis ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Pet Ct ◽  
18F Fdg ◽  
Needle Aspiration Cytology ◽  
Fdg Pet Ct

Thyroid nodules with indeterminate fine-needle aspiration cytology (FNA) represent a major challenge in clinical practice. We conducted a systematic review and meta-analysis evaluating the ability of hybrid imaging using fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to appropriately select these nodules for surgery. PubMed, CENTRAL, Scopus, and Web of Science were searched until July 2019. Original articles reporting data on the performance of 18F-FDG PET/CT in thyroid nodules with indeterminate FNA were included. Summary operating points including 95% confidence interval values (95% CI) were estimated using a random-effects model. Out of 786 retrieved papers, eight studies evaluating 104 malignant and 327 benign thyroid nodules were included. The pooled positive and negative likelihood ratios (LR+ and LR-) and diagnostic odds ratio (DOR) of 18F-FDG PET/CT were 1.7 (95% CI: 1.4–2.0), 0.4 (95% CI: 0.2–0.7), and 3.5 (95% CI: 1.7–7.1), respectively. No heterogeneity was found for LR+ and DOR. In patients with thyroid nodules with indeterminate FNA, 18F-FDG PET/CT has a moderate ability to correctly discriminate malignant from benign lesions and could represent a reliable option to reduce unnecessary diagnostic surgeries. However, further studies using standardized criteria for interpretation are needed to confirm the reproducibility of these findings.

The impact of endoscopic ultrasound-guided fine-needle aspiration of lymph nodes on subsequent positron emission tomography/computed tomography imaging: a prospective study

Endoscopy ◽  
2018 ◽  
Vol 51 (02) ◽  
pp. 165-168
Author(s):  
Ole Bjerring ◽  
Søren Hess ◽  
Claus Fristrup ◽  
Poul Høilund-Carlsen ◽  
Michael Mortensen
Keyword(s):  
Lymph Nodes ◽  
Fdg Pet ◽  
Needle Aspiration ◽  
Emission Tomography ◽  
Fine Needle ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Upper Gastrointestinal

Abstract Background Modern cancer diagnostic work-up is based on multiple modalities within a short time period. The interplay between these modalities is complex and not well known. Performing biopsy procedures prior to (18)F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) is considered to pose a risk of false-positive imaging results; however, this is not based on solid scientific evidence. The use of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) is commonly used in upper gastrointestinal malignancies, is proven safe, and has very little risk of complications. This study aimed to assess whether EUS-FNA induces inflammation that would increase FDG uptake on subsequent PET/CT. Methods 27 patients who were referred for upper gastrointestinal EUS for different reasons initially underwent FDG-PET/CT to detect biopsy-eligible lymph nodes with no FDG uptake. Patients then underwent EUS-FNA of the benign lymph nodes, with a minimum of three passes. Patients were re-evaluated with FDG-PET/CT 1 week later, with specific emphasis on the biopsied lymph nodes. Results None of the biopsied lymph nodes showed increased FDG uptake on follow-up FDG-PET/CT. No adverse events occurred. Conclusion EUS-FNA prior to FDG-PET/CT did not lead to false-positive FDG uptake. The interpretive impact of minor procedures prior to FDG-PET/CT needs to be re-evaluated.

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