Page 82 - Read Online

Page 4 of 19 Corn et al. J Cancer Metastasis Treat 2021;7:41 https://dx.doi.org/10.20517/2394-4722.2021.63

Table 1. Incidence and malignancy in PET-detected thyroid incidentalomas
Incidence Malignancy
# PET/CT Diffuse + Diffuse +
Authors Country Cumulative Focal Diffuse Focal Diffuse
scans focal focal
[25]
Ceriani et al. Switzerland 12,652 333 (2.6%) 187 (1.5%) 146 (1.2%) - 30 - -
Beck et al. [40] USA 35,124 - 227 - - 59 - -
(0.6%)
Kim et al. [41] Korea 39,098* - - 635 - - - -
(1.6%)
Gedberg et al. [26] Denmark 2451 - 59 (2.4%) - - 10 - -
[32]
Pattison et al. Australia 45,680 - 500 - - - - -
(1.1%)
Ozderya et al. [42] Turkey 6873 138 (2.0%) 135 3 (0.04%) - 27 - -
(2.0%)
Makis et al. [43] Canada 7252 - 157 - - 14 - -
(2.2%)
Sencan Eren et al. [35]† Turkey 4204 178 (4.2%) 68 (1.6%) 35 (0.8%) 13 (0.3%) 11 - 4
[24]
Kim et al. Korea 18,172 - 358 - - 51 - -
(2.0%)
[29]
Chun et al. Korea 2584 - 52 (2.0%) - - 15 - -
Jamsek et al. [36] Slovenia 5911 230 (3.9%) 148 82 (1.4%) - 10 - -
(2.5%)
[33]
Brindle et al. UK 7221 156 (2.2%) 81 (1.1%) 75 (1.0%) - 7 1 -
[30]
Lee et al. Korea 2368 - 64 (2.7%) - - 11 - -
[18]
Nishimori et al. Canada 6457 160 (2.5%) 103 57 (0.9%) - 9 0 -
(1.6%)
[44]
Kang et al. Korea 12,840* 1151 (9.0%) 612 539 - 55 2 -
(4.8%) (4.2%)
[45]
Chen et al. USA 2594 99 (3.8%) 53 (2.0%) 46 (1.8%) - 7 0 -
Karantanis et al. [34] USA 4732 - - 138 - - 0 -
(2.9%)
Kurata et al. [46] Japan 1626 - - 25 (1.5%) 4 (0.24%) - 1 2
[16]
Choi et al. Korea 1763 - 65 (3.7%) - 5 (0.28%) 18 - 0
[47]†
Nockel et al. USA 237 26 (11.0%) 14 (5.9%) 12 (5.1%) - 3 0 -
DOTATATE
# †
Number of PET/CT scans. *Study population included PET/CT scans completed for screening/preventative measures. Prospective study.
In a review of eight studies, the frequency of diffuse FDG uptake ranged from 0.1%-4.5%, with a mean of
1.9% [11,38,44,45,48,53-55] . Contemporary studies con similar to Yasuda et al. , namely that the diffuse uptake
[52]
pattern is an indication of benign disease [34,37,46] , predominantly attributed to inflammatory or autoimmune
forms of thyroiditis such as Hashimoto’s thyroiditis. Of note, only 10% of patients with these conditions
exhibit diffuse FDG uptake on PET scan , and studies report chronic thyroiditis as the etiology of diffuse
[56]
uptake in 47%-100% of patients [34,45,54] . Furthermore, there is no apparent relationship between serum TSH
levels and diffuse FDG avidity in patients diagnosed with thyroiditis, and thyroid hormone replacement
seems to have no effect on patterns of uptake [34,57] . The afore-mentioned studies were cross-sectional so that
any impact of incidentally identified diffuse uptake on subsequent thyroid dysfunction was unclear.
[41]
Kim et al. did a cross-sectional and longitudinal study on 39,098 subjects undergoing comprehensive
health examinations. At baseline, the prevalence of diffuse thyroidal FDG uptake was 1.6%. During
104,261.4 person-years of follow-up, 102 incident hypothyroid cases and 172 hyperthyroid cases were
identified. The multivariable-adjusted HR for incident hypothyroidism and hyperthyroidism (comparing
diffuse uptake to no uptake) were 15.72 and 7.38, respectively. Thus, euthyroid patients identified with
diffuse thyroid uptake on PET scan should be regarded as being at risk for future development of thyroid