Lee H, Chung YS, Lee JH, Lee KY, Hwang KH. Characterization of focal hypermetabolic thyroid incidentaloma: An analysis with F-18 fluorodeoxyglucose positron emission tomography/computed tomography parameters. World J Clin Cases 2022; 10(1): 155-165 [PMID: 35071515 DOI: 10.12998/wjcc.v10.i1.155]
Corresponding Author of This Article
Kyung-Hoon Hwang, MD, Professor, Department of Nuclear Medicine, Gachon University College of Medicine, Gil Medical Center, Namdong-daero 774 beon-gil, Namdong-gu, Incheon 21565, South Korea. forrest88@hanmail.net
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Haejun Lee, Kyung-Hoon Hwang, Department of Nuclear Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon 21565, South Korea
Yoo Seung Chung, Joon-Hyop Lee, Department of Endocrine Surgery, Gachon University College of Medicine, Gil Medical Center, Incheon 21565, South Korea
Ki-Young Lee, Department of Endocrinology and Metabolism, Gachon University College of Medicine, Gil Medical Center, Incheon 21565, South Korea
Author contributions: Lee H and Hwang KH contributed to this work; Lee H and Hwang KH designed the research study; Lee H, Chung YS, Lee JH, Lee KY and Hwang KH performed the research; Lee H contributed analytic tools; Lee H, Chung YS, Lee JH, Lee KY and Hwang KH analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: This retrospective study was approved by the institutional review board of our hospital (IRB no. GAIRB2020-297), and the requirement to obtain informed consent was waived. The study was conducted in accordance with the 1964 Declaration of Helsinki and later amendments.
Informed consent statement: The requirement to obtain informed consent was waived.
Conflict-of-interest statement: The authors have no potential conflicts of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at [forrest88@hanmail.net].
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kyung-Hoon Hwang, MD, Professor, Department of Nuclear Medicine, Gachon University College of Medicine, Gil Medical Center, Namdong-daero 774 beon-gil, Namdong-gu, Incheon 21565, South Korea. forrest88@hanmail.net
Received: August 19, 2021 Peer-review started: August 19, 2021 First decision: September 29, 2021 Revised: October 9, 2021 Accepted: November 22, 2021 Article in press: November 22, 2021 Published online: January 7, 2022 Processing time: 133 Days and 4.4 Hours
ARTICLE HIGHLIGHTS
Research background
Thyroid incidentaloma (TI) is detected on imaging studies for non-thyroid purposes and the lesion may harbor a risk of malignancy. It is critical to distinguish malignant TI from benign disease.
Research motivation
The higher the metabolism on F-18 fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) image, the higher the possibility of malignancy. TI might be characterized depending on the FDG metabolism.
Research objectives
To distinguish malignant hypermetabolic TIs from benign disease by analyzing F-18 FDG PET-CT parameters and to identify a cut-off value.
Research methods
The values of parameters from FDG PET-CT of 46 focal hypermetabolic thyroid lesions were measured, calculated, and compared. Receiver operating characteristic (ROC) curve was plotted to determine a cut-off value.
Research results
Standardized uptake value (SUV)max was the only statistically significant discriminator in differentiation. From the ROC curve, the AUC was 0.702 and the SUVmax cut-off value was 8.5.
Research conclusions
TIs with SUVmax above the cut-off value 8.5 may have a greater than 70% chance of malignancy. A further active assessment is required.
Research perspectives
Other studies and controversies on the parameters included in this study are ongoing. Further studies with a large number of subjects are guaranteed.
