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Thyroid incidentalomas detected on (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography: Thyroid Imaging Reporting and Data System (TIRADS) in the diagnosis and management of patients

 Jung Hyun Yoon  ;  Arthur Cho  ;  Hye Sun Lee  ;  Eun-Kyung Kim  ;  Hee Jung Moon  ;  Jin Young Kwak 
 SURGERY, Vol.158(5) : 1314-1322, 2015 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma/diagnosis* ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Female ; Fluorodeoxyglucose F18 ; Humans ; Incidental Findings ; Male ; Middle Aged ; Multimodal Imaging* ; Positron-Emission Tomography* ; Predictive Value of Tests ; ROC Curve ; Radiology Information Systems* ; Radiopharmaceuticals ; Retrospective Studies ; Risk Assessment ; Thyroid Nodule/classification ; Thyroid Nodule/diagnosis* ; Tomography, X-Ray Computed*
BACKGROUND: Our aim was to evaluate the role of the Thyroid Imaging Reporting and Data System (TIRADS) in the risk stratification of thyroid incidentalomas detected on (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG-PET/CT) scans. METHODS: Eighty-seven thyroid nodules in 84 patients showing incidentally detected increased uptake on (18)F-FDG-PET/CT who also had ultrasonography (US)-guided fine needle aspiration performed were included. On review of the US images, a TIRADS category was assigned to each thyroid nodule based on the number of suspicious US features. The correlation between the TIRADS category and the standard uptake values (SUV) on (18)F-FDG-PET/CT were calculated and compared. RESULTS: Of the 87 thyroid nodules, 47 (54%) were benign, and 40 (46%) were malignant. The malignancy rate of the TIRADS categories were as follows: 9% for category 3, 15% for category 4a, 39% for category 4b, 72% for category 4c, and 100.0% for category 5. Combining the TIRADS with the SUV showed increased specificity and positive predictive value but decreased sensitivity and negative predictive value compared with TIRADS alone (all P < .05). The area under the receiver operating characteristics curve value of TIRADS was the greatest, comparable with the combined TIRADS and SUV (0.737 to 0.724, P = .788). CONCLUSION: TIRADS may be applied in the risk stratification of thyroid incidentalomas detected on (18)F-FDG-PET/CT. Considering the high malignancy rate of thyroid incidentalomas showing increased (18)F-FDG uptake, ultrasonography-guided fine needle aspiration is mandatory even if there are no suspicious features present on US
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
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