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Fluorodeoxyglucose-avid thyroid incidentaloma

Authors: Sujoy Ghosh; Deepanjan Mitra;

Fluorodeoxyglucose-avid thyroid incidentaloma

Abstract

Positron emission tomography–computed tomography (PET-CT) has become a standard investigation oncology workup.18F-fluorodeoxyglucose (18F-FDG) is the main radiopharmaceuticals for most of the studies. Since malignant cells overexpress glucose transporter receptors, they internalize FDG, and FDG undergoes the first rate-limiting step of glycolysis to form FDG-6-phosphate. In a whole-body PET-CT study, a lot of incidental findings are noticed and often bear significant clinical relevance. A normal thyroid gland does not show any demonstrable FDG uptake. However, sometimes, a normal-looking thyroid gland shows up increased FDG uptake in a diffuse manner in both lobes without any obvious focal FDG-avid lesion. This is attributed to autoimmune lymphocytic thyroid diseases and hypothyroidism. A hyperthyroid gland may appear diffusely enlarged with intense FDG uptake throughout the gland suggesting the hyperfunctioning of its follicular cells. However, any focal FDG uptake in either lobe of the thyroid needs an evaluation, particularly if there is any hypodense nodule on corresponding CT study. It is observed that FDG-avid thyroid nodules can harbor malignancy in almost 33% of cases. Hence, any FDG-avid incidentaloma needs an image-guided fine-needle aspiration cytology to rule out occult malignancy.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
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