The FUSION iENA Study: Comparison of I-124-PET/US Fusion Imaging with Conventional Diagnostics for the Functional Assessment of Thyroid Nodules by Multiple Observers.
Nuklearmedizin
; 58(6): 434-442, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-31711244
ABSTRACT
AIM:
To investigate the value of I-124 positron emission tomography (PET) / ultrasound (US) fusion imaging in comparison to conventional diagnostics (CD) of Thyroid nodules (TN) by multiple observers.METHODS:
Digital patient case files (PCF) of patients that received CD and I-124-PET/US in clinical routine were prepared containing cine-loops of the examinations. All physicians with nuclear medicine specialty from Germany, Austria, and Switzerland were invited to participate. 106 acquired observers completed 7.2â±â1.8 (median 8, range 4-14) randomly assigned PCF (CD only or CD+PET/US). They assessed the TN function, stated their confidence in functional assessment, and suggested a treatment course for each TN.RESULTS:
68 PCF of 34 patients comprising 66 TN ≥â1âcm (=â1.94 TN/patient) were created. A total of 748 (11.2/TN), and 751 ratings (11.4/TN) were recorded for CD only, and CD+PET/US, respectively. The functional assessment revealed more hyper- or hypofunctioning (524 vs. 320, pâ<â0.0001) and less indifferent or not rateable (209 vs. 428, pâ<â0.0001) TN in CD+PET/US vs. CD only. The observers' confidence in functional assessment was superior in CD+PET/US (pâ<â0.0001). Furthermore, the ratings were carried out more homogeneous in CD+PET/US (pâ<â0.0001). Fewer suggestion of follow up (pâ<â0.0001), and more (pâ<â0.0001) suggestion of invasive treatments (fine-needle aspiration & surgery) was observed in CD+PET/US.âRadioiodine therapy was more often (pâ=â0.0036), and thyroid medication less often (pâ=â0.0167) advised in CD+PET/US.CONCLUSION:
Functional assessment of equivocal TN shows frequent failures in CD, underestimating the incidence of hyper- and hypofunctioning lesions. Confidence in functional assessment significantly increases with additional PET/US.âThis influences the proposed treatment course.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Glândula Tireoide
/
Tomografia por Emissão de Pósitrons
/
Imagem Multimodal
/
Radioisótopos do Iodo
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article