RESUMEN
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Asunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Hallazgos Incidentales , Enfermedades Renales/complicaciones , Enfermedades Renales , Tomografía de Emisión de Positrones/métodos , Tomografía de Emisión de Positrones , Renografía por Radioisótopo , Riñón/patología , Riñón , Cintigrafía/instrumentación , Cintigrafía/métodos , Tomografía de Emisión de Positrones/instrumentación , Tomografía de Emisión de Positrones/normas , Tomografía de Emisión de Positrones/tendencias , Renografía por Radioisótopo/métodos , Renografía por Radioisótopo/tendenciasRESUMEN
Objetivo: Los incidentalomas tiroideos en estudios PET/TC con 18F-FDG son relativamente frecuentes y su significado clínico es causa de controversia. El presente estudio muestra nuestra experiencia en la detección de incidentalomas tiroideos a partir de estudios PET/TC y de su seguimiento. Material y métodos: Estudio retrospectivo descriptivo de los pacientes que presentaron incidentalomas tiroideos en los estudios PET/TC con 18F-FDG, entre junio de 2010 y marzo de 2013. Se evaluaron los siguientes datos y antecedentes clínicos: edad, sexo, valor máximo estandarizado de captación (SUVmáx), enfermedades tiroideas, niveles de TSH y anticuerpos antitiroideos, ecografía, punción-aspiración con aguja fina (PAAF) y citología. Resultados: Se realizaron 4.085 PET/TC, de los cuales 83 (2,03%) mostraron incidentalomas tiroideos. Treinta y siete de estos pacientes presentaron un incremento difuso del metabolismo glicídico tiroideo y 46 un incremento focal. Cinco de los 46 pacientes con captación focal (11%) fueron diagnosticados de enfermedad neoplásica por citología. No se encontraron diferencias significativas entre los valores del SUVmáx de las enfermedades tiroideas benignas y de las malignas (media: 10,26 y 5,92 respectivamente). Conclusión: En nuestra experiencia, los incidentalomas tiroideos de características focales detectados en los estudios PET/TC con18F-FDG, presentan un considerable riesgo de malignidad (11%). Por este motivo, se debe indicar siempre el seguimiento de estos hallazgos mediante ecografía y PAAF. Por otra parte, y tal como está descrito en la literatura, el incremento difuso del metabolismo glicídico tiroideo se asocia casi siempre a patología tiroidea benigna (AU)
Objective: Thyroid findings or incidentalomas in 18F-FDG PET/CT studies are relatively frequent, being its clinical significance subject of controversy. The aim of this study was to show our experience in the detection of thyroid incidentalomas by PET/CT studies as well as its follow up. Material and methods: A retrospective and descriptive review was conducted on patients who had thyroid incidentalomas detected in18F-FDG PET/CT studies between June 2010 and March 2013. Patients medical records were reviewed for age, genre, maximum standardized uptake value (SUVmax), thyroid diseases, TSH and antithyroid antibodies levels, ultrasound, fine-needle aspiration (FNA) and cytology. Results: 4085 PET/CT studies for several purposes were performed. Eighty-three of these studies (2.03%) showed thyroid incidentalomas. Thirty-seven patients showed a diffuse increase of glucose metabolism in the thyroid gland and 46 showed a focal increase of glucose metabolism. Five out of 46 patients with focal uptake were diagnosed of a neoplastic disease by cytology (11%). The SUVmax of malignant pathology did not differ from that of benign thyroid diseases (Mean: 10,26 and 5,92 respectively). Conclusion: In our experience, focal thyroid incidentalomas detected in18F-FDG PET/CT studies are related to a significant risk of malignancy (11%). Therefore, in these situations, an ultrasound study with fine needle biopsy should be recommended. Moreover, a diffuse increase of glucose metabolism in the thyroid gland is often associated with benign thyroid pathology (AU)
Asunto(s)
Humanos , Neoplasias de la Tiroides , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Fluorodesoxiglucosa F18 , Hallazgos Incidentales , Biopsia con Aguja Fina/métodos , Estudios RetrospectivosAsunto(s)
Coristoma/diagnóstico por imagen , Riñón , Pelvis/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Anciano de 80 o más Años , Enfermedades Asintomáticas , Humanos , Hallazgos Incidentales , Masculino , Radiofármacos/farmacocinética , Ácido Dimercaptosuccínico de Tecnecio Tc 99m/farmacocinética , Tecnecio Tc 99m Mertiatida/farmacocinéticaRESUMEN
OBJECTIVE: Thyroid findings or incidentalomas in (18)F-FDG PET/CT studies are relatively frequent, being its clinical significance subject of controversy. The aim of this study was to show our experience in the detection of thyroid incidentalomas by PET/CT studies as well as its follow up. MATERIAL AND METHODS: A retrospective and descriptive review was conducted on patients who had thyroid incidentalomas detected in (18)F-FDG PET/CT studies between June 2010 and March 2013. Patient's medical records were reviewed for age, genre, maximum standardized uptake value (SUVmax), thyroid diseases, TSH and antithyroid antibodies levels, ultrasound, fine-needle aspiration (FNA) and cytology. RESULTS: 4085 PET/CT studies for several purposes were performed. Eighty-three of these studies (2.03%) showed thyroid incidentalomas. Thirty-seven patients showed a diffuse increase of glucose metabolism in the thyroid gland and 46 showed a focal increase of glucose metabolism. Five out of 46 patients with focal uptake were diagnosed of a neoplastic disease by cytology (11%). The SUVmax of malignant pathology did not differ from that of benign thyroid diseases (Mean: 10,26 and 5,92 respectively). CONCLUSION: In our experience, focal thyroid incidentalomas detected in (18)F-FDG PET/CT studies are related to a significant risk of malignancy (11%). Therefore, in these situations, an ultrasound study with fine needle biopsy should be recommended. Moreover, a diffuse increase of glucose metabolism in the thyroid gland is often associated with benign thyroid pathology.
