目的:目的是评估11C-胆碱PET/CT对前列腺癌的局部甲状腺摄取的病理学性质。
方法:该研究获得IRB批准。回顾性审查了2018年1月1日至2021年7月30日期间在我们机构中男性前列腺癌患者中进行的所有11C-胆碱PET/CT检查报告。选择了最终报告中带有“局灶性甲状腺摄取”的检查。在PET/CT之前进行甲状腺手术或消融的患者,经证实的甲状旁腺腺瘤或甲状腺超声缺失被排除.排除同一患者的重复PET/CT检查。通过测量局灶性甲状腺摄取的最大标准化摄取值(SUVmax),对PET图像进行视觉和半定量分析。可用的甲状腺超声图像,细胞学和病理学报告进行审查。进行统计分析。
结果:在10,047个序贯11C-胆碱PET/CT研究中,318例报告包括“局灶性甲状腺摄取”。“这些研究中约有128项是重复考试,被排除在外。另有87名患者被排除在外,因为摄取被确定为相邻的,而不是局限于甲状腺。在剩下的103名患者中,74例患者进行了局灶性甲状腺摄取和甲状腺超声检查。在用超声波评估的74个局灶性吸收中,根据超声检查,21个被认为是良性甲状腺结节,53个被活检进一步评估。63个结节是良性的(21个超声诊断为良性,42个细胞学检查或手术病理证实),9个结节是恶性的,2个仍不确定。良、恶性组SUV比较差异无统计学意义(P>3)。
结论:在这项对前列腺癌患者进行11C-胆碱PET/CT的回顾性研究中,我们确定了一组因偶然发现局灶性11C-胆碱甲状腺摄取而接受甲状腺超声检查的患者.该组恶性肿瘤的发生率为12%。因此,如果在胆碱PET上偶然发现了富含胆碱的甲状腺结节,则可能需要进一步的超声检查以及超声引导下的活检.
OBJECTIVE: The purpose was to evaluate the pathological nature of focal thyroid uptake seen in 11C-Choline PET/CT performed for prostate cancer.
METHODS: The study was IRB-approved. All 11C-Choline PET/CT exam reports for studies performed between January 01, 2018, and July 30, 2021, in male patients with prostate cancer in our institution were retrospectively reviewed. Exams with \"focal thyroid uptake\" on their final report were selected. Patients with surgery or ablation in the thyroid prior to the PET/CT, proven parathyroid adenomas or absent thyroid ultrasound were excluded. Repeated PET/CT exams of same patient were excluded. PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax) of the focal thyroid uptake. Available thyroid ultrasound images, cytology and pathology reports were reviewed. Statistical analyses were performed.
RESULTS: Out of 10,047 sequential 11C-Choline PET/CT studies, 318 reports included \"focal thyroid uptake.\" About 128 of these studies were repeat exams and were excluded. Additional 87 patients were excluded, because the uptake was determined to be adjacent, rather than confined to the thyroid gland. Out of the remaining 103 patients, 74 patients had focal thyroid uptake and concurrent thyroid sonographic evaluation. Out of the 74 focal uptakes evaluated with ultrasound, 21 were presumed benign thyroid nodules based on the ultrasound and 53 had further evaluation with biopsy. Sixty three nodules were benign (21 presumed benign on ultrasound and 42 cytology or surgical pathology-proven), 9 nodules were malignant and 2 remained indeterminate. There was no significant difference between the SUVs of the benign and malignant groups (P > .3).
CONCLUSIONS: In this retrospective study of patients with prostate cancer who underwent 11C-Choline PET/CT, we identified a group of patients who underwent thyroid ultrasound for incidental finding of focal 11C-Choline thyroid uptake. Incidence of malignancy in this group was 12%. Therefore, further investigation with ultrasound and possibly ultrasound-guided biopsy may be warranted when a choline avid thyroid nodule is found incidentally on choline PET.