Journal article Open Access

Evaluación de incidentalomas tiroideos mediante PET/CT con 18F-FDG

Muñoz López, Jaczibe Yajaira; Arroyo Castelán, Claudia; Rodríguez Palomares, Luis Alfonso; Padilla-Santamaría, Fernando

RESUMEN

Introducción: La tomografía por emisión de positrones/tomografía computada (PET/CT) con Fluor18-fluorodeoxiglucosa (18F-FDG) posee un amplio uso, específicamente en pacientes oncológicos para: estadificar la patología neoplásica, vigilar la aparición de recurrencias, valorar la respuesta al tratamiento y predecir pronóstico. La glándula tiroides es uno de los órganos que más hallazgos incidentales imagenológicos presenta. Por ello, el objetivo de este estudio fue explorar las captaciones y el valor máximo estandarizado de captación (SUVmáx) en incidentalomas tiroideos mediante PET/CT con 18F-FDG y evaluar su utilidad diagnóstica comparado con estudios citológicos (biopsia por aspiración con aguja fina, BAAF).

Metodología: Estudio transversal retrospectivo analítico. Se revisó el archivo histórico del departamento de Imagenología del Centro Médico Dalinde de enero de 2016 a marzo de 2020. Se incluyeron pacientes con incidentalomas tiroideos detectados por PET/CT con 18F-FDG; el muestreo empleado fue por conveniencia.

Resultados: Se revisaron 1,283 expedientes; 102 correspondieron a incidentalomas tiroideos: 83 mujeres (81.37%) y 19 hombres (18.63%). Se encontró captación focal en 66 pacientes (64.7%) y difusa en 36 (35.3%). La media de SUVmax fue 7.9±9.1653, mediana 4.6 (2-55); no se encontraron diferencias entre SUVmax y el tipo de captación (p=0.6). Del total de la muestra, únicamente 35 casos contaron con reporte de BAAF; se observaron mayores cifras de SUVmáx en neoplasias malignas (p=0.028).

Conclusiones: Los valores altos de SUVmáx se relacionaron con neoplasias tiroideas malignas; es necesario que cada institución de salud determine los parámetros de SUVmáx con base en su población.

 

 

ABSTRACT

Introduction: Positron emission tomography/computed tomography (PET/CT) with Fluor18-fluorodeoxyglucose (18F-FDG) is widely used, specifically in cancer patients to: stage neoplastic pathology, monitor the appearance of recurrences, assess the response to treatment and predict prognosis. The thyroid gland is one of the organs with the most incidental imaging findings. Therefore, the objective of this study was to explore the uptakes and the standardized maximum uptake value (SUVmax) in thyroid incidentalomas by PET/CT with 18F-FDG and to evaluate its diagnostic utility compared with cytological studies (fine needle aspiration biopsy, FNAB).

Methodology: Analytical retrospective cross-sectional study. The historical archive of the Centro Médico Dalinde Imaging department was reviewed from January 2016 to March 2020. Patients with thyroid incidentalomas detected by PET/CT with 18F-FDG were included; the sampling used was for convenience.

Results: 1,283 files were reviewed; 102 corresponded to thyroid incidentalomas: 83 women (81.37%) and 19 men (18.63%). Focal uptake was found in 66 patients (64.7%) and diffuse in 36 (35.3%). The mean of SUVmax was 7.9 ± 9.1653, median 4.6 (2-55); no differences were found between SUVmax and the type of uptake (p=0.6). Only 35 cases had a FNAB report; higher SUVmax were observed in malignant neoplasms (p=0.028).

Conclusions: High SUVmax values were related to thyroid malignancies; It is necessary for each health institution to determine the SUVmax parameters based on its population.

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