Thyroid incidentalomas detected on 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography: Thyroid Imaging Reporting and Data System (TIRADS) in the diagnosis and management of patients

• Published in: Surgery 2015, Vol.158 (5), p.1314-1322
• Main Authors: Yoon, Jung Hyun, MD, PhD, Cho, Arthur, MD, PhD, Lee, Hye Sun, MS, Kim, Eun-Kyung, MD, PhD, Moon, Hee Jung, MD, PhD, Kwak, Jin Young, MD, PhD
• Format: Article
• Language: English
• Subjects: Surgery
• ISSN: 0039-6060
• DOI: 10.1016/j.surg.2015.03.017

Background Our aim was to evaluate the role of the Thyroid Imaging Reporting and Data System (TIRADS) in the risk stratification of thyroid incidentalomas detected on18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (18 F-FDG-PET/CT) scans. Methods Eighty-seven thyroid nodules in 84 patients showing incidentally detected increased uptake on18 F-FDG-PET/CT who also had ultrasonography (US)-guided fine needle aspiration performed were included. On review of the US images, a TIRADS category was assigned to each thyroid nodule based on the number of suspicious US features. The correlation between the TIRADS category and the standard uptake values (SUV) on18 F-FDG-PET/CT were calculated and compared. Results Of the 87 thyroid nodules, 47 (54%) were benign, and 40 (46%) were malignant. The malignancy rate of the TIRADS categories were as follows: 9% for category 3, 15% for category 4a, 39% for category 4b, 72% for category 4c, and 100.0% for category 5. Combining the TIRADS with the SUV showed increased specificity and positive predictive value but decreased sensitivity and negative predictive value compared with TIRADS alone (all P