Document Detail


The role of [(18) F]-2-fluoro-2-deoxy-d-glucose-positron emission tomography in thyroid nodules with indeterminate fine-needle aspiration biopsy: Systematic review and meta-analysis of the literature.
MedLine Citation:
PMID:  21432844     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Indeterminate results at fine-needle aspiration biopsy (FNAB) of thyroid nodules pose a clinical dilemma, because only 20% to 30% of patients suffer from malignancy. Previous studies suggested that the false-negative ratio of [(18) F]-2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) is very low; therefore, it may help identify patients who would benefit from (hemi)thyroidectomy. A systematic literature search was performed in 5 databases. After assessment, the identified studies were analyzed for heterogeneity, and the extracted data of test characteristics were pooled using a random-effects model. Threshold effects were examined, and publication bias was assessed. The query resulted in 239 records, of which 6 studies met predefined inclusion criteria. Data from 225 of the 241 described patients could be extracted. There was mild to moderate heterogeneity in study results (inconsistency index [I(2) ] = 0.390-0.867). The pooled prevalence of malignancy was 26%. Pooled sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95% (95% confidence interval [95% CI], 86%-99%), 48% (95% CI, 40%-56%), 39% (95% CI, 31%-47%), 96% (95% CI, 90%-99%), and 60% (95% CI, 53%-67%), respectively. Sensitivity increased to 100% for the 164 lesions that measured >15 mm in greatest dimension. There was no evidence of threshold effects or publication bias. A negative FDG-PET scan in patients who had thyroid nodules >15 mm with indeterminate FNAB results excluded thyroid cancer in a pooled population of 225 patients. Conversely, a positive FDG-PET result did not identify cancer, because approximately 50% of these patients had benign nodules. The authors concluded that the incorporation of FDG-PET into the initial workup of such patients before surgery deserves further investigation. Cancer 2011. © 2011 American Cancer Society.
Authors:
Dennis Vriens; Johannes H W de Wilt; Gert J van der Wilt; Romana T Netea-Maier; Wim J G Oyen; Lioe Fee de Geus-Oei
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-22
Journal Detail:
Title:  Cancer     Volume:  -     ISSN:  0008-543X     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Cancer Society.
Affiliation:
Department of Nuclear Medicine, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. d.vriens@nucmed.umcn.nl.
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