The Proportion of Malignancy in Incidental Thyroid Lesions on 18‐FDG PET Study: A Systematic Review and Meta‐analysis
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abstract
ObjectiveTo evaluate through a systematic review and meta‐analysis the malignancy rates of thyroid incidentalomas identified in adults by 18‐fluorodeoxyglucose positron emission tomography, computed tomography (18‐FDG PET‐CT) imaging studies.Data SourcesThe literature search was conducted using OVID Medline, EMBASE, the Cochrane Library, Google Scholar, Pubmed, and reference list review (inception to April 2013) by 2 independent review authors.Review MethodsStudies with adults undergoing 18‐FDG PET scan identifying a thyroid incidentaloma with definitive histological or cytological results reported were included.ResultsThirty‐one studies with a total of 197,296 PET studies and 3659 focal thyroid incidentalomas were identified with 1341 having definitive cytopathology or histopathology. The pooled proportion of malignancy was calculated as 19.8% (95% confidence interval [CI], 15.3%‐24.7%) with 15.4% (95% CI, 11.4%‐20.0%) of the total cases being papillary thyroid cancer. Distant metastases represented 1.1% (95% CI, 0.6%‐1.8%) of the total cases.ConclusionsOur systematic review and meta‐analysis suggests that the incidence of malignancy is high in thyroid incidentalomas identified through 18‐FDG PET imaging studies. Thyroid incidentalomas identified through 18‐FDG PET require thorough investigation.
