Molecular Diagnostics and [ 18 F]FDG-PET/CT in Indeterminate Thyroid Nodules: Complementing Techniques or Waste of Valuable Resources?
Authors' conclusion
MD and [18F]FDG-PET/CT are both accurate rule-out tests when unresected nodules that remain unchanged on ultrasound follow-up are considered benign.
Study context
- Population
- Adult, euthyroid patients with a Bethesda III or IV cytologically indeterminate thyroid nodule (indeterminate thyroid nodules (ITN))MD diagnostic in 115
- Participants
- 132 participants
- Comparison
- Molecular diagnostics vs [18F]FDG-PET/CT, alone and combined
- Outcome
- Sensitivity, specificity, NPV, PPV and benign call rate (BCR) of MD and [18F]FDG-PET/CT separately and combined
Methodological detailsprospective, multicenter
- Prospective
- Multicenter
Performance
As reported in the abstract
Diagnostic performance
| Test or model | Sensitivity | Specificity | NPV | PPV | Benign call rate (BCR) |
|---|---|---|---|---|---|
| MD | 80% | 69% | 91% | 48% | 57% |
| [18F]FDG-PET/CT | 93% | 41% | 95% | 36% | 32% |
Sensitivity
MD80%
[18F]FDG-PET/CT93%
Specificity
MD69%
[18F]FDG-PET/CT41%
NPV
MD91%
[18F]FDG-PET/CT95%
PPV
MD48%
[18F]FDG-PET/CT36%
Benign call rate (BCR)
MD57%
[18F]FDG-PET/CT32%
- Combined, double-negative test: sensitivity / specificity
- 95% / 44%
- Combined, double-positive test: sensitivity / specificity
- 68% / 86%
Further findings
| Outcome | [18F]FDG-PET/CT | P value |
|---|---|---|
| MD-positive nodules among benign nodules by [18F]FDG uptake[18F]FDG-positive benign vs [18F]FDG-negative benign · more MD-positive among [18F]FDG-positive | P = 0.02 | |
| Oncocytic ITN | ||
| BCR | 3% |
- MD-positive nodules among benign nodules by [18F]FDG uptake — Isolated RAS mutations among MD-positive [18F]FDG-positive benign nodules
- 11 (44%)
- MD-positive nodules among benign nodules by [18F]FDG uptake: [18F]FDG-positive benign 42%
- MD-positive nodules among benign nodules by [18F]FDG uptake: [18F]FDG-negative benign 19%
Concordance between MD and [18F]FDG-PET/CT
- Concordance
- 63% (82/130)
Oncocytic ITN
- MD was the superior technique in oncocytic ITN
Original publication
Molecular Diagnostics and [ 18 F]FDG-PET/CT in Indeterminate Thyroid Nodules: Complementing Techniques or Waste of Valuable Resources? Thyroid. Published 28 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →