Is ^1H-MR-spectroscopy useful for the estimation of thyroid nodule detected by FDG-PET/CT?

FDG-PET经常检测甲状腺偶发瘤。我们回顾性地获得了从2009年4月至2006年5月在5,027例患者中通过FDG-PET或PET/CT检测偶然发现的甲状腺结节的组织病理学验证。共发现甲状腺结节125个，其中45个经病理证实（恶性27个，良性18个）。恶性病变与良性病变的标准摄取值（SUVmax）（均数±标准差）差异无统计学意义（恶性3.8 ±5.4，良性2.3±3.7）。1535例患者行FDG-PET/CT检查，18例患者偶发FDG阳性甲状腺结节大于1cm，但其中16例因未获得知情同意或优先治疗基础疾病而意外排除。其余2例，在颈部超声检查中诊断为腺瘤性甲状腺肿，而未行活检取材。最初，本研究中，FDG对甲状腺结节阳性，1H-MRS峰值检测及Colin甲状腺结节检出，本打算对其恶性状态进行评估，但难以进行，故改变了方案。甲状腺癌术后FDG或I-131阳性病灶可作为1H-MRS检查的下一个目标，而FDG或I-131阳性的颈部、纵隔病灶可通过MRI确诊。在MRS基线的大偏差中检测有意义的频谱。对于颈部发现的甲状腺手术结节的定性诊断，使用1H-MRS目前被认为充满了挑战。

FDG-PET detects frequently thyroid incidentalomas. We retrospectively obtained histopathological verification for the incidentally found thyroid nodule by FDG-PET or PET/CT performed from April 2009 until May 2006 testing in 5,027 patients. One-hundred and 25 thyroid nodules were noted, and histological verification been made 45 of them (27 malignant lesion, and 18 benign lesions by biopsy or resection). The Standardized Uptake value (SUVmax in the nodules) (mean±SD) of malignant lesion was not significantly differed from the benign lesions; malignant3.8±5.4, benign 2.3±3.7).Next step, we planned to perform 1H MR-spectroscopy for the cases with FDG-PET positive thyroid nodules in April 2010 to March 2011. FDG-PET/CT was performed in 1535 cases, and 18 patients had incidental FDG-positive thyroid nodules more than 1cm.However, 16 of these cases were unexpectedly excluded from this research, because the consent was not obtained, or the treatment of the underlying disease was prioritized. The remaining two cases, the diagnosis of adenomatous goiter in the neck ultrasonography, and biopsy was not performed extraction.Initially, in this study, FDG for thyroid nodules positive, 1H-MRS peak detection and Colin thyroid nodules by, was intended for it to evaluate the malignant status and it is difficult to perform, we changed the plan. The FDG or I-131 positive lesions after total thyroidectomy in patients with thyroid carcinoma were the next target for the 1H-MRS study.FDG or I-131-positive cervical, mediastinal lesions could be confirmed by MRI. The detection of a meaningful spectrum in the large deflection of the baseline of MRS. For qualitative diagnosis for thyroid gland surgery nodule found in the neck to use 1H-MRS is currently considered to be fraught with challenges.