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

FDG-PET经常检测到甲状腺偶发瘤。我们从2009年4月至2006年5月对5,027名患者进行了FDG-PET或PET/CT检查，对偶然发现的甲状腺结节进行了组织病理学验证。共发现甲状腺结节100个，其中45个经病理证实，其中恶性病变27个，良性病变18个。恶性结节的标准摄取值(SUVmax)(平均值±SD)与良性病变无显著差异；恶性为3.8±5.4，良性为2.3±3.7。下一步，我们计划于2010年4月至2011年3月对FDG-PET阳性的甲状腺结节患者进行1H磁共振波谱检查。1535例患者接受了FDG-PET/CT检查，其中18例偶然发现1 cm以上的甲状腺结节呈FDG阳性，但其中16例因未征得同意或优先考虑基础疾病的治疗而意外被排除在本次研究之外。其余2例，颈部超声诊断为甲状腺腺瘤性肿大，未行活检。本研究最初以FDG为甲状腺结节阳性，1H-MRS峰值检测和Colin法为甲状腺结节检查，本研究旨在对其恶性程度进行评估，且实施难度较大，我们改变了治疗计划。甲状腺癌患者全甲状腺切除后的FDG或I-131阳性病变是1H-MRS研究的下一个目标。FDG或I-131阳性的颈部、纵隔病变可通过MRI确诊。目前认为，利用1H-MRS对甲状腺手术后颈部结节进行定性诊断，在MRS基线的较大偏转范围内检测有意义的波谱是一项充满挑战的工作。

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.