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Incidence of diffuse FDG uptake in the thyroid of patients with hypothyroidism

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Abstract

Positron emission tomography (PET) positive lesions are common in the thyroid. The uptake can be focal or diffuse. Diffuse thyroid uptake is thought to be indicative of autoimmune thyroiditis and not for lesions of malignant potential. Hashimoto’s thyroiditis as a cause for diffusely positive thyroid glands has been demonstrated. We determine the incidence of diffuse thyroid PET positivity in hypothyroid patients, presumed to have Hashimoto’s thyroiditis. The study design was retrospective database and electronic medical record review. The study setting includes tertiary care and academic health sciences center. The subjects were patients at our medical center who underwent positron emission tomography. Hypothyroid patients were identified who had total body PET imaging performed for any reason. Patients were excluded if they were not taking levothyroxine, had a history of neck surgery, neck irradiation, Graves’ disease, taking lithium, thalidomide, amiodarone or interleukin. Patients remaining after the application of these exclusion criteria were presumed to be hypothyroid from Hashimoto’s thyroiditis. Only 9.5% of PET scans of hypothyroid patients display diffuse thyroid activity. Only a small minority of presumed Hashimoto’s thyroiditis patients will display diffuse thyroid activity after PET imaging. The etiology of this effect is unknown. Diffuse thyroid activity rarely requires surgical intervention. Level of evidence: IV.

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Acknowledgments

Research supported by faculty salaries. Dr. Stack is an expert witness for the defense in class action lawsuit against Novartis Pharmaceuticals.

Conflict of interest

There are no commercial associations that represent a conflict of interest in connection with the submitted manuscript. No competing financial interests exist for any of the authors.

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Authors and Affiliations

  1. Department of Geriatrics, University of Arkansas for Medical Sciences, 4301 West Markham Street, #806, Little Rock, AR, 72205, USA

    Ivey N. Rothman, Laura Middleton & Donald L. Bodenner

  2. Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, 4301 West Markham, #543, Little Rock, AR, 72205, USA

    Brendan C. Stack Jr. & Donald L. Bodenner

  3. UAMS Thyroid Center, Little Rock, USA

    Brendan C. Stack Jr., Twyla Bartel & Donald L. Bodenner

  4. Division of Nuclear Medicine, Department of Radiology, University of Arkansas for Medical Sciences, 4301 West Markham, #556, Little Rock, AR, 72205, USA

    Twyla Bartel

  5. Department of Geriatrics, University of Arkansas for Medical Sciences, 4301 West Markham, #748, Little Rock, AR, 72205, USA

    Ann T. Riggs

Authors
  1. Ivey N. Rothman
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  2. Laura Middleton
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  3. Brendan C. Stack Jr.
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  4. Twyla Bartel
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  5. Ann T. Riggs
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  6. Donald L. Bodenner
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Correspondence to Brendan C. Stack Jr..

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Rothman, I.N., Middleton, L., Stack, B.C. et al. Incidence of diffuse FDG uptake in the thyroid of patients with hypothyroidism. Eur Arch Otorhinolaryngol 268, 1501–1504 (2011). https://doi.org/10.1007/s00405-011-1512-3

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  • DOI: https://doi.org/10.1007/s00405-011-1512-3

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