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Characteristics of Primary Papillary Thyroid Carcinoma with False-Negative Findings on Initial 18F-FDG PET/CT

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

We often observe that uptake of tracer is not detected in the primary cancer focus in patients with histologically proven papillary thyroid carcinoma (PTC) on preoperative 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT). Therefore, we analyzed the clinical and pathologic variables affecting false-negative findings in primary tumors on preoperative 18F-FDG PET/CT.

Methods

We retrospectively reviewed the medical records of 115 consecutive patients who underwent 18F-FDG PET/CT for initial evaluation and were diagnosed with PTC by postoperative permanent biopsy. The clinical and pathologic characteristics that influence the 18F-FDG PET/CT findings in these patients were analyzed with respect to the following variables: age, gender, tumor size, multifocality of the primary tumor, perithyroidal invasion, lymphovascular or capsular invasion, and central lymph node metastasis-based final pathology.

Results

Twenty-six (22.6%) patients had false-negative 18F-FDG PET/CT findings. In patients with negative 18F-FDG PET/CT findings, tumor size, and perithyroidal and lymphovascular invasion were significantly less than in patients with positive 18F-FDG PET/CT findings. Tumors >1 cm in size were correlated with 18F-FDG PET/CT positivity. On multivariate analysis, perithyroidal invasion (P = 0.026, odds ratio = 7.714) and lymphovascular invasion (P = 0.036, odds ratio = 3.500) were independent factors for 18F-FDG PET/CT positivity. However, there were no significant differences between 18F-FDG PET/CT positivity and age, gender, capsular invasion, and central lymph node metastasis based on final pathology.

Conclusions

Tumor size and perithyroidal and lymphovascular invasion of papillary carcinoma can influence 18F-FDG PET/CT findings. Absence of perithyroidal and lymphovascular invasion were independent variables for false-negative findings on initial 18F-FDG PET/CT in patients with PTC.

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Acknowledgment

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry for Health, Welfare, and Family Affairs, Republic of Korea (0720560).

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Cancer Research Institute, Research Institute for Medical Sciences, Chungnam National University College of Medicine, School of Medicine, Daejeon, Korea

    Jin Woong Choi MD, Young Hoon Yoon MD, Yeo Hoon Yoon MD & Bon Seok Koo MD

  2. Department of Nuclear Medicine, Chungnam National University College of Medicine, Daejeon, Korea

    Seong Min Kim MD

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  1. Jin Woong Choi MD
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  2. Young Hoon Yoon MD
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  3. Yeo Hoon Yoon MD
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  4. Seong Min Kim MD
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  5. Bon Seok Koo MD
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Correspondence to Bon Seok Koo MD.

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Choi, J.W., Yoon, Y.H., Yoon, Y.H. et al. Characteristics of Primary Papillary Thyroid Carcinoma with False-Negative Findings on Initial 18F-FDG PET/CT. Ann Surg Oncol 18, 1306–1311 (2011). https://doi.org/10.1245/s10434-010-1469-2

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  • DOI: https://doi.org/10.1245/s10434-010-1469-2

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