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ArticleSisli Etfal Hastanesi tip bulteni2025

Deciding on Fine Needle Aspiration Biopsy in Thyroid Incidentalomas in FDG-PET/CT: Should Ultrasonographic Evaluation or FDG Uptake Be in the Foreground?

Mehmet Kostek, Hatice Kostek, Mehmet Taner Unlu, Ozan Caliskan, Yasin Cakir, Zerin Sengul, Ozgul Ekmekcioglu, Mesut Kafi, Alper Ozel, Nurcihan Aygun and 1 more

Abstract read
In one paragraph

Article in Sisli Etfal Hastanesi tip bulteni, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Author's Reply.Sisli Etfal Hastanesi tip bulteni · 2026
    Article
  3. Article
  4. Article
  5. Author's Reply.Sisli Etfal Hastanesi tip bulteni · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mehmet KostekDivision of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Hatice KostekDivision of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Mehmet Taner UnluDivision of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Ozan CaliskanDivision of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Yasin CakirDivision of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Zerin SengulDivision of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Ozgul EkmekciogluDepartment of Nuclear Medicine, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Mesut KafiDepartment of Nuclear Medicine, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Alper OzelDepartment of Radiology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Nurcihan AygunDivision of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.
Mehmet UludagDivision of Endocrine Surgery, Department of General Surgery, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: 18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) is a widespread imaging technique for whole-body scanning. Incidental lesions may be detected in thyroid gland and the importance and management of these lesions are still a matter of debate. The aims of this study were the evaluation of the diagnostic success of ultrasonography and FDG-PET/CT for predicting malignancy and contribution of these techniques for the decision of Fine Needle Aspiration Biopsy (FNAB) in incidental thyroid lesions detected in FDG-PET/CT. Methods: Patients who underwent FDG-PET/CT in Nuclear Medicine Unit in a single institution between January 2018 and December 2022 were screened for thyroid incidentaloma with increased focal FDG uptake. Imaging studies and pathology results of the patients with Focal Thyroid Incidentalomas (FTI) were reviewed retrospectively. Results: A total of 14.003 FDG-PET/CT reports of 8.259 patients were evaluated. In FDG-PET/CT imaging, 495 (6.0%) patients had increased uptake in thyroid gland, 383 (4.6%) patients had focal and 112 (1.4%) patients had diffuse FDG uptake. The rate of malignancy in FTIs was 19.2%. In the ROC curve analysis, regarding the prediction of malignancy in FTIs with FDG uptake, a SUVmax value of 5.5 and above predicts malignancy with a sensitivity of 71.4% and a specificity of 68.6% (AUC:0.718, p=0.018, 95%CI:0.564-0.872). The sensitivity of ACR-TIRADS-5 was 35.7% (95%CI:14.6-61.7) and sensitivity of the combination of SUVmax>5.5 and ACR-TIRADS-5 was 30.0% (95%CI:8.5-60.7). Conclusion: FDG-PET/CT findings can be used for determining malignancy risk and cutoff values such as 5.5 can be threshold for ordering FNAB. In patients with SUVmax less than 5.5, ultrasonographic risk classification criteria should be used for decision-making.

Indexed as

Positron Emission Tomographythyroid cancerthyroid noduleultrasonography

Identifiers

PMID40226554
PMCPMC11983016

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.