Significance of FDG–PET standardized uptake values in predicting thyroid disease

Author:

Kikuchi Tomohiro12ORCID,Hanaoka Shouhei3,Nakao Takahiro1,Nomura Yukihiro14,Yoshikawa Takeharu1,Alam Ashraful1,Mori Harushi2ORCID,Hayashi Naoto1

Affiliation:

1. Department of Computational Diagnostic Radiology and Preventive Medicine, the University of Tokyo Hospital, Hongo, Bunkyo–ku, Tokyo, Japan

2. Department of Radiology, Jichi Medical University, School of Medicine, Shimotsuke, Tochigi, Japan

3. Department of Radiology, The University of Tokyo Hospital, Hongo, Bunkyo–ku, Tokyo, Japan

4. Center for Frontier Medical Engineering, Chiba University, Yayoicho, Inage–ku, Chiba, Japan

Abstract

Objective This study aimed to determine a standardized cut-off value for abnormal 18F-fluorodeoxyglucose (FDG) accumulation in the thyroid gland. Methods Herein, 7013 FDG–PET/CT scans were included. An automatic thyroid segmentation method using two U-nets (2D- and 3D-U-net) was constructed; mean FDG standardized uptake value (SUV), CT value, and volume of the thyroid gland were obtained from each participant. The values were categorized by thyroid function into three groups based on serum thyroid-stimulating hormone levels. Thyroid function and mean SUV with increments of 1 were analyzed, and risk for thyroid dysfunction was calculated. Thyroid dysfunction detection ability was examined using a machine learning method (LightGBM, Microsoft) with age, sex, height, weight, CT value, volume, and mean SUV as explanatory variables. Results Mean SUV was significantly higher in females with hypothyroidism. Almost 98.9% of participants in the normal group had mean SUV < 2 and 93.8% participants with mean SUV < 2 had normal thyroid function. The hypothyroidism group had more cases with mean SUV ≥ 2. The relative risk of having abnormal thyroid function was 4.6 with mean SUV ≥ 2. The sensitivity and specificity for detecting thyroid dysfunction using LightGBM (Microsoft) were 14.5 and 99%, respectively. Conclusions Mean SUV ≥ 2 was strongly associated with abnormal thyroid function in this large cohort, indicating that mean SUV with FDG–PET/CT can be used as a criterion for thyroid evaluation. Preliminarily, this study shows the potential utility of detecting thyroid dysfunction based on imaging findings.

Publisher

Bioscientifica

Subject

Endocrinology, Diabetes and Metabolism

Reference30 articles.

1. Prevalence and significance of thyroid uptake detected by 18F–FDG PET;Ho,2011

2. Clinical significance of patterns of incidental thyroid uptake at 18F–FDG PET/CT;Agrawal,2015

3. Clinical significance of patterns of increased (18F)–FDG uptake in the thyroid gland: a pictorial review;Tsubaki,2018

4. Evaluating focal 18F–FDG uptake in thyroid gland with radiomics;Aksu,2020

5. Artificial intelligence for nuclear medicine in oncology;Hirata,2022

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