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Is 18F-FDG PET/CT Useful for Distinguishing Between Primary Thyroid Lymphoma and Chronic Thyroiditis?

Nakadate, Masashi MD*; Yoshida, Katsuya MD, PhD; Ishii, Akihiro MD, PhD; Koizumi, Masayuki MD, PhD; Tochigi, Naobumi MD, PhD§; Suzuki, Yoshio MD, PhD§; Ryu, Yoshiharu MD, PhD*; Nakagawa, Tassei MD, PhD; Umehara, Isao MD, PhD; Shibuya, Hitoshi MD, PhD*

Clinical Nuclear Medicine:
doi: 10.1097/RLU.0b013e31829b2686
Original Articles
Abstract

Purpose: This study aims to investigate the usefulness of 18F-FDG PET/CT for distinguishing between primary thyroid lymphoma (PTL) and chronic thyroiditis.

Methods: We retrospectively reviewed the data of 196 patients with diffuse 18F-FDG uptake of the thyroid gland and enrolled patients who were diagnosed as having PTL or chronic thyroiditis based on the medical records, pathological findings, and laboratory data. The enrolled patients comprised 10 PTL patients (M/F = 4:6) and 51 chronic thyroiditis patients (M/F = 8:43). Images had been acquired on a PET/CT scanner at 100 minutes after intravenous injection of 18F-FDG.

Results: The PTL group consisted of 7 patients with diffuse large B-cell lymphoma (DLBCL) and 3 with mucosa-associated lymphoid tissue (MALT) lymphoma. The maximum standardized uptake value (SUVmax) was significantly higher in the PTL group than that in the chronic thyroiditis group (25.3 ± 8.0 and 7.4 ± 3.2, P < 0.001). On the other hand, the CT density (Hounsfield unit: HU) was significantly lower in the PTL group than that in the chronic thyroiditis group (46.1 ± 7.0 HU and 62.1 ± 6.9 HU, P < 0.001). Within the PTL group, the SUVmax was significantly higher in the cases of DLBCL than in those of MALT lymphoma (29.0 ± 6.4 and 16.7 ± 2.3, P = 0.017).

Conclusions: The SUVmax was significantly higher and the CT density was significantly lower in PTL as compared with those in chronic thyroiditis. Thus, 18F-FDG PET/CT may be useful for distinguishing between PTL and chronic thyroiditis.

Author Information

From the *Department of Diagnostic Radiology and Oncology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo; †PET Imaging Center, Asahi General Hospital, Asahi, Chiba; ‡Departments of Hematology, §Anatomic Pathology, and ¶Radiology, Asahi General Hospital, Asahi, Chiba, Japan.

Received for publication March 28, 2013; and revision accepted May 8, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Masashi Nakadate, MD, Department of Diagnostic Radiology and Oncology, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan. E-mail: nkdtmrad@tmd.ac.jp.

© 2013 by Lippincott Williams & Wilkins