Retrospective analysis of thyroid incidentalomas detected by [68Ga]Ga-PSMA-11 PET/CT

İlkcan Çerçi Koçar; Pınar Pelin Özcan; Zehra Pınar Koç; Mehmet Süle; Esen Akbay; Ramazan Gen; Kerem Sezer

doi:10.1007/s12020-024-03847-8

Retrospective analysis of thyroid incidentalomas detected by [⁶⁸Ga]Ga-PSMA-11 PET/CT

Endocrine. 2024 May 10. doi: 10.1007/s12020-024-03847-8. Online ahead of print.

Authors

İlkcan Çerçi Koçar^{1

2}, Pınar Pelin Özcan³, Zehra Pınar Koç³, Mehmet Süle⁴, Esen Akbay⁴, Ramazan Gen⁴, Kerem Sezer⁴

Affiliations

¹ Mersin University Medical School, Endocrinology and Metabolism Department, Mersin, Turkey. dr.ilkcan_33@hotmail.com.
² Gaziantep City Educational and Research Hospital, Endocrinology and Metabolism Department, Gaziantep, Turkey. dr.ilkcan_33@hotmail.com.
³ Mersin University Medical School, Nuclear Medicine Department, Mersin, Turkey.
⁴ Mersin University Medical School, Endocrinology and Metabolism Department, Mersin, Turkey.

PMID: 38727868
DOI: 10.1007/s12020-024-03847-8

Abstract

Background: Prostate cancer patients, undergo imaging procedures, with [⁶⁸Ga]Ga-PSMA-11 PET/CT (prostate-specific membrane antigen based positron emission tomography/computed tomography) utilized for primary and secondary staging. PSMA thyroid incidentalomas (PTI) are discovered in the thyroid gland while imaging prostate cancer patients with [⁶⁸Ga]Ga-PSMA-11 PET/CT.

Aims: The aim of the study was to determine the clinical significance of PTIs detected on [⁶⁸Ga]Ga-PSMA-11 PET/CT. Another goal was to identify a possible threshold for the maximum standardized uptake value (SUVmax), above which a malignant growth could be suspected.

Study design: A retrospective cross-sectional study.

Methods: 769 patients with prostat cancer who underwent [⁶⁸Ga]Ga-PSMA-11 PET/CT scans in the nuclear medicine department of a tertiary care hospital between January 2020 and December 2022 were retrospectively screened in this study. We analyzed 67 patients in whom PTI was detected. Patients who exceeded the inclusion criteria had their thyroid ultrasonography and ultrasonography -guided fine needle aspiration findings analyzed.

Results: PTI was discovered in 67 patients (8%). 42 patients who met the inclusion and exclusion criteria were included in the study. Of the 4 malignant patients (9.5%) in the study population, 2 were classified as TIRADS 3 and 2 were classified as TIRADS 4. The cut-off SUVmax value was found to be 5.6. With 100% sensitivity and 47.37% specificity, a cutoff SUVmax of 5.3 was determined through receiver-operator characteristic analysis in order to predict malignant cytology.

Conclusion: PTI is a significant clinical finding; most of diffuse and focal uptakes are frequently related to benign diseases. Each center should establish its own a possible SUVmax cut-off over which a malignant lesion should be suspected.

Keywords: PET (Positron emission tomography); PSMA (Prostate-specific membrane antigen); Prostate cancer; Thyroid; Thyroid incidentaloma.