Radiologic and clinicopathologic characteristics of thyroid nodules with focal 68Ga-DOTATATE PET activity

Jacob D. Kohlenberg, Ananya Panda, Geoffrey B. Johnson, M. Regina Castro

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6 Scopus citations


OBJECTIVE: Our aim was to determine the radiologic and clinicopathologic characteristics of thyroid nodules with focal 68Ga-DOTATATE activity.

METHODS: In this retrospective study of 1927 consecutive 68Ga-DOTATATE PET scans, 85 patients with incidental and nonincidental focal 68Ga-DOTATATE avid thyroid nodules were identified, of which 31 patients with 33 thyroid nodules underwent fine-needle aspiration (FNA) or surgery. These 33 nodules were reviewed for Krenning score and SUVmax of the thyroid nodule, contralateral thyroid lobe and left atrium.

RESULTS: Cytology/histopathology included 58% (19/33) with benign findings, 18% (6/33) medullary thyroid carcinoma (MTC), 9% (3/33) atypia or follicular lesion of undetermined significance (AUS/FLUS), 9% (3/33) suspicious for follicular neoplasm and Hurthle cell adenoma (SFN/HCA) and 6% (2/33) nondiagnostic cytology. Median serum calcitonin was 1156 pg/mL (range, 460-1828) in MTC and was <5.0 pg/mL (<5.0-12.5) in patients with benign nodules. Nodules had Krenning score of 1, 2 and 3 in 46% (15/33), 27% (9/33) and 27% (9/33). The majority of MTC and AUS/FLUS nodules had a Krenning score of 3, and there was substantial intragroup variation in Krenning score among the benign nodules. The mean SUVmax for the entire cohort was 5.5 ± 2.9 (mean ± SD), and the range was 2.0-13.0. There was overlap in the nodule/contralateral thyroid SUVmax ratios between groups. The MTC and AUS/FLUS nodules tended to have a higher nodule/blood pool SUVmax ratio than the other pathologic groups.

CONCLUSION: There was considerable variation in radiologic characteristics among benign thyroid nodules. The ratio of thyroid nodule SUVmax/blood pool SUVmax may be useful to differentiate pathologic groups, but larger studies are needed to investigate this further. Given the potential for malignancy in thyroid nodules with focal 68Ga-DOTATATE activity, further evaluation with serum calcitonin and FNA may be considered.Video Abstract:

Original languageEnglish (US)
Pages (from-to)510-516
Number of pages7
JournalNuclear Medicine Communications
Issue number5
StatePublished - May 1 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.


  • calcitonin
  • Krenning score
  • neuroendocrine tumor
  • thyroid carcinoma
  • thyroid nodule
  • Thyroid Nodule/diagnostic imaging
  • Humans
  • Middle Aged
  • Male
  • Positron-Emission Tomography
  • Organometallic Compounds
  • Young Adult
  • Adult
  • Female
  • Retrospective Studies

PubMed: MeSH publication types

  • Journal Article


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