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First published online May 15, 2007, 10.2967/jnumed.106.039024
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Clinical Significance of Diffusely Increased 18F-FDG Uptake in the Thyroid Gland

Dimitrios Karantanis1,2, Trond V. Bogsrud1, Gregory A. Wiseman1, Brian P. Mullan1, Rathan M. Subramaniam1, Mark A. Nathan1, Patrick J. Peller1, Rebecca S. Bahn3 and Val J. Lowe1

1 Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, Minnesota; 2 Department of Nuclear Medicine, Greek Air Force Hospital, Athens, Greece; and 3 Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota


Figure 1
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  		FIGURE 1.  Normal, low 18F-FDG uptake in thyroid of 37-y-old woman referred for restaging of previously treated tongue cancer. Thyroid is not normally visible on 3-dimensional maximum-intensity-projection images.

 

Figure 2
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  		FIGURE 2.  Diffusely increased 18F-FDG uptake in thyroid of 47-y-old man referred for evaluation of neck lymphadenopathy. Patient was taking thyroxine replacement therapy for hypothyroidism. On ultrasound examination, thyroid gland was prominent and heterogeneous. Fine-needle aspiration biopsy of thyroid revealed chronic thyroiditis. Serum TSH was 0.2 mIU/L (reference range, 0.3–5.0 mIU/L), free thyroxine was 1.6 ng/dL (reference range, 0.8–1.8 ng/dL), and TPO antibodies were elevated at 6,160 IU/mL (reference range, <40 IU/mL), suggesting diagnosis of lymphocytic thyroiditis. Shown are transaxial CT image (A), transaxial PET image (B), transaxial fused PET/CT image (C), and 3-dimensional maximum-intensity-projection image (D).

 

Figure 3
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  		FIGURE 3.  Thyroid-related findings in 133 patients with diffuse thyroid 18F-FDG uptake.

 

Figure 4
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  		FIGURE 4.  Plot of serum TSH vs. SUVmax in 21 patients with no prior history of thyroid disease. P value was found to be 0.089.

 




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