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Background <p>[<sup>68</sup>Ga]Ga-DOTA-TATE PET/CT is primarily used for imaging neuroendocrine tumors, yet incidental thyroid uptake is observed in 7–11% of scans. While focal uptake has been associated with an increased risk of malignancy, the ultrasonographic and pathological features of these cases remain underexplored. This study aimed to investigate the ultrasonographic and clinicopathological features of patients with abnormal [<sup>68</sup>Ga]Ga-DOTA-TATE uptake in the thyroid gland.</p> Results <p>Among 2,971 patients who underwent [<sup>68</sup>Ga]Ga-DOTA-TATE PET/CT between April 2019 and November 2023, abnormal thyroid uptake was detected in 154 patients (5.2%). Of these, 39 patients with complete ultrasonographic evaluation constituted the final analytical cohort and were included in the detailed clinicopathological analysis. Uptake was focal in 59%, diffuse in 17.9%, and heterogeneous in 23.1% of cases. Fine-needle aspiration biopsy (FNAB) was performed in 24 patients, with 41.7% yielding non-diagnostic results. Only one case of papillary thyroid carcinoma was detected, corresponding to a 2.6% malignancy rate. Diffuse uptake was commonly linked to Hashimoto’s thyroiditis. A moderate inverse correlation was observed between SUVmax and BMI (<i>r</i> = − 0.54, <i>p</i> &lt; 0.05), with a mean SUVmax of 7.35 ± 3.08.</p> Conclusions <p>Focal [<sup>68</sup>Ga]Ga-DOTA-TATE thyroid uptake may suggest malignancy, though the observed malignancy rate in our cohort was lower than previously reported. Diffuse uptake was generally associated with benign inflammatory conditions. The inverse association between SUVmax and BMI is a novel finding warranting further investigation. Comprehensive evaluation, including ultrasonography and FNAB, is advised for patients with incidental focal uptake.</p>

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Evaluation of ultrasonographic and clinicopathological features of patients with abnormal [68Ga]Ga-DOTA-TATE uptake in the thyroid gland

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月1日

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  • Beril Turan Erdogan,
  • Fatma Dilek Dellal Kahramanca,
  • Gulsum Karaahmetli,
  • Seyda Turkolmez,
  • Fazli Erdogan,
  • Cevdet Aydin,
  • Oya Topaloglu,
  • Reyhan Ersoy,
  • Bekir Cakir

摘要

Background

[68Ga]Ga-DOTA-TATE PET/CT is primarily used for imaging neuroendocrine tumors, yet incidental thyroid uptake is observed in 7–11% of scans. While focal uptake has been associated with an increased risk of malignancy, the ultrasonographic and pathological features of these cases remain underexplored. This study aimed to investigate the ultrasonographic and clinicopathological features of patients with abnormal [68Ga]Ga-DOTA-TATE uptake in the thyroid gland.

Results

Among 2,971 patients who underwent [68Ga]Ga-DOTA-TATE PET/CT between April 2019 and November 2023, abnormal thyroid uptake was detected in 154 patients (5.2%). Of these, 39 patients with complete ultrasonographic evaluation constituted the final analytical cohort and were included in the detailed clinicopathological analysis. Uptake was focal in 59%, diffuse in 17.9%, and heterogeneous in 23.1% of cases. Fine-needle aspiration biopsy (FNAB) was performed in 24 patients, with 41.7% yielding non-diagnostic results. Only one case of papillary thyroid carcinoma was detected, corresponding to a 2.6% malignancy rate. Diffuse uptake was commonly linked to Hashimoto’s thyroiditis. A moderate inverse correlation was observed between SUVmax and BMI (r = − 0.54, p < 0.05), with a mean SUVmax of 7.35 ± 3.08.

Conclusions

Focal [68Ga]Ga-DOTA-TATE thyroid uptake may suggest malignancy, though the observed malignancy rate in our cohort was lower than previously reported. Diffuse uptake was generally associated with benign inflammatory conditions. The inverse association between SUVmax and BMI is a novel finding warranting further investigation. Comprehensive evaluation, including ultrasonography and FNAB, is advised for patients with incidental focal uptake.