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What Does "intense Take Up In Thyroid" On A PET Scan Report Indicate?
Question: Hi
I seem to be asking alot about this lately so please bear with me. If you can give as detailed and non generic answer as possible I would appreciate it.
I have malignant melamona diagnosed in XXXXXXX with two primaries in neck and toe, no suspected move to my lymph nodes. PET scan showed " Intense take up in thyroid" US revealed three complex nodules and the only one listed as being over 1cm ( 1.7) had an fna which I have been told was indeterminate.
What does this mean ? Iam due a partial thyroidectomy on tues.
Please can you look at my US slides and tell me what you see ? My dr didnt see these only the report.
Pus no mention is made of what I call slide A - is this a nodule ? If so is it bigger than 1cm and should have had an FNA ?
Can you tell me what you see about the nodules - the report only mentions the size. Does that mean no clacifications etc ? I am questioning whether to have the operation if its not absolutely necessary as I already have had neck surgery for the melanoma
Thank you
I seem to be asking alot about this lately so please bear with me. If you can give as detailed and non generic answer as possible I would appreciate it.
I have malignant melamona diagnosed in XXXXXXX with two primaries in neck and toe, no suspected move to my lymph nodes. PET scan showed " Intense take up in thyroid" US revealed three complex nodules and the only one listed as being over 1cm ( 1.7) had an fna which I have been told was indeterminate.
What does this mean ? Iam due a partial thyroidectomy on tues.
Please can you look at my US slides and tell me what you see ? My dr didnt see these only the report.
Pus no mention is made of what I call slide A - is this a nodule ? If so is it bigger than 1cm and should have had an FNA ?
Can you tell me what you see about the nodules - the report only mentions the size. Does that mean no clacifications etc ? I am questioning whether to have the operation if its not absolutely necessary as I already have had neck surgery for the melanoma
Thank you
Brief Answer:
Thyroid
Detailed Answer:
I am sorry to learn about your malignant history.
1 Indeterminate means there are no unequivocal characteristics in the cells obtained by FNA, to make a definite call as to whether or not the cells are malignant looking or benign looking. This can happen in upto 15% of FNA samples. In such circumstances the FNA is often repeated later. However in your case, owing to the PET uptake, it is quite likely the endocrinologist right away recommended proceeding to surgery to remove that part of the thyroid (partial thyroidectomy) which has this indeterminate nodule plus making sure just about enough is left behind so that your chances of requiring lifelong thyroid medication after surgery are small.
2 I reviewed all the images and slides you have provided
The picture in slide A is a nodule. It is not possible to conclude from the limited pictures provided about the exact ultrasonographic findings. That is why a report is provided by the radiologist after thoroughly viewing several more images.
So I cannot be certain if this is the one they performed an FNA on. Further, a good ultrasound report often includes greater description on nodule characteristics such as
if it is taller than wider
margins
vascularity(blood flow features)
calcifications (micro and macro)
peripheral halo
solid versus complex
hypoechoic versus iso versus hyperechoic
It would be desirable to get a clear picture on this from the radiologist who signed off on this report
3 Furthermore, it would be ideal to match the ultrasound report with that of the PET scan findings. Is the intense uptake through out the gland or localized to specific areas? If it is the latter then it would be important to know if the uptake was predominantly at the largest nodule that was biopsied and found to be indeterminate, or another of the 3 nodules described.
Thyroid
Detailed Answer:
I am sorry to learn about your malignant history.
1 Indeterminate means there are no unequivocal characteristics in the cells obtained by FNA, to make a definite call as to whether or not the cells are malignant looking or benign looking. This can happen in upto 15% of FNA samples. In such circumstances the FNA is often repeated later. However in your case, owing to the PET uptake, it is quite likely the endocrinologist right away recommended proceeding to surgery to remove that part of the thyroid (partial thyroidectomy) which has this indeterminate nodule plus making sure just about enough is left behind so that your chances of requiring lifelong thyroid medication after surgery are small.
2 I reviewed all the images and slides you have provided
The picture in slide A is a nodule. It is not possible to conclude from the limited pictures provided about the exact ultrasonographic findings. That is why a report is provided by the radiologist after thoroughly viewing several more images.
So I cannot be certain if this is the one they performed an FNA on. Further, a good ultrasound report often includes greater description on nodule characteristics such as
if it is taller than wider
margins
vascularity(blood flow features)
calcifications (micro and macro)
peripheral halo
solid versus complex
hypoechoic versus iso versus hyperechoic
It would be desirable to get a clear picture on this from the radiologist who signed off on this report
3 Furthermore, it would be ideal to match the ultrasound report with that of the PET scan findings. Is the intense uptake through out the gland or localized to specific areas? If it is the latter then it would be important to know if the uptake was predominantly at the largest nodule that was biopsied and found to be indeterminate, or another of the 3 nodules described.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response
I have included all the slides from the disk. The report only mentions the three nodules but doesnt mention the one I mentioned as Slide A. I thought this was a nodule but it wasnt mentioned so I am a little concerned that something else may not be picked up.
I already have had neck surgery for my melanoma and so if you see anything that is suspsicious for cancer then this helps in my thinking and questions to ask.
I have read about follicular adenomas - do they present on an us in similar ways ?
Should I refer the images to a radiographer on her do you think ?
Thank you
I have included all the slides from the disk. The report only mentions the three nodules but doesnt mention the one I mentioned as Slide A. I thought this was a nodule but it wasnt mentioned so I am a little concerned that something else may not be picked up.
I already have had neck surgery for my melanoma and so if you see anything that is suspsicious for cancer then this helps in my thinking and questions to ask.
I have read about follicular adenomas - do they present on an us in similar ways ?
Should I refer the images to a radiographer on her do you think ?
Thank you
Brief Answer:
Follow up
Detailed Answer:
It is unusual for a radiologist to miss a nodule on ultrasound. It is typically a very simple and straightforward test.
Follicular adenomas can present like a nodule on ultrasound.
I would like to believe that the images were interpreted by a radiologist only, unless your endocrinologist specifically states otherwise (ie he or she read it himself or herself)
Follow up
Detailed Answer:
It is unusual for a radiologist to miss a nodule on ultrasound. It is typically a very simple and straightforward test.
Follicular adenomas can present like a nodule on ultrasound.
I would like to believe that the images were interpreted by a radiologist only, unless your endocrinologist specifically states otherwise (ie he or she read it himself or herself)
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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