{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T23:55:48Z","timestamp":1770076548347,"version":"3.49.0"},"reference-count":36,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T00:00:00Z","timestamp":1606435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>This study assesses the role of [18F] FDG PET\/CT, fine needle aspiration (FNA) cytology and ultrasound in the 1\u20132% of patients with focally positive thyroid nodules on FDG PET\/CT. All FDG PET\/CT scans with focally increased thyroid FDG PET\/CT uptake performed over 37 months in one institution were matched to patients undergoing thyroid FNA. Diffuse FDG PET\/CT uptake patients were excluded. A total of 47 patients showed focally increased thyroid uptake. Consistent with previous studies, 18 (38.2%) patients had malignancy\u201412 primary thyroid carcinoma, 1 parathyroid carcinoma, 3 metastatic carcinoma to the thyroid and 2 lymphoma. A total of 15 (31.9%) lesions categorized as non-malignant contained H\u00fcrthle cells\/oncocytes. A total of 14 lesions (29.8%) had focally increased FDG PET\/CT uptake with no specific cytological or histopathological cause identified. No focally PET avid H\u00fcrthle cell\/oncocytic lesions were found to be malignant. Exclusion of oncocytic lesions increased the calculated risk of malignancy (ROM) of focally PET avid nodules from 38% to 68%. It may be useful to exclude focally FDG PET\/CT avid H\u00fcrthle cell\/oncocytic lesions, typically reported as follicular neoplasm or suspicious for a follicular neoplasm, H\u00fcrthle cell type (Oncocytic) type, RCPath Thy 3F: Bethesda IV or sometimes Thy 3a: Bethesda III FNAs) from ROM calculations. Oncocytic focally PET\/CT FDG avid lesions appear of comparatively lower risk of malignancy and require investigation or operation but these lesions should be readily identified by FNA cytology on diagnostic work up of focally PET avid thyroid nodules.<\/jats:p>","DOI":"10.3390\/cancers12123544","type":"journal-article","created":{"date-parts":[[2020,11,27]],"date-time":"2020-11-27T09:16:49Z","timestamp":1606468609000},"page":"3544","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["H\u00fcrthle Cells on Fine-Needle Aspiration Cytology Are Important for Risk Assessment of Focally PET\/CT FDG Avid Thyroid Nodules"],"prefix":"10.3390","volume":"12","author":[{"given":"David N.","family":"Poller","sequence":"first","affiliation":[{"name":"Departments of Cytology &amp; Pathology, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakim","family":"Megadmi","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J. A.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of ENT Surgery, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2125-4937","authenticated-orcid":false,"given":"Pierpaolo","family":"Trimboli","sequence":"additional","affiliation":[{"name":"Clinic of Endocrinology, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana (USI), 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1126\/science.123.3191.309","article-title":"On the origin of cancer cells","volume":"123","author":"Warburg","year":"1956","journal-title":"Science"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"011013","DOI":"10.1117\/1.JMI.4.1.011013","article-title":"History and future technical innovation in positron emission tomography","volume":"4","author":"Jones","year":"2017","journal-title":"J. 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