{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:46:10Z","timestamp":1787582770433,"version":"build-2736575974"},"reference-count":80,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background: Meta-analyses on the prevalence and significance of thyroid incidentalomas at PET (TIP) are available only about [18F]FDG. Focal TIP at [18F]FDG PET is not rare and may be malignant lesions in about one-third of cases. The aim of this study is to perform a meta-analysis on the prevalence and clinical significance of TIP using other PET radiotracers beyond [18F]FDG. Methods: A comprehensive literature search of studies about TIP was carried out using four different databases, screened until 31 December 2024. Only original articles about TIP using radiopharmaceuticals other than [18F]FDG were selected. A proportion meta-analysis on the prevalence and clinical significance of TIP was carried out on a patient-based analysis using a random-effects model. Results: 21 studies (29,409 patients) were included in the meta-analysis. PET was performed using radiolabeled somatostatin analogues (SSA) [n = 5], choline [n = 6], prostate-specific membrane antigen (PSMA) [n = 7], or fibroblast activation protein inhibitors (FAPI) [n = 3]. The uptake pattern of TIP was described as focal, diffuse, or mixed\/heterogeneous. The pooled prevalence of TIP was 5.6% for SSA-PET, 6.1% for choline-PET, 4.2% for PSMA-PET, and 3.6% for FAPI-PET. The final diagnosis of TIP with a diffuse pattern was a benign condition or represented a physiological uptake. Conversely, TIP with focal or mixed\/heterogeneous pattern may represent a benign condition in most cases, but even a malignant lesion in 6\u201310% of cases. Conclusions: As for [18F]FDG, TIP using other radiopharmaceuticals is not rare. Most of them are benign, but those with focal or heterogeneous uptake patterns may represent a malignant lesion in some cases (even if the risk of malignancy is lower compared to [18F]FDG PET), thus requiring further evaluation. Further studies are warranted to better clarify the clinical impact of TIP detection.<\/jats:p>","DOI":"10.3390\/ph18050723","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T04:39:16Z","timestamp":1747283956000},"page":"723","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Meta-Analysis on the Prevalence and Significance of Incidental Findings in the Thyroid Gland Using Other PET Radiopharmaceuticals Beyond [18F]FDG"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8951-382X","authenticated-orcid":false,"given":"Cesare Michele","family":"Iacovitti","sequence":"first","affiliation":[{"name":"Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0810-6494","authenticated-orcid":false,"given":"Domenico","family":"Albano","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, ASST Spedali Civili di Brescia and University of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5438-8230","authenticated-orcid":false,"given":"Alessio","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6779-1471","authenticated-orcid":false,"given":"Arnoldo","family":"Piccardo","sequence":"additional","affiliation":[{"name":"Thyroid Center, Department of Nuclear Medicine, Ente Ospedaliero Ospedali Galliera, 16128 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8214-562X","authenticated-orcid":false,"given":"Marco","family":"Cuzzocrea","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2864-5364","authenticated-orcid":false,"given":"Gaetano","family":"Paone","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana, 6900 Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2125-4937","authenticated-orcid":false,"given":"Pierpaolo","family":"Trimboli","sequence":"additional","affiliation":[{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana, 6900 Lugano, Switzerland"},{"name":"Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9808-780X","authenticated-orcid":false,"given":"Giorgio","family":"Treglia","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland"},{"name":"Faculty of Biomedical Sciences, Universit\u00e0 della Svizzera Italiana, 6900 Lugano, Switzerland"},{"name":"Faculty of Biology and Medicine, University of Lausanne, 1015 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"ref_1","first-page":"k2387","article-title":"Prevalence and outcomes of incidental imaging findings: Umbrella review","volume":"361","author":"Muntinga","year":"2018","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.rcl.2021.03.002","article-title":"General Review on the Current Management of Incidental Findings on Cross-Sectional Imaging: What Guidelines to Use, How to Follow Them, and Management and Medical-Legal Considerations","volume":"59","author":"Alabousi","year":"2021","journal-title":"Radiol. 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