311 [18F]FDG-PET/CT to prevent futile surgery: a blinded, randomised controlled multicentre trial 4 Table 5. Discordant histopathology diagnoses on blinded central review no. [18F]FDG-PET/CT result Local histopathology diagnosis Initial classification Central review of histopathology Final classification 1 positive Malignant (eFVPTC)* True-positive Borderline (NIFTP)* True-positive 2 positive Malignant (PTC) True-positive Benign (follicular adenoma) False-positive 3 negative Borderline (FT-UMP) True-negative Malignant (FVPTC) False-negative 4 negative Malignant (FVPTC) False-negative Benign (follicular adenoma) True-negative 5 positive Borderline (NIFTP) True-positive Benign (follicular adenoma) False-positive 6 positive Malignant (Hürthle cell carcinoma) True-positive Borderline (FT-UMP, oncocytic type) False-positive *: initial histopathological diagnosis was made prior to the global introduction and acceptance of the NIFTP diagnosis. eFVPTC=encapsulated FVPTC. FT-UMP=follicular tumour of uncertain malignant potential. FVPTC=follicular variant PTC. PTC=papillary thyroid carcinoma. NIFTP=non-invasive follicular thyroid neoplasm with papillary-like nuclear features. Table 6. Therapeutic yield after one year of follow-up [18F]FDG-PET/CT-driven group n=91 diagnostic surgery group n=41 n % (95% CI) n % (95% CI) pa adjusted pb adjusted OR (95% CI)b Beneficial management 53 / 91 58% (47%-68%) 7 / 41 17% (7%-32%) <0.001 <0.001 6.9 (2.7-17.7) Surgery for malignant/borderline nodule 28 / 91 31% (22%-41%) 6 / 41 15% (6%-29%) 0.05 0.08 2.5 (0.9-7.0) Surveillance for benign nodule 25 / 91 27% (19%-38%) 1 / 41 2% (0%-13%) 0.001 0.007 17.3 (2.2-135.2) Unbeneficial management 38 / 91 42% (32%-53%) 34 / 41 83% (68%-93%) <0.001 <0.001 0.1 (0.1-0.4) Surgery for benign nodule 38 / 91 42% (32%-53%) 34 / 41 83% (68%-93%) <0.001 <0.001 0.1 (0.1-0.4) Surveillance for malignant/borderline nodule 0 / 91 0% (0%-4%) 0 / 41 0% (0%-9%) n.a. n.a. n.a. Avoided surgery in benign nodules 25 / 63 40% (28%-53%) 1 / 35 3% (0%-15%) 0.001 0.002 26.9 (3.3-219.0) CI=confidence interval. n.a.=not applicable. OR=odds ratio. a: Pearson’s chi-squared test. b: binary logistic regression to adjust for stratifying variables.
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