331 [18F]FDG-PET/CT to prevent futile surgery: a blinded, randomised controlled multicentre trial 4 Table 21. therapeutic yield after one year of follow-up in AUS/FLUS, FN/SFN and HCN/SHCN for differentiation between strictly benign and malignant nodules [18F]FDG-PET/CT-driven group diagnostic surgery group n % (95% CI) n % (95% CI) p non-Hürthle cell nodules, AUS/FLUS + FN/SFN (n=101) n=68 n=33 Beneficial management 37 / 68 54% (42%-67%) 5 / 33 15% (5%-32%) <0.001a Surgery for malignant nodule 14 / 68 21% (12%-32%) 5 / 33 15% (5%-32%) 0.51a Surveillance for benign nodule 23 / 68 34% (23%-46%) 0 / 33 0% (0%-11%) <0.001a Unbeneficial management Surgery for benign nodule 31 / 68 46% (33%-58%) 28 / 33 85% (68%-95%) <0.001a Surveillance for malignant nodule 0 / 68 0 % (0%-5%) 0 / 33 0% (0%-11%) n.a. Avoided surgery in benign nodules 23 / 54 43% (29%-57%) 0 / 28 0% (0%-12%) <0.001a AUS/FLUS (n=60) n=40 n=20 Beneficial management 20 / 40 50% (34%-66%) 1 / 20 5% (0%-25%) <0.001a Surgery for malignant nodule 5 / 40 13% (4%-27%) 1 / 20 5% (0%-25%) 0.65b Surveillance for benign nodule 15 / 40 38% (23%-54%) 0 / 20 0% (0%-17%) 0.002a Unbeneficial management Surgery for benign nodule 20 / 40 50% (34%-66%) 19 / 20 95% (75%-100%) 0.001a Surveillance for malignant nodule 0 / 40 0% (0%-9%) 0 / 20 0% (0%-17%) n.a. Avoided surgery in benign nodules 15 / 35 43% (26%-61%) 0 / 19 0% (0%-18%) <0.001a FN/SFN (n=41) n = 28 n = 13 Beneficial management 17 / 28 61% (41%-78%) 4 / 13 31% (9%-61%) 0.07a Surgery for malignant nodule 9 / 28 32% (16%-52%) 4 / 13 31% (9%-61%) 1b Surveillance for benign nodule 8 / 28 29% (13%-49%) 0 / 13 0% (0%-25%) 0.04b Unbeneficial management Surgery for benign nodule 11 / 28 39% (22%-59%) 9 / 13 69% (39%-91%) 0.07a Surveillance for malignant nodule 0 / 28 0% (0%-12%) 0 / 13 0% (0%-25%) n.a. Avoided surgery in benign nodules 8 / 19 42% (20%-67%) 0 / 9 0% (0%-34%) 0.03b Hürthle cell nodules, HCN/SHCN (n=31) n=23 n=8 Beneficial management 8 / 23 35% (16%-57%) 1 / 8 13% (0%-53%) 0.38 Surgery for malignant nodule 6 / 23 26% (10%-48%) 0 / 8 0% (0%-37%) 0.30b Surveillance for benign nodule 2 / 23 9% (1%-28%) 1 / 8 13% (0%-53%) 1b Unbeneficial management Surgery for benign nodule 15 / 23 65% (43%-84%) 7 / 8 88% (47%-100%) 0.38b Surveillance for malignant nodule 0 / 23 0% (0%-15%) 0 / 8 0% (0%-37%) n.a. Avoided surgery in benign nodules 2 / 17 12% (1%-36%) 1 / 8 13% (0%-53%) 1b AUS/FLUS=atypia of undetermined significance or follicular lesions of undetermined significance. CI=confidence interval. FN/SFN=(suspicious for a) follicular neoplasm. HCN/SHCN=(suspicious for a) Hürthle cell neoplasm. N.a.=not applicable. a: Pearson’s chi-squared test. b: Fisher’s exact test.
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