Is Needle Aspiration of the Cystic Thyroid Nodule Effective and Safe Treatment?

1981 ◽  
pp. 209-236 ◽  
Author(s):  
J. Martin Miller ◽  
Joel I. Hamburger ◽  
Charles I. Taylor
Keyword(s):  
Thyroid Nodule ◽  
Needle Aspiration ◽  
Safe Treatment

scholarly journals Choosing the best algorithm among five thyroid nodule ultrasound scores: from performance to cytology sparing—a single-center retrospective study in a large cohort

2021 ◽  
Author(s):  
Clotilde Sparano ◽  
Valentina Verdiani ◽  
Cinzia Pupilli ◽  
Giuliano Perigli ◽  
Benedetta Badii ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Real Life ◽  
Scoring Systems ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Common Disease ◽  
Single Center ◽  
Thyroid Microcarcinoma ◽  
Thyroid Malignancies

Abstract Objective Incidental diagnosis of thyroid nodules, and therefore of thyroid cancer, has definitely increased in recent years, but the mortality rate for thyroid malignancies remains very low. Within this landscape of overdiagnosis, several nodule ultrasound scores (NUS) have been proposed to reduce unnecessary diagnostic procedures. Our aim was to verify the suitability of five main NUS. Methods This single-center, retrospective, observational study analyzed a total number of 6474 valid cytologies. A full clinical and US description of the thyroid gland and nodules was performed. We retrospectively applied five available NUS: KTIRADS, ATA, AACE/ACE-AME, EUTIRADS, and ACRTIRADS. Thereafter, we calculated the sensitivity, specificity, PPV, and NPV, along with the number of possible fine-needle aspiration (FNA) sparing, according to each NUS algorithm and to clustering risk classes within three macro-groups (low, intermediate, and high risk). Results In a real-life setting of thyroid nodule management, available NUS scoring systems show good accuracy at ROC analysis (AUC up to 0.647) and higher NPV (up to 96%). The ability in FNA sparing ranges from 10 to 38% and reaches 44.2% of potential FNA economization in the low-risk macro-group. Considering our cohort, ACRTIRADS and AACE/ACE-AME scores provide the best compromise in terms of accuracy and spared cytology. Conclusions Despite several limitations, available NUS do appear to assist physicians in clinical practice. In the context of a common disease, such as thyroid nodules, higher accuracy and NPV are desirable NUS features. Further improvements in NUS sensitivity and specificity are attainable future goals to optimize nodule management. Key Points • Thyroid nodule ultrasound scores do assist clinicians in real practice. • Ultrasound scores reduce unnecessary diagnostic procedures, containing indolent thyroid microcarcinoma overdiagnosis. • The variable malignancy risk of the “indeterminate” category negatively influences score’s performance in real-life management of thyroid lesions.

scholarly journals Can sonographic features of microcalcification predict thyroid nodule malignancy? a prospective observational study

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mehrdad Nabahati ◽  
Rahele Mehraeen ◽  
Zoleika Moazezi ◽  
Naser Ghaemian
Keyword(s):  
Thyroid Nodule ◽  
Roc Analysis ◽  
Thyroid Nodules ◽  
Area Under The Curve ◽  
Positive Association ◽  
Needle Aspiration ◽  
Northern Iran ◽  
Significant Positive Association ◽  
Irregular Margin ◽  
Benign Nodules

Abstract Background The aim of this study was to investigate the diagnostic accuracy of microcalcification, as well as its associated sonographic features, for prediction of thyroid nodule malignancy. We prospectively assessed the patients with thyroid nodule, who underwent ultrasound-guided fine-needle aspiration during 2017–2020 in Babol, northern Iran. The ultrasonographic characteristics of the nodules, as well as their cytological results, were recorded. We used regression analysis to evaluate the relation between sonographic findings and nodule malignancy. A receiver operator characteristics (ROC) analysis was also used to estimate the ability of ultrasound to predict the characteristic features of malignancy, as estimated by the area under the curve (AUC). Results Overall, 1129 thyroid nodules were finally included in the study, of which 452 (40%) had microcalcification. A significant positive association was found between nodule malignancy and microcalcification in both univariate (OR=3.626, 95% CI 2.258–5.822) and multivariable regression analyses (OR=1.878, 95% CI 1.095–3.219). In the nodules with microcalcification, significant positive relations were seen between malignancy and hypoechogenicity (OR=3.833, 95% CI 1.032–14.238), >5 microcalcification number (OR=3.045, 95% CI 1.328–6.982), irregular margin (OR=3.341, 95% CI 1.078–10.352), and lobulated margin (OR=5.727, 95% CI 1.934–16.959). The ROC analysis indicated that AUC for hypoechogenicity, >5 microcalcification number, irregular margin, and lobulated margin were 60%, 62%, 55%, and 60%, respectively, in predicting malignant thyroid nodules. Conclusion The findings indicated that microcalcification can be a potential predictor of thyroid nodule malignancy. Also, the presence of irregular or lobulated margins, multiple intranodular microcalcification (>5 microcalcifications), and/or hypoechogenicity can improve the ability of microcalcification in distinguishing malignant from benign nodules.

Chemical neuritis after fine needle aspiration biopsy of thyroid nodule

2006 ◽  
Vol 29 (10) ◽  
pp. 947-948 ◽  
Author(s):  
U. M. Musharrafieh ◽  
M. P. Nasrallah ◽  
R. A. Sawaya ◽  
Z. M. Hijazi ◽  
M. C. Haddad
Keyword(s):  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Needle Aspiration Biopsy

Surgical Management of the Thyroid Nodule: Patient Selection Based on the Results of Fine-Needle Aspiration Cytology

1992 ◽  
Vol 102 (12) ◽  
pp. 1353-1356 ◽  
Author(s):  
Michael Bouvet ◽  
Jeffrey I. Feldman ◽  
Gordon N. Gill ◽  
Wolfgang H. Dillmann ◽  
Alan M. Nahum ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Surgical Management ◽  
Patient Selection ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

NO BENEFIT OF DEDICATED THYROID NODULE SCREENING IN PATIENTS WITH ACROMEGALY

2020 ◽  
Vol 26 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Ngan Betty Lai ◽  
Dave Garg ◽  
Anthony P. Heaney ◽  
Marvin Bergsneider ◽  
Angela M. Leung
Keyword(s):  
United States ◽  
Growth Hormone ◽  
Thyroid Cancer ◽  
Growth Factor ◽  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Fine Needle

Objective: Acromegaly results from the excessive production of growth hormone and insulin-like growth factor-1. While there is up to a 2-fold increased prevalence of thyroid nodules in patients with acromegaly, the incidence of thyroid cancer in this population varies from 1.6 to 10.6% in several European studies. The goal of our study was to determine the prevalence of thyroid nodules and thyroid cancer among patients with acromegaly at a large urban academic medical center in the United States (U.S.). Methods: A retrospective chart review was performed of all patients with acromegaly between 2006–2015 within the University of California, Los Angeles health system. Data were collected regarding patient demographics, thyroid ultrasounds, thyroid nodule fine needle aspiration (FNA) biopsy cytology, and thyroid surgical pathology. Results: In this cohort (n = 221, 49.3% women, mean age 53.8 ± 15.2 [SD] years, 55.2% Caucasian), 102 patients (46.2%) underwent a thyroid ultrasound, from which 71 patients (52.1% women, mean age 52.9 ± 15.2 [SD] years, 56.3% Caucasian) were found to have a thyroid nodule. Seventeen patients underwent a thyroid nodule FNA biopsy and the results revealed 12 benign biopsies, 1 follicular neoplasm, 3 suspicious for malignancy, and 1 papillary thyroid cancer (PTC), from which 6 underwent thyroidectomy; PTC was confirmed by surgical pathology for all cases (8.5% of all nodules observed). Conclusion: In this sample, the prevalence of thyroid cancer in patients with acromegaly and coexisting thyroid nodules is similar to that reported in the general U.S. population with thyroid nodules (7 to 15%). These findings suggest that there is no benefit of dedicated thyroid nodule screening in patients newly diagnosed with acromegaly. Abbreviations: AACE = American Association of Clinical Endocrinologists; ATA = American Thyroid Association; DTC = differentiated thyroid cancer; FNA = fine needle aspiration; GH = growth hormone; IGF-1 = insulin-like growth factor-1; PTC = papillary thyroid cancer; U.S. = United States

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