scholarly journals Repeat FNA Significantly Lowers Number of False Negative Results in Patients with Benign Nodular Thyroid Disease and Features of Chronic Thyroiditis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Dorota Słowińska-Klencka ◽  
Ewa Woźniak-Oseła ◽  
Bożena Popowicz ◽  
Stanisław Sporny ◽  
Mariusz Klencki

Purpose. The aim of the study was to compare the risk of thyroid malignancy and efficacy of repeat FNA in patients with thyroid nodules diagnosed cytologically as benign lesion (BL) with features of chronic thyroiditis (BL-CT) and BL without CT features (BL-nCT).Methods. The analysis included 917 patients with BL-CT and 7046 with BL-nCT in the first FNA. Repeat biopsy was carried out in 787 patients of BL-CT and 5147 of BL-nCT; 218 patients of BL-CT and 2462 of BL-nCT were operated; in 88 cases of BL-CT and 563 of BL-nCT both ways of follow-up were available.Results. Outcome of repeat cytology implied surgery more frequently in patients with BL-CT than with BL-nCT—3.2% versus 1.9%,P< 0.05. Incidence of cancer (including incidentalomas) was higher in patients with BL-CT operated after one benign cytology than in patients with two benign FNA outcomes: 10.8% versus 1.6%,P< 0.05. In patients with BL-nCT that difference was not significant: 3.2% versus 2.6%.Conclusions. Patients with thyroid nodules diagnosed as BL with CT features have higher risk of malignancy than patients with BL without CT features. Repeat biopsy significantly lowers percentage of FN results in patients with BL-CT in the first FNA.

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Shin Hye Hwang ◽  
Ji Min Sung ◽  
Eun-Kyung Kim ◽  
Hee Jung Moon ◽  
Jin Young Kwak

Objective. To determine the role of imaging-cytology correlation in reducing false negative results of fine-needle aspiration (FNA) at thyroid nodules.Methods. This retrospective study included 667 nodules 1 cm or larger in 649 patients diagnosed as benign at initial cytologic evaluation and that underwent follow-up ultrasound (US) or FNA following a radiologist’s opinion on concordance between imaging and cytologic results. We compared the risk of malignancy of nodules classified into subgroups according to the initial US features and imaging-cytology correlation.Results. Among included nodules, 11 nodules were proven to be malignant (1.6%) in follow-up FNA or surgery. The malignancy rate was higher in nodules with suspicious US features (11.4%) than in nodules without suspicious US features (0.5%,P<0.001). When a thyroid nodule had discordant US findings on image review after having benign FNA results, malignancy rate increased to 23.3%, significantly higher than that of nodules with suspicious US features (P<0.001). However, no significant difference was found in the risk of malignancy between the nodules without suspicious US features (0.5%) and imaging-cytology concordant nodules (0.6%,P=0.438).Conclusions. Repeat FNA can be effectively limited to patients with cytologically benign thyroid nodules showing discordance in imaging-cytology correlation after initial biopsy, which reduces unnecessary repeat aspirations.


2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.


Author(s):  
Suzanne Lisbeth Ekelund

This paper describes the problems with false covid-19 test results, both false positive and false negative results. The problems are related to the quality of tests, test sampling and the currently limited follow-up procedures. A test and follow-up strategy that could decrease the potential problems is suggested.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P154-P154
Author(s):  
Eveling Y Rojas ◽  
Leonardo Ordoñez ◽  
Victor Hernandez ◽  
Jose E Guzman ◽  
Juan Izquierdo ◽  
...  

Objectives The Cochlear Hydrops Analysis Masking Procedure (CHAMP) has been reported with a high sensibility and specificity for the diagnosis of endolymphatic hydrops (ELH). Nevertheless, a complete validation of CHAMP with precise methods has not been done. Our objectives: To determine whether CHAMP has a diagnostic value in patients with definite, probable/possible diagnosis of Meniere's disease or endolymphatic hydrops, based on the criteria of the AAO-HNS. Methods Prospective validation study for a diagnostic test: phase II. Latency of wave V was assessed using CHAMP. We classified subjects in 5 groups: 1-Definite ELH, 2-Probable ELH, 3-Possible ELH, 4-subjects with other otovestibular symptoms, 5-normal hearing subjects. We included cases (groups 1–4) with an episode of vertigo with duration equal or longer than 20 minutes, with or without other otovestibular symptoms. Results We included 67 cases (132 ears). 38 cases (76 ears) completed the follow up and their results are presented. In group 1, the sensibility of CHAMP was 43% and its specificity was 100%. In groups 2–3, the sensitivity was 20% and the specificity 100%, with 0% false positive and 80% false negative results. Other indicators of validity for this diagnostic test are presented. Conclusions CHAMP has a high specificity and low sensibility for the diagnosis of ELH when the delay in wave V latency is used. Future studies may assess the relationship between wave amplitudes to improve the clinical value of CHAMP.


2016 ◽  
Vol 24 (4) ◽  
pp. 664-670 ◽  
Author(s):  
Kittisak Unsrisong ◽  
Siriporn Taphey ◽  
Kanokporn Oranratanachai

OBJECT The object of this study was to evaluate the accuracy of fast 3D contrast-enhanced spinal MR angiography (MRA) using a manual syringe contrast injection technique for detecting and evaluating spinal arteriovenous shunts (AVSs). METHODS This was a retrospective study of 15 patients and 20 spinal MRA and catheter angiography studies. The accuracy of using spinal MRA to detect spinal AVS, localize shunts, and discriminate the subtype and dominant arterial feeder of the AVS were studied. RESULTS There were 14 pretherapeutic and 6 posttherapeutic follow-up spinal MRA and catheter spinal angiography studies. The spinal AVS was demonstrated in 17 of 20 studies. Spinal MRA demonstrated 100% sensitivity for detecting spinal AVS with no false-negative results. A 97% accuracy rate for AVS subtype discrimination and shunt level localization was achieved using this study's diagnostic criteria. The detection of the dominant arterial feeder was limited to 9 of these 17 cases (53%). CONCLUSIONS The fast 3D contrast-enhanced MRA technique performed using manual syringe contrast injection can detect the presence of a spinal AVS, locate the shunt level, and discriminate AVS subtype in most cases, but is limited when detecting small arterial feeders.


2003 ◽  
Vol 10 (5) ◽  
pp. 802-807 ◽  
Author(s):  
Andréia R. Neves ◽  
Ronei L. Mamoni ◽  
Cláudio L. Rossi ◽  
Zoilo P. de Camargo ◽  
Maria Heloísa S. L. Blotta

ABSTRACT Immunodiffusion (ID) is the serologic test most frequently used for the diagnosis and posttherapy follow-up of patients with paracoccidioidomycosis (PCM). The ID test is highly specific (100%), but its sensitivity is relatively low (90%), leading to false-negative results. The aim of this study was to determine the profiles of antibodies in sera from patients with proven PCM and with negative results in the ID test (IDneg) versus positive results in the ID test (IDpos). We analyzed 46 sera from patients with active PCM for total immunoglobulin G (IgG) and IgG subclass responses to Paracoccidioides brasiliensis gp43 antigen (treated or not treated with sodium metaperiodate) by enzyme-linked immunosorbent assay and immunoblotting. Immunoblotting showed that both IDneg and IDpos sera recognized predominantly the gp43 fraction of the P. brasiliensis antigen used in the ID test. IDneg sera contain low-avidity antibodies, low levels of specific IgG (total) and IgG1, and high levels of IgG2 compared with IDpos sera. The antibodies present in IDneg sera were predominantly directed against carbohydrate epitopes, since treatment with sodium metaperiodate resulted in a significant decrease in antibody reactivity. These data suggest that the lack of reactivity of sera from PCM patients in the ID test may be related to the production of low-avidity IgG2 antibodies directed against carbohydrate epitopes.


Pharmacia ◽  
2021 ◽  
Vol 68 (1) ◽  
pp. 155-161
Author(s):  
Maria Georgieva Moneva-Sakelarieva ◽  
Yozlem Ali Kobakova ◽  
Petar Yordanov Atanasov ◽  
Danka Petrova Obreshkova ◽  
Stefka Achkova Ivanova ◽  
...  

The new pandemic disease COVID is quick spread worldwide.The primary method used for diagnosing of COVID-19 is detecting viral nucleic acids. The main problem with RT-PCR test is the false negative results. The negative RT-PCR does not exclude a SARS-CoV-2 infection and this method should not be used as the only diagnostic criteria. The RT-PCR result does not change the complex treatment of the disease. The aim of the current study is to compare the four groups clinical cases of the different parameters: RT-PCR test, rapid test, clinical picture, laboratory tests as hematology, inflammatory markers, coagulation status and chemistry and imaging examinations: Chest X-ray at and Chest CT scan. Complex therapeutic approach has been implemented: antibiotic, inflammatory, anticoagulants, oxygen therapy, hepatoprotectors, antimycotics, fibrinolytics, probiotics, essential oils, vitamins. During the follow-up period, a tendency for significant reduction and resorption of the pulmonary changes on the CT scans has been seen.


2020 ◽  
Author(s):  
Ying Zhang ◽  
Feng Lu ◽  
Yi-Feng Zhang ◽  
Han-Xiang Wang ◽  
Shi Hui ◽  
...  

Abstract Objectives: Ultrasound-guided fine-needle aspiration (FNA) is the most accurate and economical means for the differential diagnosis of thyroid nodules, but false negative results also existed. This study aimed to predict the false negative results of FNA, reduce the missed diagnosis and improve the current management strategy of thyroid nodules. Methods: A total of 1232 consecutive patients with thyroid nodules who received FNA and BRAF V600E detection were adopted. All patients received both CUS (conventional ultrasound) and SWE (shear wave elastography) examinations and characteristics of these thyroid nodules were analyzed to evaluated the diagnostic performances of risk factors for malignancy.Results: Finally, 26 nodules with benign cytology and BRAF V600E mutations were enrolled. Undefined boundary, microcalcification and E max ratio > 1.49 were risk factors for malignancy (P<0.05), and the area under the receiver operating curve (ROC) of above CUS features and elastic value were 0.817 (95% CI: 0.617, 0.940), 0.792 (95% CI: 0.588, 0.925) and 0.792 (95% CI: 0.617, 0.940) respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 80.0%, 83.3%, 94.1%, 55.6% and 80.7% for undefined boundary, 75.0%, 83.3%, 93.8%, 50.0% and 76.9% for microcalcification and 75.0%, 83.3%, 93.8%, 50.0% and 76.9% for E max ratio > 1.49 respectively. There was no difference between benign and malignant nodules in the patient age, sex and nodule sizes (P>0.05).Conclusions: Undefined boundary, microcalcification and E max ratio > 1.49 were risk factors for malignancy in benign cytology nodules. When FNA results were benign but above characteristics could be found in the thyroid nodules with BRAF V600E mutation, further clinical decisions should be carried out to reduce the missed diagnosis.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Amir Khorasani ◽  
Amir Chegini ◽  
Arezoo Mirzaei

The globally inimitable and unremitting outbreak of COVID-19 infection confirmed the emergency need for critical detection of human coronavirus infections. Laboratory diagnostic tests and imaging modalities are two test groups used for the detection of COVID-19. Nowadays, real-time polymerase chain reaction (RT-PCR) and computed tomography (CT) have been frequently utilized in the clinic. Some limitations that confront with these tests are false-negative results, tests redone for follow-up procedure, high cost, and unable to do for all patients. To overcome these limitations, modified and alternative tests must be considered. Among these tests, RdRp/Hel RT-PCR assay had the lowest diagnostic limitation and highest sensitivity and specificity for the detection of SARS-CoV-2 RNA in both respiratory tract and nonrespiratory tract clinical specimens. On the other hand, lung ultrasound (LUS) and magnetic resonance imaging (MRI) are CT-alternative imaging modalities for the management, screening, and follow-up of COVID-19 patients.


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