scholarly journals Ultrasound Microvascular Blood Flow Evaluation: A New Tool for the Management of Thyroid Nodule?

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Carlo Cappelli ◽  
Ilenia Pirola ◽  
Elena Gandossi ◽  
Fiorella Marini ◽  
Alessandra Cristiano ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Univariate Analysis ◽  
Power Doppler ◽  
Needle Aspiration ◽  
Microvascular Blood Flow ◽  
Microvascular Flow ◽  
Multivariate Logistic Model ◽  
Needle Aspiration Cytology ◽  
Benign Nodules

Background. Toshiba Medical System has developed a new Doppler technique [Superb Microvascular Imaging (SMI)] that has improved microvascular flow imaging. SMI depicts perinodular and intranodular thyroid microvascular flow in higher detail compared to standard colour Doppler (CD) and power Doppler (PD) imaging. Objective. Assess the nodular microvascular architecture by SMI compared to CD and PD features in a series of thyroid nodules submitted to fine needle aspiration cytology, in order to evaluate the potential of SMI in detecting thyroid cancer. Materials and Methods. From April 2016 to July 2017, 254 patients with thyroid nodules, evaluated as at high risk for malignancy in agreement with AACE/ACE/AME guidelines, were submitted to cytology. All nodules were previously submitted to ultrasound grayscale, CD, PD, and SMI evaluation. Benign and malignant nodules were stratified in accordance to the number of vessels visualised by SMI: score 1 with a maximum of two blood vessels and score 2 with three or more vessels. Results. Score 1 was found in 59.6% of benign nodules and in 17.9% of malignant nodules, whereas score 2 was found in 40.4% and in 82.1%, respectively (sensitivity 81.7%; specificity 60.5%, p<0.001). Variables significantly associated with malignancy in the univariate analysis were gender (OR, 0.18; 95% CI, 0.08-0.37; p<0.001), vascularity (OR, 1.91; 95% CI, 1.65-3.89; p<0.001), and SMI (OR, 6.72; 95% CI, 3.89-11.59; p<0.001); multivariate logistic model confirmed SMI score 2 as an independent risk factor for malignancy (OR, 6.99; 95% CI, 3.46-12.09; p<0.001). Conclusions. This prospective pilot study showed that SMI can depict intranodular flow in higher detail compared to CDI and PDI, thus improving thyroid cancer detection.

scholarly journals What is New on Thyroid Cancer Biomarkers

2008 ◽  
Vol 3 ◽  
pp. BMI.S669 ◽  
Author(s):  
Rosaria M. Ruggeri ◽  
Alfredo Campennì ◽  
Sergio Baldari ◽  
Francesco Trimarchi ◽  
Maria Trovato
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Follicular Epithelium ◽  
Routine Practice ◽  
Appropriate Treatment ◽  
Follicular Lesions ◽  
Needle Aspiration Cytology ◽  
Well Differentiated

Thyroid cancer harbours in about 5% of thyroid nodules. The majority of them are well-differentiated cancers originating from the follicular epithelium, and are subdivided into papillary and follicular carcinomas. Undifferentiated carcinomas and medullary thyroid carcinomas arising from C cells are less common. Although most thyroid nodules are benign, distinguishing thyroid cancer from benign lesions is crucial for an appropriate treatment and follow-up. The fine needle aspiration cytology (FNAC) allows the diagnosis of nature of thyroid nodules in the majority of cases. However, FNAC has some limitations, particularly in the presence of follicular lesions which can appear dubious in rare instances even at histology. In an effort to improve diagnostic accuracy and offer new prognostic criteria, several immunohistochemical and molecular markers have been proposed. However, most of them have to be validated on large series before being used in routine practice.

scholarly journals Thyroid B-flow twinkling sign: a new feature of papillary cancer

2008 ◽  
Vol 159 (4) ◽  
pp. 447-451 ◽  
Author(s):  
Luca Brunese ◽  
Antonio Romeo ◽  
Sergio Iorio ◽  
Giuseppina Napolitano ◽  
Stefano Fucili ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Diagnostic Technique ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
General Electric Company ◽  
Cross Sectional ◽  
Twinkling Sign ◽  
New Feature ◽  
Needle Aspiration Cytology ◽  
Benign Nodules

BackgroundMicrocalcifications (aggregated with psammoma bodies), detected by ultrasound (US), are the most specific feature of papillary thyroid cancer (PTC). Using B-flow imaging (BFI), we identified a new sign (the twinkling sign; BFI-TS) in ‘suspect’ PTC nodules, which appeared to be generated by microcalcifications.ObjectiveTo evaluate whether the BFI-TS was predictive of malignancy, we correlated the BFI-TS with the results of fine needle aspiration cytology and histology.DesignCross-sectional cohort study from September 2006 to April 2008.SettingDepartment of Radiology and Endocrinology, University of Naples Federico II, and Department of Endocrinology, Second University of Naples.PatientsA total of 306 consecutive patients with 539 thyroid nodules >8 mm in diameter.Main outcome measureUS and BFI examinations were performed with the Logiq 9 system (General Electric Company, Milan, Italy); all patients underwent cytological examination.ResultsCytology revealed 455 (84.4%) benign nodules and 84 (15.6%) malignant nodules; the latter were confirmed by postsurgical histological examination (76 cases of PTC, 7 follicular carcinoma, and 1 Hürthle cell carcinoma). All suspect nodules, namely, nodules with potential predictors of thyroid malignancy (e.g., microcalcifications and intra-nodal vascularity), were analyzed by cytology or histology (or both). Of 84, 68 (80.9%) of malignant nodules had ≥4 or more BFI-TSs in at least one scan versus only 12 of 455 (2.6%) of benign lesions.ConclusionsOur results indicate that the BFI-TS could be a reliable diagnostic technique in the management of suspect thyroid nodules.

scholarly journals Patients with chronic autoimmune thyroiditis are not at higher risk for developing clinically overt thyroid cancer: a 10-year follow-up study

2020 ◽  
Vol 183 (3) ◽  
pp. 317-323
Author(s):  
Mario Rotondi ◽  
Gloria Groppelli ◽  
Laura Croce ◽  
Francesco Latrofa ◽  
Giuseppe Ancona ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Autoimmune Thyroiditis ◽  
Thyroid Nodules ◽  
Thyroid Volume ◽  
Needle Aspiration ◽  
Chronic Autoimmune Thyroiditis ◽  
Needle Aspiration Cytology ◽  
Design And Methods

Objective: The association between chronic autoimmune thyroiditis (CAT) and differentiated thyroid cancer (DTC) remains controversial. The incidence of DTC increases when screening procedures are implemented, as typically occurs in CAT patients being routinely submitted to thyroid ultrasound (US). The aim of this study was to longitudinally evaluate the long-term development of DTC in patients with CAT. Design and methods: A retrospective longitudinal cohort study was designed. For the study, 510 patients with chronic autoimmune thyroiditis (CAT) with a 10-year follow-up were enrolled. Patients were divided in two groups according to the presence (CAT+ NOD+; n = 115) or absence (CAT+ NOD−; n = 395) of co-existent nodules at diagnosis. The main outcome measures were appearance of new thyroid-nodules and development of DTC during follow-up. Results: During a 10-year median follow-up period, new thyroid-nodules were detected in 34/115 (29.5%) patients in the CAT+ NOD+ group and in 41/395 (10.3%) in the CAT+ NOD− group (P < 0.001). Logistic regression analysis showed that thyroid-volume at diagnosis and belonging to the CAT+ NOD+ group significantly predicted the appearance of a new thyroid nodule during follow-up, independently of baseline age and sex. Among the 75 patients experiencing the appearance of a new nodule, 27 (39%) met the criteria for fine-needle-aspiration-cytology (FNAC). A benign cytological diagnosis was rendered in all cases. Conclusions: In our series of CAT patients, the appearance of new thyroid-nodules was frequent, but none of them were found to be malignant. The presence of CAT appears to be associated with a negligible risk of developing clinically overt DTC.

scholarly journals Diagnostic Strategies for Thyroid Nodules Based on Ultrasonographic Findings in Japan

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4629
Author(s):  
Hiroki Shimura ◽  
Yoshiko Matsumoto ◽  
Tsukasa Murakami ◽  
Nobuhiro Fukunari ◽  
Masafumi Kitaoka ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Diagnostic Criteria ◽  
Thyroid Nodules ◽  
The United States ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Management Guidelines ◽  
Diagnostic Strategies ◽  
Needle Aspiration Cytology ◽  
Meta Analyses

In recent years, the incidence of thyroid cancer has been increasing worldwide, which is believed to be mainly due to the widespread use of imaging examinations, such as ultrasonography. In this context, ultrasonography has become increasingly important because it can evaluate not only the presence or absence of nodules, but also the detailed characteristics of the nodule, making it possible to diagnose benign or malignant nodules before cytology is performed. In Japan, the third edition of the sonographic diagnostic criteria for thyroid nodules is currently widely used, and its content is similar to that of recent meta-analyses and guidelines from medical societies in other countries. In addition, since overdiagnosis of very-low-risk thyroid cancer has recently become an issue, criteria for the implementation of fine needle aspiration cytology (FNAC) have been published by various countries. The Japan Society of Breast and Thyroid Sonology provides guidelines for FNAC implementation for solid and cystic nodules. In the United States, the ATA, NCCA, and ACR have published guidelines, whereas in Europe, the ESMO and ETA have done the same. All of these guidelines used to classify risk are based on nodule size and sonographic findings. This article outlines the diagnostic criteria and management guidelines in Japan in comparison with those published in other countries. Case studies using actual images were also performed to examine the differences in the FNAC guidelines.

Thyroid Cancer in the Thyroid Nodules Evaluated by Ultrasonography and Fine-Needle Aspiration Cytology

Thyroid ◽  
2005 ◽  
Vol 15 (7) ◽  
pp. 708-717 ◽  
Author(s):  
Jen-Der Lin ◽  
Tzu-Chieh Chao ◽  
Bie-Yu Huang ◽  
Szu-Tah Chen ◽  
Hung-Yu Chang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

scholarly journals Association of Ultrasonography and Ultrasound-guided Fine Needle Aspiration Cytology in the Diagnosis of Thyroid Nodules

2021 ◽  
Vol 6 (2) ◽  
pp. 1573-1578
Author(s):  
Binit Dev ◽  
Ajay Kumar Yadav ◽  
Sushil Taparia ◽  
Roshana Khadka ◽  
Shripad J Walavalkar
Keyword(s):  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Cervical Lymph Nodes ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Benign Nodules

Introduction: Ultrasound (USG) is the most commonly used imaging method to evaluate thyroid nodules. The sonographic features of thyroid nodules are very important to determine whether the nodule is benign or malignant. Fine Needle Aspiration Cytology (FNAC) is the gold standard to determine whether the nodule is benign or malignant. Objective: The purpose of this study was to compare ultrasound and color Doppler features of thyroid nodules with ultrasound-guided FNAC results to determine the relative importance of these features in predicting the risk of malignancy. Methodology: This prospective cross-sectional study was conducted in Birat medical college teaching hospital in Tankisinuwari, Morang, Nepal. The study was conducted from September 2019 to April 2021.  In total sixty-one patients with thyroid nodules were evaluated for sonographic characteristics. Finally, USG guided FNA for cytopathological examination was performed. Both descriptive and inferential statistics were used to analyze the result. Results: Out of the 61 patients, 34 (55.7%) were females and 27 (44.2%) were males. Majority of the malignant nodules were solid 11 (91.6%), whereas cystic and mixed nodules were predominantly seen in benign nodules 18 (36.7%) and 30 (61.2%) respectively. In malignant nodules 10 (83.3%) were heterogeneous and 2 (16.6%) were isoechoic. In benign nodules 29 (59.1%) were heterogeneous and 15 (30.6%) were anechoic with comet-tail artifact and 5 (10.2%) were isoechoic. Among 12 malignant cases, internal and peripheral vascularity were equally present in six cases each. Benign nodules showed peripheral vascularity in 48 (97.9%) and internal vascularity was noted in only one nodule. All of the malignant nodules showed calcification. None of the benign nodules showed micro-calcification. In malignant cases, cervical lymph nodes were present in 7 (58.3%) and absent in 5 (41.6%). In benign cases, cervical lymph nodes were present in 4 (8.1%) and absent in 45 (91.83%). Conclusion: The ultrasound features associated with malignancy in thyroid nodules are predominantly solid component, presence of micro-calcifications and internal vascularity. Enlarged cervical lymph nodes are good predictors for malignancy. USG guided FNAC confirms the suspicious features of thyroid nodules seen on USG.

scholarly journals Cytomorphological patterns of thyroid lesions among 1646 Sudanese patients: what we can learn from fine needle aspiration cytology retrospective analysis?

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Ali I. E. Osman ◽  
Ahmed O. Almobarak ◽  
Asma Kamalaldin Mohammed ◽  
Nouh S. Mohamed ◽  
Mohamed S. Muneer ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Follicular Adenoma ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Benign Thyroid ◽  
Thyroid Lesions

Introduction: Fine-needle aspiration (FNA) cytology biopsy of the thyroid gland is an accurate and useful diagnostic tool in the initial evaluation of nodular thyroid lesions. We aimed in this study to determine the cytomorphological patterns of thyroid lesions diagnosed by FNA among Sudanese patients. Methods: A descriptive retrospective, clinic-based study was performed. Cytopathological records of patients that attended the Total Lab Care Clinic in Khartoum-Sudan between January 2016 and December 2017 were reviewed. Results: A total of 1646 patients records were reviewed; 1385 (84.1%) were females and 261 (15.9%) males. A total of 1563 (94.9%) were negative for malignancy, 39 (2.4%) were positive for malignancy, 42 (2.6%) were indeterminate for malignancy and 2 (0.1%) were non-diagnostic. Colloid goiter was seen in 1147 patients (73.4%), benign hemorrhagic cysts were seen in 257, Hashimoto thyroiditis was seen in 77, benign thyroid nodules were seen in 76, keratocysts were seen in 2, thyroglossal duct cysts were seen in 2, thyroid follicular adenoma was seen in 1 and myxedema was seen in 1. For malignant patients; 11 had anaplastic thyroid cancer, 8 had papillary thyroid cancer, 7 had follicular thyroid cancer, 5 had metastatic thyroid cancer, 4 had medullary thyroid cancer, 3 had non-Hodgkin lymphoma and 1 had thyroid follicular adenoma. For those indeterminate for malignancy, 24 had follicular neoplasm and 18 had Hurthle cell neoplasm. Conclusions: Fine needle aspiration cytology for thyroid nodules provides a rapid and non-invasive technique for the evaluation and differentiation between benign and malignant lesions. This study also addresses the increased predominance of benign thyroid lesions among young patients and thyroid malignancy among the 4th decade of life.

scholarly journals Significance of RAS Mutations in Thyroid Benign Nodules and Non-Medullary Thyroid Cancer

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3785
Author(s):  
Vincenzo Marotta ◽  
Maurizio Bifulco ◽  
Mario Vitale
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Clinical Impact ◽  
General Context ◽  
Ras Mutations ◽  
Specificity And Sensitivity ◽  
Indeterminate Cytology ◽  
Benign Nodules

Thyroid nodules are detected in up to 60% of people by ultrasound examination. Most of them are benign nodules requiring only follow up, while about 4% are carcinomas and require surgery. Malignant nodules can be diagnosed by the fine-needle aspiration cytology (FNAC), which however yields an indeterminate result in about 30% of the cases. Testing for RAS mutations has been proposed to refine indeterminate cytology. However, the new entity of non-invasive follicular thyroid neoplasm, considered as having a benign evolution and frequently carrying RAS mutations, is expected to lower the specificity of this mutation. The aggressive behavior of thyroid cancer with RAS mutations, initially reported, has been overturned by the recent finding of the cooperative role of TERT mutations. Although some animal models support the carcinogenic role of RAS mutations in the thyroid, evidence that adenomas harboring these mutations evolve in carcinomas is lacking. Their poor specificity and sensitivity make the clinical impact of RAS mutations on the management of thyroid nodules with indeterminate cytology unsatisfactory. Evidence suggests that RAS mutation-positive benign nodules demand a conservative treatment. To have a clinical impact, RAS mutations in thyroid malignancies need not to be considered alone but rather together with other genetic abnormalities in a more general context.

Value of repeated fine-needle aspiration cytology and cytologic experience on the management of thyroid nodules

1998 ◽  
Vol 119 (1) ◽  
pp. 121-124 ◽  
Author(s):  
Jose Aguilar ◽  
Jose M. Rodriguez ◽  
Benito Flores ◽  
Joaquin Sola ◽  
Agueda Bas ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Power Of The Test ◽  
Needle Aspiration Cytology ◽  
Benign Nodules ◽  
Head Neck

Although fine-needle aspiration is being currently accepted as the most reliable method to select patients with thyroid nodules for surgery, controversy remains about the accuracy in distinguishing benign nodules. We present our results from 636 fine-needle aspirations performed from 1984 to 1989. Our article focuses on the value of cytologic expertise and repeated punctures for follow-up of benign nodules. We found annual figures for specificity and positive predictive value to increase steadily from 1984 to 1989, thus suggesting that the power of the test is proportional to the experience of the cytologist. We also state that the value of performing repeated punctures for the follow-up of unselected benign nodules is low. (Otolaryngol Head Neck Surg 1998;119:121-4.)

Sign in / Sign up

Export Citation Format

Share Document