scholarly journals High Serum Thyrotropin Concentrations within the Reference Range: A Predictor of Malignancy in Nodular Thyroid Disease

2018 ◽  
Vol 27 (3) ◽  
pp. 272-277 ◽  
Author(s):  
Karla Duccini ◽  
Marcus Vinicius Leitão de Souza ◽  
Ricardo Delfim ◽  
Ana Paula Aguiar ◽  
Patricia Teixeira ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Reference Range ◽  
Biochemical Parameter ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Cross Sectional Study ◽  
High Serum ◽  
University Hospital ◽  
Cross Sectional ◽  
Serum Tsh

Objective: This study assessed whether or not a simple biochemical parameter, serum thyrotropin (TSH), within the reference range can predict the likelihood of thyroid malignancy in subjects undergoing fine-needle aspiration biopsy (FNAB) for thyroid nodules. Subjects and Methods: This cross-sectional study evaluated 236 patients without overt thyroid dysfunction who were not on levothyroxine therapy. They underwent FNAB of the thyroid nodules at the Clementino Fraga Filho University Hospital between 2011 and 2012. The reference range and serum TSH quartiles were determined according to age-specific values for serum TSH and then compared between the cases with benign thyroid nodular disease and differentiated thyroid carcinoma (DTC) based on surgical pathology reports. Results: Of the 236 patients, 201 (85.1%) underwent a surgical procedure (thyroidectomy) and 89/236 (44.3%) had DTC. The mean TSH concentrations were 2.09 ± 1.15 mU/L in benign patients versus 2.73 ± 1.33 mU/L in cases of DTC (p < 0.01). As TSH increased from quartiles 1 to 4, the frequency of a malignant diagnosis also increased progressively from 22% in quartile 1 to 65% in the last quartile (p ≤ 0.001). Conclusion: Thyrotropin levels were positively associated with the diagnosis of DTC in thyroid nodules.

scholarly journals Quantitative Assessment Of The Variations In Thyroid Dimensions In Relation To Increase In Serum TSH In Euthyroids

2018 ◽  
Vol 08 (02) ◽  
pp. 72-76
Author(s):  
Mahrukh Kamran ◽  
Sahar Mubeen ◽  
Iffat Raza ◽  
Sanobar Bughio ◽  
Hira Waseem ◽  
...  
Keyword(s):  
Total Variation ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Left Lobe ◽  
University Hospital ◽  
P Value ◽  
Cross Sectional ◽  
Right Lobe ◽  
The Right ◽  
Serum Tsh

Objectives: To determine the effect of serum TSH on thyroid dimensions of each lobe and to measure the amount of effect of per unit increase in serum TSH on thyroid dimensions of each lobe in euthyroids. Study Design: It was a cross-sectional study. Setting: The study was conducted at Ziauddin University Hospital, Clifton, Karachi. Methodology: Healthy participants aged 21 years and above were included through convenient sampling. Serum Thyroid stimulating hormone was evaluated and ultrasound of thyroid gland TG of 192 euthyroid participants was performed. Spearman correlation and regression analysis was applied to evaluate the relationship between TSH and TG dimensions Results: Relationship of increase in serum TSH with decrease in light lobe AP dimension was most significant. (r= -0.142 P-Value=0.001) and CC dimension least significant (r= -0.0098 P-Value=0.001). Where as in the left lobe AP dimension decreases significantly with increase serum TSH (r= -0.147 P-value=0.001). 11.7% of total variation in AP dimension, 3.5% of total variation in ML dimension and 6.5% of total variation in CC dimension in right lobe thyroid are because of serum TSH. While 9.5% of the total variation in AP dimension in left lobe is also due to serum TSH. Conclusion: Negative and significant correlation between serum TSH and thyroid dimensions was observed. Serum TSH inversely and significantly affects all the dimensions of the right lobe and only one dimension in the left lobe

scholarly journals Computerized Cytological Features for Papillary Thyroid Cancer Diagnosis—Preliminary Report

Cancers ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 1645
Author(s):  
Shyang-Rong Shih ◽  
I-Shiow Jan ◽  
Kuen-Yuan Chen ◽  
Wan-Yu Chuang ◽  
Chih-Yuan Wang ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Follicular Neoplasm ◽  
Papillary Thyroid ◽  
Operating Characteristics ◽  
Histologic Diagnosis ◽  
Cross Sectional ◽  
Cytological Features

Fine needle aspiration cytology (FNAC) is the final diagnosis of thyroid nodules before surgery. It is important to further improve the indeterminate FNAC diagnosis results using computerized cytological features. This retrospective cross-sectional study included 240 cases, of whom 110 had histologic diagnosis of papillary thyroid cancers (PTC), 100 had nodular/adenomatous goiters/hyperplasia (benign goiters), 10 had follicular/Hurthle cell carcinomas, and 20 had follicular adenomas. Morphological and chromatic features of FNAC were quantified and analyzed. The result showed that six quantified cytological features were found significantly different between patients with a histologic diagnosis of PTC and patients with histologic diagnosis of benign goiters in multivariate analysis. These cytological features were used to estimate the malignancy risk in nodules with indeterminate FNAC results. The Area Under the Receiver Operating Characteristics (AUROC) of the diagnostic accuracy with a benign or malignant nature was 81.3% (p < 0.001), 78.7% (p = 0.014), and 56.8% (p = 0.52) for nodules with FNAC results of atypia, which is suspicious for malignancy and follicular neoplasm, respectively. In conclusion, quantification of cytological features could be used to develop a computer-aided tool for diagnosing PTC in thyroid nodules with indeterminate FNAC results.

Solitary Thyroid Nodules - Validity of Ultrasonography, Fine Needle Aspiration Cytology and Sestamibi in Detecting Thyroid Malignancies - A Cross-Sectional Study in Kerala

2021 ◽  
Vol 8 (31) ◽  
pp. 2885-2889
Author(s):  
Shilpa Suresh ◽  
Riju R. Menon ◽  
Pradeep Jacob ◽  
Gopalakrishnan Nair C
Keyword(s):  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Fine Needle ◽  
Sestamibi Scintigraphy ◽  
Needle Aspiration Cytology ◽  
Thyroid Malignancies

BACKGROUND The diagnosis of thyroid malignancies continues to remain a challenge, due to lack of specificity with various modalities, and intrinsic variability with clinical examination. Although histopathological diagnosis is confirmatory, there is a need for pre-surgical assessment and confirmation, which will prove to be useful in decision making regarding the course of management. The present study was carried out to evaluate the validity of various modalities for detection of thyroid malignancies. METHODS This cross-sectional study was carried out among 40 patients who presented to the outpatient clinic with thyroid nodules. All the participants were evaluated by ultrasound, fine needle aspiration cytology (FNAC) and sestamibi scintigraphy. All the participants were taken up for surgery and the resected specimen was sent for histopathology for confirmatory diagnosis. RESULTS Ultrasound and FNAC detected malignancy in 25 % of the participants, while sestamibi scintigraphy detected malignancy in 30 % of the participants. Based on histopathology, the gold standard confirmatory test, malignancy was detected in 35 % of the participants. It was observed that the sensitivity was highest for FNAC (75 %) followed by TC methoxyisobutylisonitrile (TC MIBI) (50 %). Specificity was highest for FNAC (95 %) followed by ultrasound (88 %) (P < 0.0001). CONCLUSIONS FNAC has the highest sensitivity and specificity while ultrasound and sestamibi have comparable specificity. There is a high probability of malignancy when the delayed image in sestamibi scintigraphy shows retention. MIBI may prove to be useful in differentiating benign and malignant follicular lesions. KEYWORDS Papillary Carcinoma, Histopathology, Thyroid Nodule, Sestamibi, FNAC

scholarly journals Research on Clinical, Subclinical Characteristic of Incidental Thyroid Nodules

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A870-A870
Author(s):  
Bay Quang Nguyen
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Thyroid Function Tests ◽  
Cross Sectional ◽  
Normal Thyroid ◽  
Normal Thyroid Function

Abstract Background: Incidental thyroid nodules has become more prevalent in recent years due to applying diagnostic imaging tests. Many studies show that the rate of thyroid cancer in this group of patients is relatively high. Objective: To assess patients with incidentally detected thyroid nodules, including those who were diagnosed with thyroid cancer. Materials and Methods: A cross-sectional study, which involved 208 patients with 389 thyroid nodules detected by thyroid ultrasound. All patients have thyroid function tests. 272 nodules were performed fine-needle aspiration. Patients with thyroid cancer were assessed histopathology after removal. Results: The participants’ mean age was 47.22 ± 12.02. The female / male ratio is 6.7/1. No patients had history of head and neck irradiation or living in epidemiological areas with high prevalence of goiter. TSH level: 96.2% normal, 2.4% low, 1.4% high. In thyroid cancer group: 100% of patients had normal thyroid function. Nodule characteristics on ultrasound: Majority of thyroid nodules had diameters less than 1.5 cm (85.6%), multi-nodularity(52.9%). The largest carcinoma nodule was 2.35 cm, 22.2% of patients with thyroid cancer had ≥ 3 nodules. The malignancy rate of TIRADS 5 was 70.6%. FNA results of 272 thyroid nodules: the majority were Bethesda II (74,2%); the incidence of carcinoma (Bethesda V, VI) is 17.4%. 36 patients account for 17,3%, with 42 nodules were performed surgery, the results of histopathology were 100% of papillary thyroid carcinoma, which was consistent with cytological results. Conclusion: Thyroid nodules are common in women patients at the age of 31-60 with normal thyroid function. Most of them are &lt;1.5 cm in size. There are 17.3% of patients were thyroid carcinoma.

scholarly journals Prevalence and Associated Factors of Thyroid Incidentaloma among Adult People Attending Gondar University Hospital, Northwest Ethiopia Temesgen Tadesse1

1970 ◽  
Vol 30 (1) ◽  
Author(s):  
Temesgen Tadesse ◽  
Tigist Hailu ◽  
Assefa Getachew ◽  
Solomon M Abebe
Keyword(s):  
Associated Factors ◽  
Thyroid Nodules ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
University Hospital ◽  
P Value ◽  
Multivariable Logistic Regression Analysis ◽  
Cross Sectional ◽  
Thyroid Incidentaloma ◽  
Logistic Analysis

BACKGROUND: Incidentally discovered thyroid lesions have become highly common in the development and more frequent utilization of highly sensitive imaging modalities, like ultrasound. However, little is known about its prevalence and associated factors in Ethiopia. The aim of this study was to determine the prevalence of thyroid incidentalomas and associated factors through ultrasound (US) among adults attending Gondar University Hospital.METHODS: A hospital-based cross-sectional study was carried out on 290 adults aged 15 years and above. Out of the adults who visited the hospital during the study, those who neither had history of thyroid disease, thyroid surgery, nor clinically palpable thyroid nodules were involved in the investigation. The participants were examined using a high frequency linear-array transducer (7MHz). For comparing men and women, the unpaired t-test wasused. Binary logistic analysis was used to identify the associated factors, and a P-value < 0.05 was considered statistically significant.RESULT: The frequency of thyroid incidentaloma was found to be 33.4% (95% CI: 27.9, 38.9). Thyroid incidentaloma was detected in 42.4% of the females and 22.7% of the males (P<0.001). About 63% had single and 37% multiple thyroid nodules. About 25.8% had thyroid nodules greater than 1cm. In the multivariable logistic regression analysis, increasing age (AOR=5.96; 2.34, 15.15) and female sex (AOR=3.01; 1.73, 5.26) were significantly associated with thyroid incidentalomas.CONCLUSION: The frequency of thyroid incidentaloma (TI) was found to be high in this study and much higher among older women. Solitary and small sized thyroid nodules were commonly seen in the study. 

scholarly journals Diagnostic Accuracy of Fine needle Aspiration Cytology of Thyroid Nodules at two tertiary Hospitals in Zambia: a cross-sectional study

2020 ◽  
Vol 4 (2) ◽  
pp. 6-13
Author(s):  
Jackson Chipaila ◽  
◽  
Alex Makupe ◽  
Evans Malyangu ◽  
Daniel Maswahu ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Predictive Values ◽  
Tertiary Hospitals ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Introduction: Thyroid nodules are one of the common surgical presentations in Africa and are of great concern because of their potential to be malignant. Zambia is not excluded from these common surgical conditions. However, there are no pre-operative cellular or intra-operative tissue diagnoses of the thyroid nodules done before thyroidectomy making it difficult to plan for an optimal and definitive management. Fine needle aspiration cytology (FNAC) is known to play a pivotal role in the screening and management of thyroid swellings. This study serves to assess the diagnostic accuracy of FNAC on thyroid nodules in patients at two tertiary hospitals in Zambia in order to establish a basis for introducing its use in the management of thyroid nodules at the institutions. Objectives: To evaluate the accuracy of FNAC, as compared to histopathology, in the diagnosis of thyroid nodules at University Teaching Hospital (UTH) and Ndola Central Hospital (NCH) in Zambia. Methods: This was a prospective cross-sectional study conducted in UTH and NCH surgery department from June 2014 to March 2015. Seventy-three patients, who presented with palpable thyroid nodules and underwent thyroidectomy, were enrolled in the study. The FNAC diagnosis of the patients was compared to the histopathology finding following thyroidectomy. Results: Females made up the majority of the patients (n=67, 91.8%). The ages of the patients ranged from 18 to 78 years. The mean age was 44.3 years and the peak age of incidence was in the fourth decade. All patients were clinically euthyroid at the time of enrolment. The FNAC findings included 23 cases reported as unsatisfactory (31.5%); 29 cases benign (39.7%); 2 cases atypical (2.7%); 6 cases suspicious (8.2%); and 13 cases malignant (17.8%). Histopathology findings were available from all 73 tissue samples of participants, of which 55 (75.3%) and 18 (24.7%) were reported as benign and malignant respectively. Of the 18 malignant cases identified by histology, the most common cancer was follicular carcinoma (n=9, 50%), followed by papillary carcinoma (n=6, 33.3%) and undifferentiated carcinoma (n=3, 16.7%). FNAC, in this study, had sensitivity, specificity, negative and positive predictive values, and accuracy of 83.33%, 89.09%, 94.23 and 71.42%, and 87.67% respectively. Conclusion: In this study, FNAC of thyroid nodules had a high sensitivity, specificity, predictive values and accuracy, and can therefore be recommended to be adopted as a pre-operative tool for screening of thyroid nodules.

scholarly journals Ultrasound-guided fine-needle aspiration of thyroid nodules: assessment of the ideal number of punctures

2012 ◽  
Vol 45 (3) ◽  
pp. 145-148 ◽  
Author(s):  
Sandro Ceratti ◽  
Paula Giannini ◽  
Ricardo Antenor de Souza e Souza ◽  
Orlando Fermozelli Rodrigues Junior
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Fine Needle ◽  
Study Population ◽  
Ideal Number ◽  
The Mean ◽  
Conclusive Diagnosis

OBJECTIVE: To determine the number of punctures in fine-needle aspiration biopsies required for a safe cytological analysis of thyroid nodules. MATERIALS AND METHODS: Cross-sectional study with focus on diagnosis. The study population included 94 patients. RESULTS: The mean age of the patients participating in the study was 52 years (standard-deviation = 13.7) and 90.4% of them were women. Considering each puncture as an independent event, the first puncture has showed conclusive results in 78.7% of cases, the second, in 81.6%, and the third, in 71.8% of cases. With a view to the increasing chance of a conclusive diagnosis at each new puncture, two punctures have showed conclusive results in 89.5% of cases, and three punctures, in 90.6% of cases with at least one conclusive result. CONCLUSION: Two punctures in fine-needle aspiration biopsies of thyroid nodules have lead to diagnosis in 89.5% of cases in the study sample, suggesting that there is no need for multiple punctures to safely obtain the diagnosis of thyroid nodules.

scholarly journals MON-497 Evaluation and Comparison of Ultrasonographic Features According to Histology of Thyroid Nodules

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Cátia Ferrinho ◽  
Clara Valério Cunha ◽  
Eugénia Silva ◽  
Catarina Saraiva ◽  
Rute Costa Ferreira ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Statistical Tests ◽  
Positive Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Us ◽  
Risk Of Malignancy ◽  
The Eu

Abstract Introduction: The prevalence of thyroid nodules identified by ultrasonography (US) may be up to 70%, with the majority being incidentalomas. Less than 15% of thyroid nodules will be malignant. Ultrasonography plays a key role in the diagnosis and management of thyroid diseases and US features have been described in way to predict the risk of malignancy. Aim: Evaluate and correlate US features with histological results, in our hospital, from January 2017 to December 2018. Materials and methods: Cross-sectional study. A total of 117 patients were evaluated, 77 had histology of nodular hyperplasia (benign) and 40 had histology of thyroid carcinoma (malign) after partial or total thyroidectomy. We described the size of the nodule (the largest diameter), the US features detailed in the ultrasound report (shape, margins, echogenicity, composition and microcalcifications), the EU-TIRADS score of each nodule and the histology of thyroid. The data were analysed using nonparametric statistical tests. The results are presented as median (interquartile range). The level of significance accepted was p&lt;0.05. Results: Of the 117 patients, 82.1% were female, with a median age of 59.7 (25.0) years, nodule size in benign histology group was 35.0 (14.0) mm and in malign histology group was 20.0 (28.0) mm. Of malignant nodules, 90.0% (n=36) were papillary carcinomas. The prevalence of US features: 76.9% were solid, 35.0% had microcalcifications, 25.6% had irregular margins, 17.9% were markedly hypoechoic and 6.8% were taller-than-wide. Three characteristics were significantly related to malignancy: irregular margins (p=0.001), markedly hypoechoic (p=0.001) and microcalcifications (p=0.015). The taller-than-wide feature had the highest specificity of 94.8%; the marked hypoechogenicity with a specificity of 92.2%, had the highest positive likelihood ratio (LHR+: 4.81 (95% CI: 2.02–11.44)) and the highest diagnostic odds ratio (DOR: 7.10 (95% CI: 2.48–20.30)). The EU-TIRADS 5 category had a significant association with malignancy (p=0.001) and 80.0% of malignant nodules were classified in this category. The specificity was 62.3%, LHR+ was 2.12 (95% CI: 1.53–2.94) and DOR was 6.62 (95% CI: 2.69–16.31). Conclusion: In the evaluation of the US features, marked hypoechogenicity had the highest LHR+ and DOR. It was possible to verify that the EU-TIRADS 5 category was a good predictor of risk to malignancy, which reinforces the importance of categorizing the nodules for selective perform of fine needle aspiration.

scholarly journals Association between Serum Insulin-Like Growth Factor-I Levels and Thyroid Disorders in a Population-Based Study

2007 ◽  
Vol 92 (10) ◽  
pp. 4039-4045 ◽  
Author(s):  
Henry Völzke ◽  
Nele Friedrich ◽  
Sabine Schipf ◽  
Robin Haring ◽  
Jan Lüdemann ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Serum Insulin ◽  
High Serum ◽  
Current Debate ◽  
Thyroid Disorders ◽  
Cross Sectional ◽  
Igf I ◽  
Serum Tsh ◽  
Tsh Levels ◽  
Igfbp 3

Abstract Objective: There is current debate on whether serum IGF-I levels are associated with thyroid disorders. The aims of the present study were: 1) to investigate possible associations between serum IGF-I levels and thyroid disorders and 2) to analyze the role of serum IGF binding protein (IGFBP)-3 and TSH levels for these associations. Design: This was a cross-sectional Study of Health in Pomerania. Setting: The study was conducted in the general population of northeast Germany. Subjects: The study population comprised 3662 subjects (1746 women) without history of thyroid disorders. Interventions: No interventions have been performed. Main Outcome Measures: Goiter and thyroid nodules were determined by ultrasound. Serum TSH levels less than 0.25 mIU/liter were considered decreased. Results: Adjusted for major confounders and risk factors for thyroid disorders, subjects with serum IGF-I levels above the upper tertile had higher odds for goiter relative to subjects with serum IGF-I levels below the lower tertile [odds ratio (OR) 1.67; 95% confidence interval (CI) 1.24–2.26 in women; OR 2.04; 95% CI 1.55–2.68 in men]. A similar association was present for thyroid nodules in men (OR 1.64; 95% CI 1.17–2.32) and for decreased serum TSH levels in women (OR 1.65; 95% CI 1.00–2.69). Serum IGFBP-3 levels were not associated with thyroid disorders and did not represent effect modifiers for the association between serum IGF-I levels and the endpoints. Conclusions: We conclude that high serum IGF-I levels are associated with goiter. Whereas high serum IGF-I levels are also related to thyroid nodules in men, they are related to decreased serum TSH levels in women. Serum IGFBP-3 and TSH levels did not modulate these associations.

scholarly journals Differences between ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications performance in identifying cytological high-risk thyroid nodules

2018 ◽  
Vol 178 (6) ◽  
pp. 595-603 ◽  
Author(s):  
A Lauria Pantano ◽  
E Maddaloni ◽  
S I Briganti ◽  
G Beretta Anguissola ◽  
E Perrella ◽  
...  
Keyword(s):  
High Risk ◽  
Thyroid Nodules ◽  
Roc Curves ◽  
Clinical Decision ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Classification Systems ◽  
Cross Sectional ◽  
Significant Difference ◽  
Risk Of Malignancy

Objective Thyroid ultrasound is crucial for clinical decision in the management of thyroid nodules. In this study, we aimed to estimate and compare the performance of ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications in discriminating nodules with high-risk cytology. Design Cross-sectional study. Methods 1077 thyroid nodules undergoing fine-needle aspiration were classified according to ATA, AACE/ACE/AME and ACR TI-RADS ultrasound classifications by an automated algorithm. Odds ratios (ORs) and receiver operating characteristic (ROC) curves for high-risk cytology categories (TIR3b, TIR4 and TIR5) were calculated for the different US categories and compared. Results Cytological categories of risk increased together with all US classifications’ sonographic patterns (P < 0.001). The diagnostic performance (C-index) of ACR TI-RADS and AACE/ACE/AME significantly improved when adding clinical data as gender and age in the regression model (P < 0.001). A significant difference in the final model C-index between the three US classification systems was found (P < 0.029), with the ACR TI-RADS showing the highest nominal C-index value, significantly superior to ATA (P = 0.008), but similar to AACE/ACE/AME (P = 0.287). ATA classification was not able to classify 54 nodules, which showed a significant 7 times higher risk of high-risk cytology than the ‘very low suspicion’ nodules (OR: 7.20 (95% confidence interval: 2.44–21.24), P < 0.001). Conclusions The ACR TI-RADS classification system has the highest area under the ROC curve for the identification of cytological high-risk nodules. ATA classification leaves ‘unclassified’ nodules at relatively high risk of malignancy.

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