scholarly journals The Diagnostic Value of Ultrasound in Medullary Thyroid Carcinoma: A Comparison With Computed Tomography

2020 ◽  
Vol 19 ◽  
pp. 153303382090583
Author(s):  
Liang Wang ◽  
Hongju Kou ◽  
Wei Chen ◽  
Mingdong Lu ◽  
Lingling Zhou ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Gold Standard ◽  
Diagnostic Value ◽  
Benign Lesions ◽  
Clinical Value ◽  
Medullary Thyroid ◽  
Significant Difference ◽  
Enhanced Computed Tomography

Purpose: To explore the clinical value of ultrasound in the diagnosis of medullary thyroid carcinoma by comparing with enhanced computed tomography. Methods: This retrospective study was performed on 62 patients with pathologically confirmed medullary thyroid carcinoma. All patients underwent ultrasound and enhanced computed tomography examinations before surgery. The findings of the pathologic examination of resected specimens were considered as gold standard and were compared with the results of these 2 methods. Results: There were 73 medullary thyroid carcinoma lesions and 29 benign lesions in 62 patients. In all, 55 of 73 medullary thyroid carcinoma lesions and 27 of 29 benign lesions were correctly diagnosed by ultrasound; and 45 of 73 medullary thyroid carcinoma lesions and 24 of 29 benign lesions were correctly diagnosed by enhanced computed tomography. The accuracy of ultrasound and enhanced computed tomography was 80.4% and 67.6%, respectively. There was significant difference between 2 methods ( P < .05). Conclusions: Ultrasound can be used to observe the location, number, size, shape, border, internal echo, calcification, and blood flow of the lesion. It is a convenient, inexpensive, and nonradiative method with higher accuracy than enhanced computed tomography.

scholarly journals Radioactive iodine in the treatment of medullary thyroid carcinoma: a controlled multicenter study

2013 ◽  
Vol 168 (5) ◽  
pp. 779-786 ◽  
Author(s):  
J A A Meijer ◽  
L E H Bakker ◽  
G D Valk ◽  
W W de Herder ◽  
J H W de Wilt ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Multicenter Study ◽  
Radioactive Iodine ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Medullary Thyroid ◽  
Clinical Appearance ◽  
Significant Difference

ObjectiveRadioactive iodine (RAI) therapy in medullary thyroid carcinoma (MTC) is applied in some centers, based on the assumption that cross-irradiation from thyroid follicular cells may be beneficial. However, no systematic studies on the effect of RAI treatment in MTC have been performed. The aim of this study was to analyze the effect of RAI treatment on survival in MTC patients.DesignRetrospective multicenter study in eight University Medical Centers in The Netherlands.MethodsTwo hundred and ninety three MTC patients without distant metastases who had undergone a total thyroidectomy were included between 1980 and 2007. Patients were stratified by clinical appearance, hereditary stage, screening status, and localization. All patients underwent regular surgical treatment with additional RAI treatment in 61 patients. Main outcome measures were disease-free survival (DFS) and disease-specific survival (DSS). Cure was defined as biochemical and radiological absence of disease.ResultsIn multivariate analysis, stratification according to clinical appearance (P=0.72), hereditary stage (P=0.96), localization (P=0.69), and screening status (P=0.31) revealed no significant effects of RAI treatment on DFS. Multivariate analysis showed no significant difference in DSS for the two groups stratified according to clinical appearance (P=0.14). Owing to limited number of events, multivariate analysis was not possible for DSS in the other groups of stratification.ConclusionsBased on the results of the present analysis, we conclude that RAI has no place in the treatment of MTC.

scholarly journals Comparison Between Clinicopathological Characteristics, BRAF V600E and TERT Promoter Mutation of Familial Non-Medullary Thyroid Carcinomas, and Sporadic Case

2021 ◽  
Vol 11 ◽  
Author(s):  
Tian Yang ◽  
Longsheng Huang ◽  
Chang Chen ◽  
Han Luo ◽  
Yong Jiang
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Nodular Goiter ◽  
Sporadic Case ◽  
Clinicopathological Characteristics ◽  
Braf V600e ◽  
Biological Behavior ◽  
Promoter Mutation ◽  
Medullary Thyroid ◽  
Significant Difference

BackgroundIt has been debated whether familial non-medullary thyroid carcinoma (FNMTC) is more aggressive and has a worse prognosis than sporadic non-medullary thyroid carcinoma (SNMTC). Our aim was to compare the invasiveness and prognosis of FNMTC and SNMTC by their biological behavior and molecular changes.Method and MaterialOur group mainly compared 106 patients with FNMTC whom have complete clinicopathological data during 2011–2019 in West China Hospital, Sichuan University, and 212 randomly selected cases with SNMTC were included to compare their biological behavior, recurrence and mortality, and molecular expression of BRAF V600E and TERT promoter. At the same time, FNMTC cases were divided into four subgroups, namely, two affected members group, three or more affected members, parent/offspring group, and sibling group, and they were compared with SNMTC separately to analyze the difference in their invasiveness and prognosis.ResultsWe found that the mean tumor size of FNMTC (0.96 ± 0.53cm) was smaller than that of SNMTC (1.15 ± 0.72 cm) (p = 0.020), while no significant difference in the incidence of other clinicopathological factors, including bilateral growth, capsular invasion, with thyroid nodular goiter or not, multifocality, lymph node metastasis, extrathyroidal extension, iodine 131 treatments, T stage, and American Joint Committee on Cancer (AJCC) stage, was observed between FNMTC and SNMTC (p &gt; 0.05), between each FNMTC subgroup (p &gt; 0.05), and between each FNMTC subgroup and SNMTC (p &gt; 0.05). There was no significant difference in recurrence, mortality, and BRAF V600E and TERT promoter mutation between FNMTC and SNMTC, among which 50/60 (83.33%) of FNMTC patients had BRAF V600E mutation and 1/32 (3.13%) had TERT promoter mutation, while the mutation rates of SNMTC were 93/108 (86.11%) and 3/64 (4.69%) (p &gt; 0.05).ConclusionThere was no significant difference in invasiveness and prognosis between FNMTC and SNMTC by biological behavior, patient survival, and molecular level comparison.

scholarly journals The added diagnostic value of complementary gadoxetic acid-enhanced MRI to 18F-DOPA-PET/CT for liver staging in medullary thyroid carcinoma

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Daniel Puhr-Westerheide ◽  
Clemens C. Cyran ◽  
Josef Sargsyan-Bergmann ◽  
Andrei Todica ◽  
Franz-Josef Gildehaus ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Diagnostic Value ◽  
Gadoxetic Acid ◽  
Data Sets ◽  
Liver Lesions ◽  
Medullary Thyroid ◽  
Enhanced Mri ◽  
Pet Ct ◽  
Lesion Classification

Abstract Background A high proportion of patients with advanced stages of medullary thyroid carcinoma (MTC) present with liver metastasis metastases. The aim of our study was to investigate the added diagnostic value of complementary gadoxetic acid-enhanced MRI to 18F-DOPA-PET/CT for liver staging in MTC. Methods Thirty-six patients (14 female, median age 55 years) with histologically confirmed MTC undergoing gadoxetic acid-enhanced liver MRI within 1 month of matching contrast-enhanced 18F-DOPA-PET/CT between 2010 and 2016 were selected for this IRB-approved retrospective study. 18F-DOPA-PET/CT and multiparametric MRI data sets were read consecutively and liver lesions were categorised on a 5-point Likert scale (1–definitely benign; 2–probably benign; 3–intermediate risk for metastasis; 4–probably metastasis; 5–definitely metastasis). It was noted if gadoxetic acid-enhanced MRI detected additional, 18F-DOPA-PET/CT-occult metastases (category 5) or if gadoxetic acid-enhanced MRI allowed for a definite classification (categories 1 and 5) of lesions for which 18F-DOPA-PET/CT remained inconclusive (categories 2–4). Follow-up PET/CT and MRI examinations were used as a reference standard. Results A total of 207 liver lesions (18F-DOPA-PET/CT 149, MRI 207; 152 metastases, 37 benign cysts, 18 hemangiomas) were analysed. Fifty-eight additional lesions were detected by MRI, of which 54 were metastases (median diameter 0.5 cm [interquartile range 0.4–0.7 cm]) occult on 18F-DOPA-PET/CT. MRI allowed for a definite lesion classification (categories 1 and 5) in 92% (190/207) whereas 18F-DOPA-PET/CT allowed for a definite lesion classification in 76% (113/149). MRI lead to a change in lesion categorisation in 14% (21/149). Conclusion Gadoxetic acid-enhanced MRI allows for a more precise liver staging in MTC patients compared to 18F-DOPA-PET/CT alone, particularly for 18F-DOPA-negative metastases and lesions < 1 cm.

scholarly journals Medullary Thyroid Carcinoma in MEN2A: ATA Moderate- or High-Risk RET Mutations Do Not Predict Disease Aggressiveness

2017 ◽  
Vol 102 (8) ◽  
pp. 2807-2813 ◽  
Author(s):  
Rachel K Voss ◽  
Lei Feng ◽  
Jeffrey E Lee ◽  
Nancy D Perrier ◽  
Paul H Graham ◽  
...  
Keyword(s):  
High Risk ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Multivariable Analysis ◽  
Disease Onset ◽  
Moderate Risk ◽  
Medullary Thyroid ◽  
Ret Mutation ◽  
Significant Difference ◽  
Risk Patients

Abstract Context High-risk RET mutations (codon 634) are associated with earlier development of medullary thyroid carcinoma (MTC) and presumed increased aggressiveness compared with moderate-risk RET mutations. Objective To determine whether high-risk RET mutations are more aggressive. Design Retrospective cohort study using institutional multiple endocrine neoplasia type 2 registry. Setting Tertiary cancer care center. Patients Patients with MTC and moderate- or high-risk germline RET mutation. Intervention None (observational study). Main Outcome Measures Proxies for aggressiveness were overall survival (OS) and time to distant metastatic disease (DMD). Results A total of 127 moderate-risk and 135 high-risk patients were included (n = 262). Median age at diagnosis was 42.3 years (range, 6.4 to 86.4 years; mean, 41.6 years) for moderate-risk mutations and 23.0 years (range, 3.7 to 66.8 years; mean, 25.6 years) for high-risk mutations (P &lt; 0.0001). Moderate-risk patients had more T3/T4 tumors at diagnosis (P = 0.03), but there was no significant difference for N or M stage and no significant difference in OS (P = 0.40). From multivariable analysis for OS, increasing age [hazard ratio (HR), 1.05/y; 95% confidence interval (CI), 1.03 to 1.08], T3/T4 tumor (HR, 2.73; 95% CI, 1.22 to 6.11), and M1 status at diagnosis (HR, 3.93; 95% CI, 1.61 to 9.59) were significantly associated with worse OS but high-risk mutation was not (P = 0.40). No significant difference was observed for development of DMD (P = 0.33). From multivariable analysis for DMD, only N1 status at diagnosis was significant (HR, 2.10; 95% CI, 1.03 to 4.27). Conclusions Patients with high- and moderate-risk RET mutations had similar OS and development of DMD after MTC diagnosis and therefore similarly aggressive clinical courses. High-risk connotes increased disease aggressiveness; thus, future guidelines should consider RET mutation classification by disease onset (early vs late) rather than by risk (high vs moderate).

Calcitonin release from medullary thyroid carcinoma by thyrotropin-releasing hormone: comparison with calcium injection

1992 ◽  
Vol 126 (4) ◽  
pp. 325-328 ◽  
Author(s):  
Seiichi Oishi ◽  
Jouji Yamauchi ◽  
Yasuko Fujimoto ◽  
Shinichiro Hamasaki ◽  
Teruhisa Umeda ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Normal Subjects ◽  
Thyrotropin Releasing Hormone ◽  
Medullary Thyroid ◽  
Releasing Hormone ◽  
Significant Difference ◽  
Calcium Infusion ◽  
Calcium Injection ◽  
Peak Value

The effects of thyrotropin-releasing hormone on the release of calcitonin were investigated in 15 normal subjects and 12 patients with medullary thyroid carcinoma. The present study also compared the effect of TRH stimulation with calcium infusion test on calcitonin release in patients with medullary thyroid carcinoma. In normal subjects, calcitonin increased from a basal value of 7.5±2.5 pmol/l to a peak value of 9.4±3.0 pmol/l (p<0.01) after iv injection of synthetic TRH (500 μg). Basal calcitonin values in patients with medullary thyroid carcinoma were high (1216±2230 pmol/l, p<0.05), and TRH induced a further increase in calcitonin to 1 842±3149 pmol/l in all the patients (p< 0.05). They had a peak value of 7891±13 528 pmol/l after the calcium infusion, which was significantly higher than the basal value of 1463±2630 pmol/l (p<0.05). All medullary thyroid carcinoma patients displayed a marked calcitonin increase after TRH and calcium stimulation. Although the increase in serum calcitonin after TRH injection was lower than that after calcium injection (1.6-fold vs 5.4-fold, p <0.05), there was no significant difference in mean peak calcitonin value following TRH and calcium injection in patients with medullary thyroid carcinoma. These results indicated that TRH could stimulate calcitonin release from the thyroid C-cells in both normal subjects and patients with medullary thyroid carcinoma.

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