Ultrasound criteria for risk stratification of thyroid nodules in the previously iodine deficient area of Austria - a single centre, retrospective analysis

Summary:The incidentally detected thyroid nodule using sonography is described as incidentaloma; the most nodules have a diameter up to 1.5 cm. Sonography will detect thyroid nodules in more than 20% of the population in Germany. Epidemiological studies investigating the prevalence of malignancy in such incidentalomas are missing. The incidence of differentiated thyroid cancer is about 3 per 100,000 people and year. However, several monocentric studies have shown a prevalence of malignancy of up to 10% of the thyroid nodules in selected patients’ group. The histology did not found microcarcinomas only, but also small cancer with infiltration of the thyroid capsule, lymph node metastasis or multifocal spread. The studies were not designed for outcome measurement after early and incidental detection of small thyroid cancers. Hypoechogenity, ill defined borders, central hypervascularization or microcalcifications were used as combined criteria for risk stratification. The second method for risk stratification is scintigraphy and further tests are warranted for hypofunctioning nodule ≥1 cm. Additionally, the family history, patient’s age <20 years, former radiation of the neck, and measurement of calcitonin should be regarded. Without such a risk stratification selection for fine needle aspiration is impossible. Fine needle aspiration of non-palpable incidentalomas led to non-representative or unequivocal cytological findings in up to 40%. Because better outcome of incidentally detected small thyroid carcinomas is not proved and because sonography, scintigraphy and fine needle aspiration remain imprecise regarding dignity of incidentalomas, fine needle aspiration is not the standard for small, non-palpable thyroid nodules. Conclusion: For management of incidentaloma, sonographically unsuspicious, scintigraphically indifferent (nodules ≥1 cm) and without any risk factors in patients’ history, wait and see is justified when patient is informed about the problem.

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Malignancy risk stratification in thyroid nodules according to the Bethesda system for reporting thyroid cytopathology

Endocrine Abstracts ◽

10.1530/endoabs.49.ep1442 ◽

2017 ◽

Author(s):

Aldona Kowalska ◽

Agnieszka Suligowska ◽

Janusz Kopczynski ◽

Kornelia Niemyska ◽

Stanislaw Gozdz

Keyword(s):

Risk Stratification ◽

Thyroid Nodules ◽

Malignancy Risk ◽

Bethesda System ◽

Thyroid Cytopathology ◽

The Bethesda System

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On the Classification of TI-RADS and Stratification of Signs of Thyroid Cancer According to Ultrasound Data

Medical Visualization ◽

10.24835/1607-0763-2017-5-29-38 ◽

2017 ◽

pp. 29-38 ◽

Cited By ~ 1

Author(s):

E. P. Fisenko ◽

J. P. Sich ◽

N. N. Vetsheva

Keyword(s):

Thyroid Cancer ◽

Retrospective Analysis ◽

Thyroid Nodules ◽

Thyroid Ultrasound ◽

High Reproducibility ◽

System 1

Objective:a comparative “blind” assessment of the thyroid nodules identified by ultrasound, according to the TI-RADS scale in various modifications.Materials and methods.Retrospective analysis of 149 echograms of thyroid nodules by three independent experts was performed (the experience of ultrasound of thyroid ultrasound for more than 7 years).Results. In solid nodules, high-specific large (more than 94%) and small (more than 90%) ultrasound signs of thyroid cancer have been identified. The nodes are stratified according to the TI-RADS system: 1 – in the modification J.Y. Kwak et al. (2011), 2 – according to the proposed system, taking into account small ultrasound signs of thyroid cancer. High reproducibility of both systems are obtained. In the first system 13.7% of cancer nodes fell into the category of TI- RADS 3 (benign formations), in the second system only 5% of cancers fell into the category of TI-RADS 3, which is important for biopsy selection. The sensitivity of the first system was TI-RADS 82.05%, of the second system – 94.87%.Conclusions.Classification of TI-RADS can be used to interpret the ultrasound results of thyroid nodules, taking into account both the main large and small ultrasound signs of cancer. For its validation in our country, it is necessary to further broad discussion of the proposed TI-RADS system.

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