Response to Letter: “Postoperative Thyroglobulin and Neck Ultrasound in the Risk Restratification and Decision to Perform 131I Ablation”

Background.Ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) is the gold standard in diagnosing the pathological nature of undetermined thyroid nodules. However, in some instances limitations and shortcomings arise, making it insufficient for determining a specific diagnosis.Objective.Our aim was to evaluate the effectiveness of ACR TI-RADS classification of neck ultrasound as a first-line diagnostic approach for thyroid neoplasms in pediatric patients.Methods.A retrospective analysis was made of FNA and US protocols in 70 patients who underwent the examination and treatment at Dmitry Rogachev National Research Center between January 2012 and August 2017. In the retrospective series 70% (49/70) of patients undergone FNA and 43% (30/70) of them undergone repeated FNA. All US protocols were interpreted according to ACR TI-RADS system by the two independent experts. The clinical judgment was assessed using the concordance test and the reliability of preoperative diagnostic methods was analized.Results.According to histologic examination protocols, benign nodules reported greater multimorbidity 29% (20/70), compared with thyroid cancer 17% (12/70), complicating FNA procedure. A statistically significant predictor of thyroid cancer with a tumor size ACR TI-RADS showed a significant advantage of ACR TI-RADS due to higher sensitivity (97.6 vs 60%), specificity (78.6 vs 53.8%), positive predictive value (87.2 vs 71.4%), and negative predictive value (95.7 vs 41.2%). Concordance on the interpreted US protocols according to ACR TI-RADS classification between two experts was high, excluding accidental coincidence.Conclusion.The data support the feasibility of US corresponding to the ACR TI-RADS classification as a first-line diagnostic approach for thyroid neoplasm reducing the number of unnecessary biopsies for thyroid nodules.

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Personalized management of differentiated thyroid cancer in real life – practical guidance from a multidisciplinary panel of experts

Endocrine ◽

10.1007/s12020-020-02418-x ◽

2020 ◽

Vol 70 (2) ◽

pp. 280-291

Author(s):

Alfredo Campennì ◽

Daniele Barbaro ◽

Marco Guzzo ◽

Francesca Capoccetti ◽

Luca Giovanella

Keyword(s):

Nuclear Medicine ◽

Thyroid Cancer ◽

Clinical Practice ◽

Molecular Imaging ◽

Routine Clinical Practice ◽

Whole Body ◽

Neck Ultrasound ◽

Long Term Follow Up

Abstract Purpose The standard of care for differentiated thyroid carcinoma (DTC) includes surgery, risk-adapted postoperative radioiodine therapy (RaIT), individualized thyroid hormone therapy, and follow-up for detection of patients with persistent or recurrent disease. In 2019, the nine Martinique Principles for managing thyroid cancer were developed by the American Thyroid Association, European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and European Thyroid Association. In this review, we present our clinical practice recommendations with regard to implementing these principles in the diagnosis, treatment, and long-term follow-up of patients with DTC. Methods A multidisciplinary panel of five thyroid cancer experts addressed the implementation of the Martinique Principles in routine clinical practice based on clinical experience and evidence from the literature. Results We provide a suggested approach for the assessment and diagnosis of DTC in routine clinical practice, including the use of neck ultrasound, measurement of serum thyroid-stimulating hormone and calcitonin, fine-needle aspiration, cytology, and molecular imaging. Recommendations for the use of surgery (lobectomy vs. total thyroidectomy) and postoperative RaIT are also provided. Long-term follow-up with neck ultrasound and measurement of serum anti-thyroglobulin antibody and basal/stimulated thyroglobulin is standard, with 123/131I radioiodine diagnostic whole-body scans and 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography suggested in selected patients. Management of metastatic DTC should involve a multidisciplinary team. Conclusions In routine clinical practice, the Martinique Principles should be implemented in order to optimize clinical management/outcomes of patients with DTC.

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Neck Ultrasound: Anatomical Landmarks for Safe Performance of Neck RFA

Current Otorhinolaryngology Reports ◽

10.1007/s40136-020-00316-4 ◽

2021 ◽

Author(s):

Julia E. Noel ◽

Lisa A. Orloff

Keyword(s):

Anatomical Landmarks ◽

Neck Ultrasound ◽

Safe Performance

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Work-up of globus: assessing the benefits of neck ultrasound and videofluorography

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-016-4307-8 ◽

2016 ◽

Vol 274 (2) ◽

pp. 931-937 ◽

Cited By ~ 5

Author(s):

Pia Järvenpää ◽

Taru Ilmarinen ◽

Ahmed Geneid ◽

Petra Pietarinen ◽

Teemu J. Kinnari ◽

...

Keyword(s):

Neck Ultrasound ◽

Work Up

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Radioguided Parathyroidectomy with Portable Mini Gamma-Camera for the Treatment of Primary Hyperparathyroidism

International Journal of Endocrinology ◽

10.1155/2015/134731 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Claudio Casella ◽

Pierluigi Rossini ◽

Carlo Cappelli ◽

Chiara Nessi ◽

Riccardo Nascimbeni ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Diagnostic Accuracy ◽

Gamma Camera ◽

Parathyroid Glands ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Neck Ultrasound ◽

Radioguided Parathyroidectomy ◽

Correct Location ◽

Preoperative Localisation

Background. A proper localisation of pathological parathyroid glands is essential for a minimally invasive approach in the surgical treatment of primary hyperparathyroidism (PHP). The recent introduction of portable mini gamma-cameras (pMGCs) enabled intraoperative scintigraphic scanning. The aim of our study is to evaluate the efficacy of this new method and compare it with the preoperative localisation surveys.Methods. 20 patients were studied; they were evaluated preoperatively by neck ultrasound andTc-sestaMIBI-scintigraphy and intraoperatively with the pMGC IP Guardian 2. The results obtained from the three evaluations were compared.Results. The pMGC presented a sensitivity of 95%, a specificity of 98.89%, and a diagnostic accuracy of 98.18%, which were higher than those of preoperative ultrasound (sensitivity 55%; specificity 95%; diagnostic accuracy 87%) and scintigraphy withTc-sestaMIBI (sensitivity 73.68%; specificity 96.05%; diagnostic accuracy 91.58%).Conclusions. The pMGC can be used effectively as an intraoperative method to find the correct location of the pathological parathyroid glands. The pMGC is more reliable than the currently used preoperative and intraoperative localisation techniques.

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