Evaluation of thyroid nodules on radiation-exposed workers

Background. Ionizing radiation could cause negative effects on DNA molecules, which leads mutation and tumorigenesis. Thyroid gland is one of the most radiosensitive organ due to the great oxidative process on their physiological condition. Medical workers have been exposed to radiation during medical image acquisition. The relation between radiation and the increase of thyroid cancer incidence have been studied before, the discussion mostly explain the acute effect of radiation. The aim of this study is to describe the incidence of thyroid nodule on radiation-exposed worker. Methods. The study was performed in 40 radiation-exposed workers with at least has 5 years working period. We examined using thyroid ultrasonography and blood level of T3, fT4 and TSH. Result. The incidence of thyroid nodule in radiation-exposed worker is 37.5%, which is higher among female (66%) than in male (29%). Based on the age distribution, most of the nodules were find in workers with age more than 35 years old. According to ultrasonography result and TIRADS scoring, 66.7% of the nodules were benign which categorize as TIRADS 1 and only 33% of the nodules were categorize as moderately suspicious or TIRADS 4. Conclusion. Radiation-exposed workers have high risk to develop thyroid nodules. This study could be used as basic data to do further evaluation. It is important to perform thyroid screening periodically among them.

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High-resolution thyroid nodule clinic: analysis of 1674 thyroid nodules

Endocrine Abstracts ◽

10.1530/endoabs.35.p1074 ◽

2014 ◽

Author(s):

Jose Carlos Fernandez-Garcia ◽

Carmen Maria Cortes-Salazar ◽

Isabel Mancha-Doblas ◽

Francisco Tinahones

Keyword(s):

High Resolution ◽

Thyroid Nodule ◽

Thyroid Nodules

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Choosing the best algorithm among five thyroid nodule ultrasound scores: from performance to cytology sparing—a single-center retrospective study in a large cohort

European Radiology ◽

10.1007/s00330-021-07703-5 ◽

2021 ◽

Author(s):

Clotilde Sparano ◽

Valentina Verdiani ◽

Cinzia Pupilli ◽

Giuliano Perigli ◽

Benedetta Badii ◽

...

Keyword(s):

Thyroid Nodule ◽

Thyroid Nodules ◽

Real Life ◽

Scoring Systems ◽

Diagnostic Procedures ◽

Needle Aspiration ◽

Common Disease ◽

Single Center ◽

Thyroid Microcarcinoma ◽

Thyroid Malignancies

Abstract Objective Incidental diagnosis of thyroid nodules, and therefore of thyroid cancer, has definitely increased in recent years, but the mortality rate for thyroid malignancies remains very low. Within this landscape of overdiagnosis, several nodule ultrasound scores (NUS) have been proposed to reduce unnecessary diagnostic procedures. Our aim was to verify the suitability of five main NUS. Methods This single-center, retrospective, observational study analyzed a total number of 6474 valid cytologies. A full clinical and US description of the thyroid gland and nodules was performed. We retrospectively applied five available NUS: KTIRADS, ATA, AACE/ACE-AME, EUTIRADS, and ACRTIRADS. Thereafter, we calculated the sensitivity, specificity, PPV, and NPV, along with the number of possible fine-needle aspiration (FNA) sparing, according to each NUS algorithm and to clustering risk classes within three macro-groups (low, intermediate, and high risk). Results In a real-life setting of thyroid nodule management, available NUS scoring systems show good accuracy at ROC analysis (AUC up to 0.647) and higher NPV (up to 96%). The ability in FNA sparing ranges from 10 to 38% and reaches 44.2% of potential FNA economization in the low-risk macro-group. Considering our cohort, ACRTIRADS and AACE/ACE-AME scores provide the best compromise in terms of accuracy and spared cytology. Conclusions Despite several limitations, available NUS do appear to assist physicians in clinical practice. In the context of a common disease, such as thyroid nodules, higher accuracy and NPV are desirable NUS features. Further improvements in NUS sensitivity and specificity are attainable future goals to optimize nodule management. Key Points • Thyroid nodule ultrasound scores do assist clinicians in real practice. • Ultrasound scores reduce unnecessary diagnostic procedures, containing indolent thyroid microcarcinoma overdiagnosis. • The variable malignancy risk of the “indeterminate” category negatively influences score’s performance in real-life management of thyroid lesions.

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Can sonographic features of microcalcification predict thyroid nodule malignancy? a prospective observational study

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00498-x ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Mehrdad Nabahati ◽

Rahele Mehraeen ◽

Zoleika Moazezi ◽

Naser Ghaemian

Keyword(s):

Thyroid Nodule ◽

Roc Analysis ◽

Thyroid Nodules ◽

Area Under The Curve ◽

Positive Association ◽

Needle Aspiration ◽

Northern Iran ◽

Significant Positive Association ◽

Irregular Margin ◽

Benign Nodules

Abstract Background The aim of this study was to investigate the diagnostic accuracy of microcalcification, as well as its associated sonographic features, for prediction of thyroid nodule malignancy. We prospectively assessed the patients with thyroid nodule, who underwent ultrasound-guided fine-needle aspiration during 2017–2020 in Babol, northern Iran. The ultrasonographic characteristics of the nodules, as well as their cytological results, were recorded. We used regression analysis to evaluate the relation between sonographic findings and nodule malignancy. A receiver operator characteristics (ROC) analysis was also used to estimate the ability of ultrasound to predict the characteristic features of malignancy, as estimated by the area under the curve (AUC). Results Overall, 1129 thyroid nodules were finally included in the study, of which 452 (40%) had microcalcification. A significant positive association was found between nodule malignancy and microcalcification in both univariate (OR=3.626, 95% CI 2.258–5.822) and multivariable regression analyses (OR=1.878, 95% CI 1.095–3.219). In the nodules with microcalcification, significant positive relations were seen between malignancy and hypoechogenicity (OR=3.833, 95% CI 1.032–14.238), >5 microcalcification number (OR=3.045, 95% CI 1.328–6.982), irregular margin (OR=3.341, 95% CI 1.078–10.352), and lobulated margin (OR=5.727, 95% CI 1.934–16.959). The ROC analysis indicated that AUC for hypoechogenicity, >5 microcalcification number, irregular margin, and lobulated margin were 60%, 62%, 55%, and 60%, respectively, in predicting malignant thyroid nodules. Conclusion The findings indicated that microcalcification can be a potential predictor of thyroid nodule malignancy. Also, the presence of irregular or lobulated margins, multiple intranodular microcalcification (>5 microcalcifications), and/or hypoechogenicity can improve the ability of microcalcification in distinguishing malignant from benign nodules.

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NO BENEFIT OF DEDICATED THYROID NODULE SCREENING IN PATIENTS WITH ACROMEGALY

Endocrine Practice ◽

10.4158/ep-2019-0254 ◽

2020 ◽

Vol 26 (1) ◽

pp. 16-21 ◽

Cited By ~ 2

Author(s):

Ngan Betty Lai ◽

Dave Garg ◽

Anthony P. Heaney ◽

Marvin Bergsneider ◽

Angela M. Leung

Keyword(s):

United States ◽

Growth Hormone ◽

Thyroid Cancer ◽

Growth Factor ◽

Thyroid Nodule ◽

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Papillary Thyroid ◽

Fine Needle

Objective: Acromegaly results from the excessive production of growth hormone and insulin-like growth factor-1. While there is up to a 2-fold increased prevalence of thyroid nodules in patients with acromegaly, the incidence of thyroid cancer in this population varies from 1.6 to 10.6% in several European studies. The goal of our study was to determine the prevalence of thyroid nodules and thyroid cancer among patients with acromegaly at a large urban academic medical center in the United States (U.S.). Methods: A retrospective chart review was performed of all patients with acromegaly between 2006–2015 within the University of California, Los Angeles health system. Data were collected regarding patient demographics, thyroid ultrasounds, thyroid nodule fine needle aspiration (FNA) biopsy cytology, and thyroid surgical pathology. Results: In this cohort (n = 221, 49.3% women, mean age 53.8 ± 15.2 [SD] years, 55.2% Caucasian), 102 patients (46.2%) underwent a thyroid ultrasound, from which 71 patients (52.1% women, mean age 52.9 ± 15.2 [SD] years, 56.3% Caucasian) were found to have a thyroid nodule. Seventeen patients underwent a thyroid nodule FNA biopsy and the results revealed 12 benign biopsies, 1 follicular neoplasm, 3 suspicious for malignancy, and 1 papillary thyroid cancer (PTC), from which 6 underwent thyroidectomy; PTC was confirmed by surgical pathology for all cases (8.5% of all nodules observed). Conclusion: In this sample, the prevalence of thyroid cancer in patients with acromegaly and coexisting thyroid nodules is similar to that reported in the general U.S. population with thyroid nodules (7 to 15%). These findings suggest that there is no benefit of dedicated thyroid nodule screening in patients newly diagnosed with acromegaly. Abbreviations: AACE = American Association of Clinical Endocrinologists; ATA = American Thyroid Association; DTC = differentiated thyroid cancer; FNA = fine needle aspiration; GH = growth hormone; IGF-1 = insulin-like growth factor-1; PTC = papillary thyroid cancer; U.S. = United States

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Prevalence and pattern of thyroid malignancy in thyroid nodule in Aseer Central Hospital in KSA

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20174207 ◽

2017 ◽

Vol 3 (4) ◽

pp. 908 ◽

Cited By ~ 2

Author(s):

Jibril Yahya Hudise ◽

Khalid Ali Alshehri ◽

Saad Nasser Alqarni ◽

Yara Assiri ◽

Ashwaq Asiri ◽

...

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Thyroid Nodule ◽

Cell Carcinoma ◽

Thyroid Nodules ◽

Follicular Thyroid Carcinoma ◽

Papillary Thyroid ◽

Thyroid Malignancy ◽

Central Hospital ◽

Medullary Thyroid

Background: Thyroid nodules are common in the general population, especially in women. Non palpable nodules are often found when patients undergo diagnostic imaging such as ultrasonography and computed tomography of the chest and neck. This retrospective study to assess the Prevalence of thyroid malignancy in thyroid nodule related to gender, age, and pathology, in Aseer Central Hospital KSA. Methods: During a 5-year period (2011–2016), the medical records of 319 patients with thyroid nodules were collected from the department of pathology at Aseer Central Hospital KSA. The cases were reviewed for data on gender, age, and the pathological result. All patients underwent hemi or total thyroidectomy. Comparisons between genders, age groups, and tissue origins were performed. All statistical tests were performed with SPSS software. Results: Over a period of 5 years, a total of 319 patients: male 17.2% and female 82.8% Underwent for hemi or total thyroidectomy. The age of presentation was ranging from 14 to 80 years. Among the 319 cases of thyroid nodules 73.7% were benign nodules and 26.3% malignant nodules. Papillary thyroid carcinoma in 72.6%, follicular thyroid carcinoma 10.6%, Hurthle cell carcinoma 4.8%, anaplastic carcinoma 4.8%, thyroid lymphoma 4.8% and medullary thyroid carcinoma in 2.4%. Conclusions: Thyroid nodule is a common clinical problem and the proportion of such nodules that prove to be malignant is not small, investigations are of immense help to corroborate with the clinical and morphological finding. Papillary thyroid carcinoma most common malignant thyroid carcinoma followed by follicular thyroid carcinoma, hurthel cell carcinoma, anaplastic thyroid carcinoma, lymphoma and finally medullary thyroid Carcinoma. No significant different between male and female as risk factors for malignancy.

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Comparison on the Use of Spinal (Stylet) Needle and Simple Needle in Ultrasound Guided Thyroid Nodule FNA; Does the Needle Affect Thyroid FNA Result?

Iranian Journal of Radiology ◽

10.5812/iranjradiol.98754 ◽

2020 ◽

Vol 17 (2) ◽

Author(s):

Alireza Aziz Ahari ◽

Mohammad Ali Mohammadi Vajari ◽

Navid Khatibi Moghadam ◽

Hassan Hashemi ◽

Mahmoud Parvin ◽

...

Keyword(s):

Thyroid Nodule ◽

Fine Needle Aspiration ◽

Significant Relationship ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Fine Needle ◽

Needle Type ◽

Expert Radiologist ◽

Diagnostic Samples ◽

Thyroid Fna

Background: Thyroid fine needle aspiration (FNA) is currently the most acceptable method for evaluating thyroid nodules. Non-satisfactory sample is the main limitation of FNA. It has been shown that spinal needles can reduce the number of non-diagnostic samples. Objectives: In this study, we decided to compare the results obtained using spinal (stylet) needle and simple needle in thyroid nodule FNA according to the agreement between them and with the pathology results as the gold standard. Patients and Methods: Sampling of thyroid nodules of 156 patients was performed by a simple non-stylet 23 gauge needle (A) and a spinal 22 gauge needle with stylet (B). The samples were provided to the pathologist for blind examination. All samples were obtained by an expert radiologist and the pathology examination was also performed by a pathologist expert in thyroid gland diseases. Blind analysis was done using SPSS Statistics for Windows, version 16 (SPSS Inc., Chicago, Ill., USA). Results: The results of FNA with needles A and B were reported unsatisfactory in 11.51 (18 subjects) and 3.84 (six subjects), respectively (P = 0.01). The result in 63.46% (99 subjects) of the participants, in whom FNA was obtained by needle B was introduced as a better sample by the pathologist in comparison with 36.44% (57 subjects) (P < 0.001). Cancer was diagnosed in 9.56 and 7.66 of the samples yielded by needles B and A, respectively, which was not statistically significant (P = 0.54). There was also a significant relationship between thyroid imaging reporting and data system (TI-RADS) score and FNA result. Conclusion: A significant relationship between the adequate sampling results, the qualitative examination result, TI-RADS score and the needle type indicates the importance of needle type on the results of thyroid FNA. Using spinal (stylet) needles may reduce the number of non-diagnostic samples in fine needle aspiration of thyroid nodules and therefore, can have a better effect on the results of this method.

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Challenges in the functional diagnosis of thyroid nodules before surgery for TSH-producing pituitary adenoma

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-20-0221 ◽

2021 ◽

Vol 2021 ◽

Author(s):

Keita Tatsushima ◽

Akira Takeshita ◽

Shuji Fukata ◽

Noriaki Fukuhara ◽

Mitsuo Yamaguchi-Okada ◽

...

Keyword(s):

Pituitary Adenoma ◽

Thyroid Hormone ◽

Thyroid Nodule ◽

Thyroid Nodules ◽

Thyroid Stimulating Hormone ◽

Somatostatin Analogue ◽

Postoperative Phase ◽

List Type ◽

Thyroid Scintigraphy ◽

Serum Tsh

Summary A 50-year-old woman with thyroid-stimulating hormone (TSH)-producing pituitary adenoma (TSHoma) was diagnosed due to symptoms of thyrotoxicosis. Preoperatively, she showed thyrotoxicosis with the syndrome of inappropriate secretion of TSH (SITSH) and had a 5 cm nodule in her thyroid gland. Octreotide was administered preoperatively, which helped lower her serum TSH level but not her thyroid hormone level. These findings were atypical for a patient with TSHoma. The TSHoma was completely resected, and the TSH level dropped below the sensitivity limit shortly after surgery. Interestingly, however, thyroid hormone levels remained high. A clear clue to the aetiology was provided by consecutive thyroid scintigraphy. Although preoperative thyroid scintigraphy did not show a hot nodule and the mass was thought to be a non-functional thyroid nodule, the nodule was found to be hot in the postoperative phase of TSH suppression. By focusing on the atypical postoperative course of the TSHoma, we were able to conclude that this was a case of TSHoma combined with an autonomously functioning thyroid nodule (AFTN). Learning points The diagnosis of autonomously functioning thyroid nodules (AFTNs) depends on suppressed serum TSH levels. If thyroid hormones are resistant to somatostatin analogue therapy or surgery for TSHoma, complications of AFTN as well as destructive thyroiditis need to be considered. It is important to revisit the basics when facing diagnostic difficulties and not to give up on understanding the pathology.

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Use of Diagnostic Criteria from ACR and EU-TIRADS Systems to Improve the Performance of Cytology in Thyroid Nodule Triage

Cancers ◽

10.3390/cancers13215439 ◽

2021 ◽

Vol 13 (21) ◽

pp. 5439

Author(s):

Davide Seminati ◽

Giulia Capitoli ◽

Davide Leni ◽

Davide Fior ◽

Francesco Vacirca ◽

...

Keyword(s):

Thyroid Nodule ◽

Thyroid Nodules ◽

Scoring Systems ◽

Needle Aspiration ◽

Data Systems ◽

Predictive Values ◽

Radiological Features ◽

Benign Nodules ◽

Design And Methods ◽

The Eu

Objective: The American College of Radiology (ACR) and the European Thyroid Association (EU) have proposed two scoring systems for thyroid nodule classification. Here, we compared the ability of the two systems in triaging thyroid nodules for fine-needle aspiration (FNA) and tested the putative role of an approach that combines ultrasound features and cytology for the detection of malignant nodules. Design and Methods: The scores obtained with the ACR and EU Thyroid Imaging Reporting and Data Systems (TIRADS) from a prospective series of 480 thyroid nodules acquired from 435 subjects were compared to assess their performances in FNA triaging on the final cytological diagnosis. The US features that showed the highest contribution in discriminating benign nodules from malignancies were combined with cytology to improve its diagnostic performance. Results: FNA was recommended on 46.5% and 51.9% of the nodules using the ACR and EU-TIRADS scores, respectively. The ACR system demonstrated a higher specificity as compared to the EU-TIRADS (59.0% vs. 52.4%, p = 0.0012) in predicting >TIR3A/III (SIAPEC/Bethesda) nodules. Moreover, specific radiological features (i.e., echogenic foci and margins), combined with the cytological classes improved the specificity (97.5% vs. 91%, p < 0.0001) and positive predictive values (77.5% vs. 50.7%, p < 0.0001) compared to cytology alone, especially in the setting of indeterminate nodules (TIR3A/III and TIR3B/IV), maintaining an excellent sensitivity and negative predictive value. Conclusions: The ACR-TIRADS system showed a higher specificity compared to the EU-TIRADS in triaging thyroid nodules. The use of specific radiological features improved the diagnostic ability of cytology.

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THYROID NODULE GROWTH AS A PREDICTOR OF MALIGNANCY

Endocrine Practice ◽

10.4158/ep-2019-0049 ◽

2019 ◽

Vol 25 (10) ◽

pp. 1029-1034 ◽

Cited By ~ 2

Author(s):

Kathleen O'Connell ◽

Alexa Clark ◽

Wilma Hopman ◽

Joshua Lakoff

Keyword(s):

Confidence Interval ◽

Thyroid Nodule ◽

Odds Ratio ◽

Doubling Time ◽

Thyroid Nodules ◽

Volume Growth ◽

Needle Aspiration ◽

Health Science ◽

Significant Difference ◽

Nodule Growth

Objective: To assess which measure of thyroid nodule growth on serial neck ultrasound, if any, is associated with malignancy. Methods: Retrospective exploratory chart review of malignant thyroid nodules assessed at Kingston Health Sciences Centre (2006–2016) and benign thyroid nodules (2016), at least 1 cm in diameter and with 2 ultrasounds completed at least 30 days apart. Groups were compared using independent samples Student's t test, chi-square test, or Mann-Whitney U test as appropriate, as well as multivariable logistic and linear regression modelling to adjust for age and baseline volume. Results: One hundred and seventy-eight nodules were included in the study. When growth was defined as >20% increase in 2 dimensions (minimum 2 mm), malignant nodules (MNs) underwent significantly more growth than benign nodules (BNs) (16.8% BN versus 29.8% MN [ P = .026]; odds ratio = 2.49; 95% confidence interval = 1.12 to 5.56). There was no significant difference between the groups when growth was defined as >2 mm/year or ≥50% volume growth. Nodules shrank >2 mm/year in each group and the difference was not statistically significant (24.2% BN versus 20.7% MN [ P = .449]). The median doubling time for the nodules that grew was 1022.1 days in the BN group and 463.2 days in the MN group ( P = .036). The median doubling time for all nodules was 456.5 days in the BN group and 244.2 days in the MN group ( P = .015). Conclusion: Thyroid nodule growth defined as >20% increase in 2 dimensions (minimum 2 mm) is associated with risk of malignancy. Nodule shrinkage did not distinguish between BNs and MNs. Abbreviations: BN = benign nodule; CI = confidence interval; FNA = fine needle aspiration; KHSC = Kingston Health Science Centre; MN = malignant nodule; OR = odds ratio; ROC = receiver operating characteristic

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On the possibility of using temperature to aid in thyroid nodule investigation

Scientific Reports ◽

10.1038/s41598-020-78047-1 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

C. P. Damião ◽

J. R. G. Montero ◽

M. B. H. Moran ◽

R. A. da Cruz Filho ◽

C. A. P. Fontes ◽

...

Keyword(s):

Thyroid Nodule ◽

Infrared Thermography ◽

Thyroid Nodules ◽

Subcutaneous Fat ◽

Skin Surface ◽

Malignant Tumours ◽

Training Process ◽

Artificial Intelligence Technique ◽

Additional Information ◽

Fat Thickness

AbstractThyroid nodules are common, and their investigation is very important to exclude the possibility of cancer. The increase in blood vessels of malignant tumours may be related to local temperature augmentation detectable on the skin surface. The objective of this paper is to evaluate the feasibility of Infrared Thermography for cancer identification. For this purpose, two studies were performed. One used numerical modelling to simulate regional metabolic temperature propagation to evaluate whether a nodule is perceptible on the skin surface. A second study considered thyroid nodule identification by using convolutional neural networks (CNNs). First, variations in nodular size and fat thickness were investigated, showing that the fat layer has an important role in regional heat transfer. In the second study, the training process achieved accuracy of 96% for in-sample and 95% for validation. In the testing phase, 92% accuracy, 100% precision and 80% recall were achieved. Thus, the presented studies suggest the feasibility of using Infrared Thermography with the CNN Artificial Intelligence technique as additional information in the investigation of thyroid nodules for patients without a very thick subcutaneous fat layer.

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