scholarly journals LC-1000 Flow Cytometry System Improves Risk Stratification of Thyroid Nodules with Suspected Follicular Neoplasm

JMA Journal ◽  
2022 ◽  
Vol 5 (1) ◽  
pp. 124-126
Keyword(s):  
Flow Cytometry ◽  
Risk Stratification ◽  
Thyroid Nodules ◽  
Follicular Neoplasm

scholarly journals Risk Stratification in Patients With Follicular Neoplasm on Cytology: Use of Quantitative Characteristics and Sonographic Patterns

2021 ◽  
Vol 12 ◽  
Author(s):  
Ming-Hsun Wu ◽  
Kuen-Yuan Chen ◽  
Min-Shu Hsieh ◽  
Argon Chen ◽  
Chiung-Nien Chen
Keyword(s):  
Risk Stratification ◽  
Thyroid Nodules ◽  
Region Of Interest ◽  
Diagnostic Value ◽  
Follicular Neoplasm ◽  
American Thyroid Association ◽  
Cad System ◽  
Hospital Patients ◽  
Risk Of Malignancy ◽  
Us Findings

ObjectivesDifferentiating thyroid nodules with a cytological diagnosis of follicular neoplasm remains an issue. The goal of this study was to determine whether ultrasonographic (US) findings obtained preoperatively from the computer-aided detection (CAD) system are sufficient to further stratify the risk of malignancy for this diagnostic cytological category.MethodsFrom September 2016 to September 2018 in our hospital, patients diagnosed with Bethesda category IV (follicular neoplasm or suspicion of follicular neoplasm) thyroid nodules and underwent surgical excisions were include in the study. Quantification and analysis of tumor features were performed using CAD software. The US findings of the region of interest, including index of composition, margin, echogenicity, texture, echogenic dots indicative of calcifications, tall and wide orientation, and margin were calculated into computerized values. The nodules were further classified into American Thyroid Association (ATA) and American College of Radiology Thyroid Imaging Reporting & Data System (TI-RADS) categories.Results92 (10.1%) of 913 patients were diagnosed with Bethesda category IV thyroid nodules. In 65 patients, the histological type of the nodule was identified. The quantitative features between patients with benign and malignant conditions differed significantly. The presence of heterogeneous echotexture, blurred margins, or irregular margins was shown to have the highest diagnostic value. The risks of malignancy for nodules classified as having very low to intermediate suspicion ATA, non-ATA, and high suspicion ATA patterns were 9%, 35.7%, and 51.7%, respectively. Meanwhile, the risks of malignancy were 12.5%, 26.1%, and 53.8% for nodules classified as TIRADS 3, 4, and 5, respectively. When compared to human observers, among whom poor agreement was noticeable, the CAD software has shown a higher average accuracy.ConclusionsFor patients with nodules diagnosed as Bethesda category IV, the software-based characterizations of US features, along with the associated ATA patterns and TIRADS system, were shown helpful in the risk stratification of malignancy.

Abstract #564 Advanced Ultrasound Application- Impact on Presurgical Risk Stratification of Thyroid Nodules

2019 ◽  
Vol 25 ◽  
pp. 287
Author(s):  
Andreea Borlea ◽  
Dana Stoian ◽  
Adrian Apostol ◽  
Mihnea Derban ◽  
Laura Cotoi ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Thyroid Nodules ◽  
Ultrasound Application

The incidentaloma of the thyroid

2005 ◽  
Vol 44 (05) ◽  
pp. 213-224
Author(s):  
C. Kobe ◽  
M. Schmidt ◽  
H. Schicha ◽  
M. Dietlein
Keyword(s):  
Risk Stratification ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Outcome Measurement ◽  
Needle Aspiration ◽  
Epidemiological Studies ◽  
Fine Needle ◽  
Small Cancer ◽  
The Family ◽  
Wait And See

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.

scholarly journals European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS

2017 ◽  
Vol 6 (5) ◽  
pp. 225-237 ◽  
Author(s):  
Gilles Russ ◽  
Steen J. Bonnema ◽  
Murat Faik Erdogan ◽  
Cosimo Durante ◽  
Rose Ngu ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Thyroid Nodules ◽  
Malignancy Risk ◽  
The Eu

scholarly journals Highly accurate diagnosis of cancer in thyroid nodules with follicular neoplasm/suspicious for a follicular neoplasm cytology by ThyroSeq v2 next-generation sequencing assay

Cancer ◽  
2014 ◽  
Vol 120 (23) ◽  
pp. 3627-3634 ◽  
Author(s):  
Yuri E. Nikiforov ◽  
Sally E. Carty ◽  
Simon I. Chiosea ◽  
Christopher Coyne ◽  
Umamaheswar Duvvuri ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Thyroid Nodules ◽  
Accurate Diagnosis ◽  
Follicular Neoplasm ◽  
Next Generation ◽  
Diagnosis Of Cancer ◽  
Generation Sequencing

scholarly journals Establishment of an Ultrasound Malignancy Risk Stratification Model for Thyroid Nodules Larger Than 4 cm

2021 ◽  
Vol 11 ◽  
Author(s):  
Xuehua Xi ◽  
Ying Wang ◽  
Luying Gao ◽  
Yuxin Jiang ◽  
Zhiyong Liang ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Low Risk ◽  
Validation Dataset ◽  
Intermediate Risk ◽  
Solid Mass ◽  
Incidence And Mortality ◽  
Risk Stratification Model

BackgroundThe incidence and mortality of thyroid cancer, including thyroid nodules &gt; 4 cm, have been increasing in recent years. The current evaluation methods are based mostly on studies of patients with thyroid nodules &lt; 4 cm. The aim of the current study was to establish a risk stratification model to predict risk of malignancy in thyroid nodules &gt; 4 cm.MethodsA total of 279 thyroid nodules &gt; 4 cm in 267 patients were retrospectively analyzed. Nodules were randomly assigned to a training dataset (n = 140) and a validation dataset (n = 139). Multivariable logistic regression analysis was applied to establish a nomogram. The risk stratification of thyroid nodules &gt; 4 cm was established according to the nomogram. The diagnostic performance of the model was evaluated and compared with the American College Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS), Kwak TI-RADS and 2015 ATA guidelines using the area under the receiver operating characteristic curve (AUC).ResultsThe analysis included 279 nodules (267 patients, 50.6 ± 13.2 years): 229 were benign and 50 were malignant. Multivariate regression revealed microcalcification, solid mass, ill-defined border and hypoechogenicity as independent risk factors. Based on the four factors, a risk stratified clinical model was developed for evaluating nodules &gt; 4 cm, which includes three categories: high risk (risk value = 0.8-0.9, with more than 3 factors), intermediate risk (risk value = 0.3-0.7, with 2 factors or microcalcification) and low risk (risk value = 0.1-0.2, with 1 factor except microcalcification). In the validation dataset, the malignancy rate of thyroid nodules &gt; 4 cm that were classified as high risk was 88.9%; as intermediate risk, 35.7%; and as low risk, 6.9%. The new model showed greater AUC than ACR TI-RADS (0.897 vs. 0.855, p = 0.040), but similar sensitivity (61.9% vs. 57.1%, p = 0.480) and specificity (91.5% vs. 93.2%, p = 0.680).ConclusionMicrocalcification, solid mass, ill-defined border and hypoechogenicity on ultrasound may be signs of malignancy in thyroid nodules &gt; 4 cm. A risk stratification model for nodules &gt; 4 cm may show better diagnostic performance than ACR TI-RADS, which may lead to better preoperative decision-making.

scholarly journals The value of routine measurement of serum calcitonin on insufficient, indeterminate, and suspicious thyroid nodule cytology

2021 ◽  
Author(s):  
Murat Çalapkulu ◽  
Muhammed Erkam Sencar ◽  
Sema Hepsen ◽  
Hayri Bostan ◽  
Davut Sakiz ◽  
...  
Keyword(s):  
Thyroid Disease ◽  
Thyroid Nodules ◽  
Medullary Thyroid Cancer ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Follicular Neoplasm ◽  
Serum Calcitonin ◽  
Routine Measurement ◽  
Number Of Patients ◽  
Undetermined Significance

Routine calcitonin measurement in patients with nodular thyroid disease is rather controversial. The aim of this study was to evaluate the contribution of serum calcitonin measurement in the diagnostic evaluation of thyroid nodules with insufficient, indeterminate, or suspicious cytology. Out of 1668 patients who underwent thyroidectomy with the diagnosis of nodular thyroid disease and were screened, 873 patients with insufficient, indeterminate, or suspicious fine needle aspiration biopsy results were included in the study. From the total number of patients in this study, 10 (1.1%) were diagnosed as medullary thyroid cancer (MTC) using histopathology. The calcitonin level was detected to be above the assay-specific cut-off in 23 (2.6%) patients ranging between 6.5 - 4450 pg/mL. While hypercalcitoninemia was detected in all 10 MTC patients, a false positive elevation of serum calcitonin was detected in 13 patients (1.5%). Of the MTC group, 7 patients had cytology results that were suspicious for malignancy (Bethesda V), one patient’s cytology showed atypia of undetermined significance (Bethesda III) and two patient’s cytology results were suspicious for follicular neoplasm (Bethesda IV). Among the cases with non-diagnostic cytology (Bethesda I), none of the patients were diagnosed with MTC. In conclusion, routine serum calcitonin measurement can be performed in selected cases rather than in all nodular thyroid patients. While it is reasonable to perform routine calcitonin measurement in patients with Bethesda IV and Bethesda V, this measurement was not useful in Bethesda I patients. In Bethesda III patients, patient-based decisions can be made according to their calcitonin measurement. Read more in PDF.

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