scholarly journals Performance of Contrast-Enhanced Ultrasound in Thyroid Nodules: Review of Current State and Future Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5469
Author(s):  
Maija Radzina ◽  
Madara Ratniece ◽  
Davis Simanis Putrins ◽  
Laura Saule ◽  
Vito Cantisani
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Thyroid Tissue ◽  
Vascular Perfusion ◽  
Current State ◽  
Contrast Enhanced ◽  
Rim Enhancement ◽  
Reliable Performance ◽  
Meta Analyses

Ultrasound has been established as a baseline imaging technique for thyroid nodules. The main advantage of adding CEUS is the ability to assess the sequence and intensity of vascular perfusion and hemodynamics in the thyroid nodule, thus providing real-time characterization of nodule features, considered a valuable new approach in the determination of benign vs. malignant nodules. Original studies, reviews and six meta-analyses were included in this article. A total of 624 studies were retrieved, and 107 were included in the study. As recognized for thyroid nodule malignancy risk stratification by US, for acceptable accuracy in malignancy a combination of several CEUS parameters should be applied: hypo-enhancement, heterogeneous, peripheral irregular enhancement in combination with internal enhancement patterns, and slow wash-in and wash-out curve lower than in normal thyroid tissue. In contrast, homogeneous, intense enhancement with smooth rim enhancement and “fast-in and slow-out” are indicative of the benignity of the thyroid nodule. Even though overlapping features require standardization, with further research, CEUS may achieve reliable performance in detecting or excluding thyroid cancer. It can also play an operative role in guiding ablation procedures of benign and malignant thyroid nodules and metastatic lymph nodes, and providing accurate follow-up imaging to assess treatment efficacy.

scholarly journals Peripheral Halo in a Thyroid Nodule - A Sign of Benignity

2021 ◽  
Vol 10 (11) ◽  
pp. 852-853
Author(s):  
Bhavik Unadkat ◽  
Suresh Vasant Phatak ◽  
Asish Pavanan ◽  
Prerna Anup Patwa
Keyword(s):  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Adult Population ◽  
Thyroid Tissue ◽  
Malignant Lesion ◽  
Morphological Characteristics ◽  
Needle Aspiration ◽  
Endocrine Gland ◽  
Thyroid Lesion ◽  
Thyroid Cells

Thyroid pathology is very common in general population, even when on inspection no abnormality is detected, nodules are seen on ultrasound sonography (USG). We are describing importance of peripheral halo sign in the diagnosis of benign nodules. Among all the endocrine gland lesions noted in India, thyroid lesion is the most common. In about 19 - 60 % of the adult population thyroid nodules are seen; however, less than 1 % of the thyroid nodules are malignant. Halo seen on ultrasound near the thyroid is considered as reliable and specific sign of benignity. 1 The morphological characteristics that suggest that the thyroid nodule is benign are echogenicity of thyroid gland in that being the identical echo signal or being moderately hyperechogenic corresponding to surrounding normal thyroid tissue. The solid nodule may be accompanied by a hypoechoic halo, which represents compressed thyroid tissue, fibrous connective tissue and vessels. The cystic nodule lesion contains colloid, and this appears as a hyper-echogenic spot with “comet-tail shadowing or ring-down sign”.2 The spongiform appearance on ultrasound has specificity of 99.7 % for benign disease it has 98.5 % negative predictive value for malignancy. 3,4 At the peripheries of the nodule, complete eggshell calcification is noted.5 A thyroid nodule with the above-mentioned characteristics is considered to be benign nodule and it does not require fine-needle aspiration cytology (FNAC) and in such patients there is neither a risk of malignancy nor a follow up USG is recommended.2 In benign thyroid lesion, there is rapid and controlled growth of thyroid cells compressing the surrounding thyroid parenchyma appearing as the echogenic rim called as sonolucent halo, on the contrary, malignant lesion has spontaneous but uncontrolled growth of the cells which lack cellular cohesion causing incomplete halo.6

Radioiodine in the Diagnosis and Therapy of Solitary Hyperfunctioning Thyroid Nodules

1968 ◽  
Vol 07 (01) ◽  
pp. 82-90
Author(s):  
A. Y. Al Hindawi ◽  
Th. N. Al-Hiti ◽  
W. I. Baba
Keyword(s):  
Thyroid Gland ◽  
Thyroid Nodule ◽  
Thyroid Function ◽  
Thyroid Nodules ◽  
Clinical Presentation ◽  
Radioiodine Therapy ◽  
Thyroid Tissue ◽  
Toxic Adenoma ◽  
Diagnosis And Therapy ◽  
High Doses

SummaryThe clinical presentation, the incidence, and the results of radioiodine tests in 80 patients with hyperfunctioning thyroid nodule confirmed by scanning are presented. 52 patients had toxic adenoma and 28 were euthyroid.The value of different radioiodine tests of thyroid function in confirming the diagnosis is discussed.The topographical changes in both hyperfunctioning nodule and suppressed tissue of the thyroid gland following exogenous TSH and radioiodine therapy showed refunctioning of suppressed thyroid tissue.Relatively high doses of radioiodine were required to treat toxic adenoma of the thyroid gland.

The Place of Elastography in Evaluating the Efficacy of Radiofrequency Ablation of Thyroid Nodules

2017 ◽  
Vol 83 (11) ◽  
pp. 1228-1234
Author(s):  
Ufuk O. Idiz ◽  
Erhan Aysan ◽  
Leyla Elmas ◽  
Seyma Yildiz ◽  
Huseyin Akbulut
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Nodule ◽  
Inverse Relationship ◽  
Thyroid Nodules ◽  
Thyroid Tissue ◽  
Sternocleidomastoid Muscle ◽  
Normal Thyroid Tissue ◽  
Normal Thyroid ◽  
The Mean ◽  
The Relationship

The usage of radiofrequency ablation (RFA) therapy and elastography to treat thyroid nodules has been increasing recently. Elastography specifically measures the stiffness of tissue using ultra-sonography (US). The aim of the present study was to evaluate the relationship between the elastography values of thyroid nodules and the efficacy of RFA therapy. Ultrasonography was performed on 49 patients who had a thyroid nodule with a diameter of 1 cm or greater before RFA therapy. The RFA was performed under local anesthesia, and elastography was used to measure the stiffness of the normal thyroid tissue, sternocleidomastoid muscle (SCM) and thyroid nodules three months after RFA. The nodule diameter significantly decreased three months after RFA (P < 0.05). According to a cross-evaluation of the mean elastography rates, the thyroid/SCM and nodule/thyroid elastography rates had an inverse relationship (P: 0.009). However, the thyroid/ SCM elastography rates and nodule/SCM elastography rates (P: 0.022) and the thyroid/SCM elastography rates and the rates of reduction (%) of the nodule diameter before and three months after RFA (P: 0.016) had positive relationships. In conclusion, RFA therapy is more effective in patients with thyroid nodules if there are high thyroid tissue/SCM rates in elastography.

Management of toxic multinodular goitre and toxic adenoma

2011 ◽  
pp. 508-511
Author(s):  
Dagmar Führer ◽  
John H Lazarus
Keyword(s):  
Thyroid Hormones ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Thyroid Tissue ◽  
Tsh Receptor ◽  
Multinodular Goitre ◽  
Toxic Adenoma ◽  
Thyroid Autonomy ◽  
Hot Nodule ◽  
Autonomously Functioning Thyroid Nodules

Toxic adenoma and toxic multinodular goitre represent the clinically important presentations of thyroid autonomy. Thyroid autonomy is a condition where thyrocytes produce thyroid hormones independently of thyrotropin (TSH) and in the absence of TSH-receptor stimulating antibodies (TSAB). Toxic adenoma (TA) is a clinical term referring to a solitary autonomously functioning thyroid nodule. The autonomous properties of TA are best shown by radio-iodine or 99mTc imaging. The classic appearance of TA is that of circumscribed increased uptake with suppression of uptake in the surrounding extranodular thyroid tissue (‘hot’ nodule, Fig. 3.3.11.1). Toxic multinodular goitre (TMNG) is a heterogeneous disorder characterized by the presence of autonomously functioning thyroid nodules in a goitre with or without additional nodules. These additional nodules can show normal or decreased uptake (cold nodules) on scintiscan. TMNG constitutes the most frequent form of thyroid autonomy.

scholarly journals A case of papillary thyroid carcinoma in toxic adenoma: are hyperfunctioning nodules truly innocent all the times?

2017 ◽  
Vol 4 (3) ◽  
pp. 1093
Author(s):  
Banu Sarer Yurekli ◽  
Hatice Ozisik ◽  
Nilufer Ozdemir Kutbay ◽  
Ozer Makay ◽  
Gokhan Ozgen ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Thyroid Tissue ◽  
Follicular Neoplasm ◽  
Pathology Report ◽  
Papillary Thyroid ◽  
Toxic Adenoma ◽  
Thyroid Lobectomy

Thyroid nodule is seen commonly in clinical practice. Thyroid scintigraphy should be performed for the evaluation of thyroid nodules in case of suppressed TSH. We would like to present a case of toxic adenoma with the diagnosis of papillary thyroid carcinoma. Forty-four-year-old female patient had applied to the hospital with the diagnosis of thyroid nodule. Thyroid fine needle aspiration biopsy (FNAB) was performed for the evaluation of thyroid nodule measured as 47x12 mm. This nodule was in mixed solid form bearing cystic components. FNAB revealed that the thyroid nodule was benign. Our ultrasonographic evaluation was consistent with a thyroid nodule located at right lobe with a diameter of 43x18x28 mm. The patient underwent right thyroid lobectomy. Pathology report revealed macrofollicular variant of papillary thyroid carcinoma. The tumor was 3.5 cm in diameter with regular margin and 0.2 cm away from the surgical border. The tumor didn’t spread out of the thyroid capsule. Second thyroid surgery was performed due to remaining thyroid tissue. After that ablative radioactive iodine therapy was applied. Guidelines in Endocrine literature report that hyperfunctioning nodules are almost always benign. However, the risk of malignancy was reported as a weighted rate of 3.1%. As follicular lesions are seen in high percentage in hot nodules, surgery should be recommended in case of the cytological results of a follicular neoplasm of a hyperfunctioning nodule. So, hyperfunctioning thyroid nodules warrants careful evaluation and appropriate therapy. We wanted to draw attention of the clinicians for this rare issue.

Review of the Current State and Future Development in Standardizing Natural Lighting in Interiors

2018 ◽  
pp. 5-26 ◽  
Author(s):  
Stanislav Darula
Keyword(s):  
Human Life ◽  
Natural Light ◽  
Artificial Lighting ◽  
Computer Tools ◽  
Natural Lighting ◽  
Current State ◽  
Minimum Requirements ◽  
Life On Earth ◽  
Window Design

Three elements mainly wind, water and sun seemed to determine in ancient ages the basic phenomena of life on Earth. Architectural history documented the importance of sun influence on urban and building construction already in layouts of Mesopotamian and Greek houses. Not only sun radiation but especially daylight played a significant role in the creation of indoor environment. Later, in the 20th century, a search of interaction between human life in buildings and natural conditions were studied considering well­being and energy conscious design recently using computer tools in complex research and more detail interdisciplinary solutions. At the same time the restricted daytime availability of natural light was supplemented by more efficient and continually cheaper artificial lighting of interiors. There are two main approaches to standardize the design and evaluation of indoor visual environment. The first is based on the determination of the minimum requirements respecting human health and visibility needs in all activities while the second emphasizes the behaviour and comfort of occupants in buildings considering year­around natural changes of physical quantities like light, temperature, noise and energy consumption. The new current standardization basis for daylight evaluation and window design criteria stimulate the study of methodology principles that historically were based on the overcast type of sky luminance pattern avoiding yearly availability of sky illuminance levels. New trends to base the daylight standardization on yearly or long­term availability of daylight are using the averages or median sky illuminance levels to characterise local climatological conditions. This paper offers the review and discussion about the principles of the natural light standardization with a short introduction to the history and current state, with a trial to focus on the possible development of lighting engineering and its standards in future.

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

2014 ◽  
Author(s):  
Jose Carlos Fernandez-Garcia ◽  
Carmen Maria Cortes-Salazar ◽  
Isabel Mancha-Doblas ◽  
Francisco Tinahones
Keyword(s):  
High Resolution ◽  
Thyroid Nodule ◽  
Thyroid Nodules

Disability as a social phenomenon

2020 ◽  
pp. 22-38
Author(s):  
Natalia Guseva ◽  
Vitaliy Berdutin
Keyword(s):  
Social Protection ◽  
Russian Society ◽  
Stage Model ◽  
High Quality ◽  
Rehabilitation Programs ◽  
Current State ◽  
The Social ◽  
Consistent Solution ◽  
First Time

At present, the problem of establishing disability is a point at issue in Russia. Despite the fact that medical criteria for disability are being developed very actively, high-quality methods for assessing social hallmarks are still lacking. Since disability is a phenomenon inherent in any society, each state forms a social and economic policy for people with disabilities in accordance with its level of development, priorities and opportunities. We have proposed a three-stage model, which includes a system for the consistent solution of the main tasks aimed at studying the causes and consequences of the problems encountered today in the social protection of citizens with health problems. The article shows why the existing approaches to the determination of disability and rehabilitation programs do not correspond to the current state of Russian society and why a decrease in the rate of persons recognized as disabled for the first time does not indicate an improvement in the health of the population. The authors proposed a number of measures with a view to correcting the situation according to the results of the study.

Integrative Approach in Law Understanding: the History of the Origin of Ideas and the Current State

2020 ◽  
Vol 2 (1) ◽  
pp. 115-130
Author(s):  
R. R. Palekha ◽  
Keyword(s):  
Central Place ◽  
Scientific Basis ◽  
Integrative Approach ◽  
Current State ◽  
History Of ◽  
Legal Thinking ◽  
Reliable Knowledge ◽  
The Right ◽  
Fat Formulation

Introduction. Right understanding is the most live, interesting and, at the same time, the uncertain and changeable area of researches which takes the central place as in the general theory of the right, and gains the increasing value in industry jurisprudence that is connected with its considerable teoretiko-methodological and applied potential which is shown in spheres of lawmaking and law-enforcement activity. Thus, right understanding represents research tools of the subject of knowledge which allow to study all range legal and, the based on them, state phenomena for the purpose of obtaining reliable knowledge of state and legal reality. In this regard integrative approach in right understanding which has rich history of the formation and development is of special interest, allows to perceive the right as integrally complete phenomenon, as much as possible retrieves its regulatory abilities and, provides achievement of criteria of scientific research: comprehensiveness, objectivity, historicism. Materials and Methods. In article an attempt of the analysis of integrative approach in right understanding from a position of history of origin of his ideas and assessment of the current state is made. A result of studying of scientific literature, generalization and comparison of the different points of view fat formulation of author’s determination of category “right understanding” and submission of the evidence-based integrative theory of right understanding which as much as possible conforms to requirements of time and has essential regulatory and guarding potential. Results. In article the category right understanding is comprehensively considered, different integrative theories of right understanding from a position of their origin and development are submitted, the value of modern integrative approach in right understanding is shown, perspectives of its further development are evaluated. Discussion and Conclusion. The author comes to the conclusion about the theoretical and methodological consistency and inevitability of the integrative approach in law understanding, which acts as a scientifically grounded type of legal thinking capable of comprehending the law on a truly scientific basis.

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