scholarly journals Routine intraoperative frozen section adds little value to the management of thyroid nodules with Bethesda III cytology

2021 ◽  
Vol 50 (11) ◽  
pp. 865-867
Author(s):  
Hao Li ◽  
Julian Park Nam Goh ◽  
Karandikar Amit Anand ◽  
Manish Mahadeorao Bundele ◽  
Ernest Wei Zhong Fu ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Frozen Section ◽  
Intraoperative Frozen Section

Intraoperative Frozen Section Performance for Thyroid Cancer Diagnosis

2021 ◽  
Author(s):  
Iuri Martin Goemann ◽  
Francisco Paixão ◽  
Alceu Migliavaca ◽  
José Ricardo Guimarães ◽  
Rafael Selbach Scheffel ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Diagnosis ◽  
Thyroid Nodules ◽  
Frozen Section ◽  
Needle Aspiration ◽  
Intraoperative Frozen Section ◽  
Indeterminate Nodules ◽  
Intraoperative Management ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Abstract Purpose: A primary medical relevance of thyroid nodules consists of excluding thyroid cancer, present in approximately 5% of all thyroid nodules. Fine-needle aspiration biopsy (FNAB) has a paramount role in distinguishing benign from malignant thyroid nodules due to its availability and diagnostic performance. Nevertheless, intraoperative frozen section (iFS) is still advocated as a valuable tool for surgery planning, especially for indeterminate nodules. Methods: To compare the FNAB and iFS performances in thyroid cancer diagnosis among nodules in Bethesda Categories (BC) I to VI. The performance of FNAB and iFS tests were calculated using final histopathology results as the gold standard.Results: In total, 316 patients were included in the analysis. Both FNAB and iFS data were available for 272 patients (86.1%). The overall malignancy rate was 30.4%% (n=96). The FNAB sensitivity, specificity, and accuracy for benign (BC II) and malignant (BC V and VI) were 89.5%, 97.1%, and 94.1%, respectively. For all nodules evaluated, the iFS sensitivity, specificity, and accuracy were 80.9%, 100%, and 94.9%, respectively. For indeterminate nodules and follicular lesions (BC III and IV), the iFS sensitivity, specificity, and accuracy were 25%, 100%, and 88.7%, respectively. For BC I nodules, iFS had 95.2% of accuracy.Conclusion: Our results do not support routine iFS for indeterminate nodules or follicular neoplasms (BC III and IV) due to its low sensitivity. In these categories, iFS is not sufficiently accurate to guide the intraoperative management of thyroidectomies. iFS for BC I nodules could be a reasonable option and should be specifically investigated.

Management of Thyroid Nodules in Deceased Donors With Comparison Between Fine Needle Aspiration and Intraoperative Frozen Section in the Setting of Transplantation

2019 ◽  
Vol 29 (4) ◽  
pp. 316-320 ◽  
Author(s):  
Albino Eccher ◽  
Ilaria Girolami ◽  
Antonia D’Errico ◽  
Gianluigi Zaza ◽  
Amedeo Carraro ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Frozen Section ◽  
Clinical History ◽  
Needle Aspiration ◽  
Transmission Risk ◽  
Fine Needle ◽  
Intraoperative Frozen Section ◽  
History Of ◽  
Deceased Donors

Introduction: Newly discovered thyroid nodules in deceased donors are investigated to rule out cancer that can be transmitted, but there are no established protocols. The aim of the study was to compare fine needle aspiration versus intraoperative frozen section in the donor management with limited time. Methods: Data were extracted only from the records of Italian second opinion consultation service in the years 2016 to 2017 and included donor details, pathology diagnoses, complications, transmission risk profile, and impact on transplantation. Results: Among 31 deceased donors with thyroid nodules, we documented 4 with a clinical history of cancer and 27 with a newly discovered nodule. The latter was evaluated by thyroidectomy with frozen section in 22 and fine needle aspiration in 5. Among all donors, 7 had papillary thyroid carcinoma with negligible transmission risk, whereas 8 with unacceptable risk. Two donors presented major bleeding after thyroidectomy, with organ discard in 1 case. Transplantation was delayed in 4 cases that were evaluated with frozen section. Discussion: There was no uniform approach for the investigation of thyroid nodules. Our results showed that fine needle aspiration was more accurate and useful than frozen section. Fine needle aspiration had minor economic impact and a far less rate of bleeding/hemodynamic complications, potentially delaying and compromising organ recovery. Our results suggested considering fine needle aspiration as a first step in the evaluation of thyroid nodules in donors.

The Role of Fine-Needle Aspiration and Intraoperative Frozen Section in the Surgical Management of Solitary Thyroid Nodules

Surgery Today ◽  
2002 ◽  
Vol 32 (10) ◽  
pp. 857-861 ◽  
Author(s):  
Simon D. Duek ◽  
David Goldenberg ◽  
Shai Linn ◽  
Michael M. Krausz ◽  
Dan D. Hershko
Keyword(s):  
Surgical Management ◽  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Frozen Section ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Intraoperative Frozen Section

scholarly journals Correlation between fine needle aspiration and intraoperative frozen section findings for thyroid patients; a single center study

2021 ◽  
Vol 7 (1) ◽  
pp. e04-e04
Author(s):  
Azar Baradaran ◽  
Maryam Derakhshan ◽  
Negin Ghanbari
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Frozen Section ◽  
Needle Aspiration ◽  
Diagnostic Methods ◽  
Papillary Thyroid ◽  
Fine Needle ◽  
Intraoperative Frozen Section ◽  
Single Center Study ◽  
Spss Software

Introduction: Thyroid nodules are one of the most common diseases. Objectives: The aim of this study was to evaluate the correlation between fine needle aspiration (FNA) and intraoperative frozen section findings for thyroid disease patients. Patients and Methods: In this study, the FNA and intraoperative frozen section findings of 143 patients who were admitted to an educational hospital, Isfahan, Iran were collected and classified using these diagnostic methods during 2015. To find the correlation between FNA and intraoperative frozen section findings, statistical analysis was conducted using SPSS software version 16.0 (Chicago, IL). Results: Sensitivity and specificity of the positive FNA findings were 71% and 86.8%, respectively (P<0.001). The maximum concordance between FNA and intraoperative frozen section for papillary thyroid cancer was seen (P<0.001). Conclusion: In this study, a significant association between FNA and intraoperative frozen section of thyroid cancers, among our patients, however this finding requires further investigation by larger studies.

scholarly journals Intraoperative frozen section can be reduced in thyroid nodules classified as Bethesda categories V and VI

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Jing Huang ◽  
Jieli Luo ◽  
Jianshe Chen ◽  
Yang Sun ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Frozen Section ◽  
Intraoperative Frozen Section

scholarly journals Utility of Intraoperative Frozen Section in Large Thyroid Nodules

2018 ◽  
Vol 160 (1) ◽  
pp. 49-56
Author(s):  
Craig A. Bollig ◽  
Jeffrey B. Jorgensen ◽  
Robert P. Zitsch ◽  
Laura M. Dooley
Keyword(s):  
Thyroid Nodules ◽  
Cost Minimization ◽  
Frozen Section ◽  
Case Series ◽  
Cost Savings ◽  
Care Utilization ◽  
Intraoperative Frozen Section ◽  
Cost Minimization Analysis ◽  
Thyroid Lobectomy ◽  
Follicular Lesions

Objective To determine if the routine use of intraoperative frozen section (iFS) results in cost savings among patients with nodules >4 cm with nonmalignant cytology undergoing a thyroid lobectomy. Study Design Case series with chart review; cost minimization analysis. Setting Single academic center. Subjects and Methods Records were reviewed on a consecutive sample of 48 patients with thyroid nodules >4 cm and nonmalignant cytology who were undergoing thyroid lobectomy in which iFS was performed between 2010 and 2015. A decision tree model of thyroid lobectomy with iFS was created. Comparative parameters were obtained from the literature. A cost minimization analysis was performed comparing lobectomy with and without iFS and the need for completion thyroidectomy with costs estimated according to 2014 data from Medicare, the Bureau of Labor Statistics, and the Nationwide Inpatient Sample. Results The overall malignancy rate was 25%, and 33% of these malignancies were identified intraoperatively. When the malignancy rates obtained from our cohort were applied, performing routine iFS was the less costly scenario, resulting in a savings of $486 per case. When the rate of malignancy identified on iFS was adjusted, obtaining iFS remained the less costly scenario as long as the rate of malignancies identified on iFS exceeded 12%. If patients with follicular lesions on cytology were excluded, 50% of malignancies were identified intraoperatively, resulting in a savings of $768 per case. Conclusions For patients with nodules >4 cm who are undergoing a diagnostic lobectomy, the routine use of iFS may result in decreased health care utilization. Additional cost savings could be obtained if iFS is avoided among patients with follicular lesions.

Prevalence of Cancer in Follicular Thyroid Nodules: Is There Still a Role for Intraoperative Frozen Section Analysis?

Thyroid ◽  
2003 ◽  
Vol 13 (4) ◽  
pp. 389-394 ◽  
Author(s):  
Fabio Monzani ◽  
Nadia Caraccio ◽  
Pietro Iacconi ◽  
Pinuccia Faviana ◽  
Angela Dardano ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Frozen Section ◽  
Intraoperative Frozen Section ◽  
Frozen Section Analysis ◽  
Prevalence Of Cancer ◽  
Section Analysis
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