Predicting Malignancy in a Solitary Thyroid Nodule: A Prospective Study on the Role of Color Doppler Ultrasonography

ABSTRACT Palpable thyroid nodules are fairly common. While many are benign, the clinician faces the challenge of detecting the 4 to 14% of malignant lesions. Fine needle aspiration cytology (FNAC) of thyroid nodules seems to have eclipsed all other techniques for diagnosis of thyroid cancer, but has its limitations when a nodule is inaccessible or in the case of follicular neoplasm. This study from a hospital from Indian west coast shows that vascular flow pattern of extensive peripheral and central flow (Type-3) or a central flow only (Type-4) and a resistive index (RI) of >0.75 on power Doppler sonography shows a healthy sensitivity and excellent specificity for predicting malignancy. The utility becomes even more apparent among follicular neoplasms where FNAC can offer little help in distinguishing malignancy. How to cite this article Rao G, Rao S, Varma R, Bhagwat NM, Chadha MD, Joshi AS, Varthakavi PK. Predicting Malignancy in a Solitary Thyroid Nodule: A Prospective Study on the Role of Color Doppler Ultrasonography. Int J Otorhinolaryngol Clin 2014;6(1):9-14.

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Role of Color Doppler Ultrasonography in Differentiation of Graves’ Disease from Thyroiditis: A Prospective Study

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1208 ◽

2017 ◽

Vol 9 (2) ◽

pp. 41-45

Author(s):

Rv Suresh ◽

KS Thalavai Sundarram, ◽

Dhalapathy Sadacharan, ◽

Krishnan Ravikumar, ◽

S Kalpana,

Keyword(s):

Prospective Study ◽

Doppler Ultrasonography ◽

Color Doppler ◽

Cost Effective ◽

Color Doppler Ultrasonography ◽

Graves Disease ◽

Group I ◽

Group Ii ◽

A Prospective Study

ABSTRACT Introduction Thyrotoxicosis due to Graves’ disease (GD) and destructive thyroiditis (DT) needs differentiation, as management strategy differs. Factors that help in diagnosis are biochemical and nuclear imaging. Utility of high-resolution ultrasonography (HRUSG) and color Doppler (CD) in differentiation is not widely practiced. We undertook the prospective study in the Department of Endocrine Surgery at a tertiary care center among South Indian population in 1 year as a cost-effective model Materials and methods Out of 120 newly diagnosed thyrotoxicosis patients, 54 were GD (group I) and 66 were DT (group II) patients. Totally, 55 euthyroid patients served as controls. Parameters analyzed were demography, free thyroid function test (TFT) anti-thyroid-stimulating hormone receptor antibody (TSHrAB), antithyroid peroxidase antibody (ATPO), anti-thyroglobulin antibody (ATG), and Tc-99m thyroid scintigraphy. Parameters analyzed using HRUSG and CD were peak systolic velocity (PSV), end-diastolic volume (EDV), pulsatility index (PI), resistive index (RI) of bilateral superior thyroid artery (STA) and inferior thyroid artery (ITA). Results Both groups were age and sex matched. The TFT, ATPO, and ATG were comparable between both groups (p = 0.609). The TSHrAB (IU/mL) was significantly higher in group I (36.11 ± 0.82) than group II (1.23 ± 0.24) (p < 0.001). Mean thyroid volume (mL) was higher in group I (28.9 ± 14.9) than group II (26.2 ± 8.81) (p = 0.022). Mean PSV-STA (cm/s) was statistically higher in group I (54.09 ± 4.67) than group II (28.92 ± 4.39) (p ≤ 0.001). Mean PSV-ITA (cm/s) was higher in group I (32.11 ± 2.45) than group II (25.23 ± 3.45) (p = 0.006). Other parameters measured in both arteries like mean EDV (cm/s), mean RI, and mean PI were comparable between both groups. Conclusion The HRUSG with CD evaluation of PSV STA and ITA is a cost-effective alternative to TSHrAB and thyroid scintigraphy in differentiating GD from DT patients. Additionally, we observed that PSV in STA was higher than in ITA in patients with GD. To conclude, HRUSG and CD are simple, cost-effective, and widely available tools in the differentiation of GD from DT. How to cite this article Sundarram KST, Sadacharan D, Ravikumar K, Kalpana S, Suresh RV. Role of Color Doppler Ultrasonography in Differentiation of Graves’ Disease from Thyroiditis: A Prospective Study. World J Endoc Surg 2017;9(2):41-45.

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INCIDENCE OF TEMPORAL ARTERITIS IN PATIENTS WITH POLYMYALGIA RHEUMATICA: A PROSPECTIVE STUDY USING COLOR DOPPLER ULTRASONOGRAPHY OF THE TEMPORAL ARTERIES

Ultrasound Quarterly ◽

10.1097/00013644-200209000-00017 ◽

2002 ◽

Vol 18 (3) ◽

pp. 214

Author(s):

&NA;

Keyword(s):

Prospective Study ◽

Polymyalgia Rheumatica ◽

Doppler Ultrasonography ◽

Temporal Arteritis ◽

Color Doppler ◽

Color Doppler Ultrasonography ◽

Temporal Arteries ◽

A Prospective Study

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Efficacy of Technetium Scintigraphy as an investigative Tool in Papillary Carcinoma of Thyroid: A Prospective Study

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1292 ◽

2016 ◽

Vol 7 (4) ◽

pp. 220-222

Author(s):

C Sreenivas ◽

Vinay Raj ◽

V Devipriya

Keyword(s):

Prospective Study ◽

Thyroid Nodule ◽

Papillary Carcinoma ◽

Thyroid Nodules ◽

Care Providers ◽

Investigative Tool ◽

Thyroid Scan ◽

Solitary Thyroid Nodule ◽

A Prospective Study ◽

Cold Nodule

ABSTRACT Introduction and background Thyromegaly is a common cause of physician consultation. Solitary thyroid nodules are conventionally viewed with suspicion. Clinical examination cannot reliably distinguish between a solitary thyroid nodule and a dominant nodule in multinodular goiter. Ultrasonographical examination has its own pitfalls. Technetium 99 is a commonly used modality for the functional assessment of solitary thyroid nodule detection. It has the advantage of low cost with lower radiation dose to the exposed patients. On literature search, studies on Technetium 99 scintigraphy for thyroid in context to the Indian scenario does not yield much information, and very few studies are notable. This study was conducted to correlate and qualify thyroid cold nodule as detected by technetium 99 pertechnetate thyroid scan. Objective This study was conducted to correlate, qualify, and compare the predictive value of technetium 99 pertechnetate scintigraphy on solitary thyroid nodule vis-à-vis fine needle aspiration cytology (FNAC) and to countercheck with histopathological examination (HPE). Materials and methods A prospective cohort study in a National Accreditation Board for Hospitals & Health care Providers, National Assessment and Accreditation Council, and Joint Commission International-accredited tertiary care teaching university hospital was conducted over a period of 36 months. All the subjects underwent clinical assessment of the neck that included standard examination techniques to segregate solitary thyroid nodules. They were then subjected to technetium 99 pertechnetate scintigraphy using the standard protocol. All the patients with solitary cold nodule underwent FNAC followed by nodule excision or hemi-thyroidectomy under general anesthesia. All the specimens underwent HPE by an experienced histopathologist. The results were statistically analyzed using Pearson's chi-square test. Results (1) Cold nodules as detected by technetium 99 pertechnetate thyroid scan is a reasonable indicator of probable malignancy vis-à-vis FNAC. (2) Occurrence of cold nodules is highest in third to fifth decade of life (21- to 50-year age group). (3) Occurrence of cold nodules is higher in females (83%), whereas occurrence of malignancy in cold nodules is higher in males (85%). (4) Occurrence of malignancy in cold nodules is higher in subjects less than 21 and above 50 years. (5) Technetium 99m pertechnetate thyroid scintigraphy is an important preoperative tool in management of thyroid nodules, and its routine use in all such patients is recommended, especially to rule out cold nodules. How to cite this article Mohanty S, Sreenivas C, Raj V, Efficacy of Technetium Scintigraphy as an investigative Tool in Papillary Carcinoma of Thyroid: A Prospective Study. Int J Head Neck Surg 2016;7(4):220-222.

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