scholarly journals Correlation between Age, Nodule Diameter, and TI-RADS Score in Thyroid Nodule Classification on Follicular Thyroid Carcinoma

2021 ◽  
Vol 8 (8) ◽  
pp. 385-391
Author(s):  
Kania Difa Parama Citta ◽  
Sahudi Sahudi ◽  
Iskandar Ali
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Teaching Hospital ◽  
Thyroid Nodules ◽  
Follicular Thyroid Carcinoma ◽  
Data System ◽  
Endocrine Gland ◽  
Thyroid Ultrasound ◽  
Thyroid Imaging

Background: Thyroid cancer is a malignancy of the endocrine gland with the highest incidence. There are many radiological examination modalities that are used to help diagnose thyroid carcinoma, one of which is Ultrasonography. Ultrasonography (USG) can be useful to support the diagnosis of thyroid malignancy. A classification method that categorizes thyroid nodules based on risk for cancer, one of which is by using the Thyroid Imaging Reporting and Data System (TI-RADS). TI-RADS (Thyroid Imaging, Reporting and Data System) is a classification of thyroid ultrasound readings to differentiate between benign and malignant thyroid nodules. Several research efforts that have been done at Dr. Soetomo Hospital previously related to diagnostic of thyroid carcinoma but the results are meaningless and require large funds for the laboratory examination. The aim of this study is to make a relatively easy and inexpensive method using the TI-RADS classification, which is expected to assist in the preoperative diagnostics of a follicular thyroid carcinoma. It is hoped that there will be a method or modality that is easier, cheaper, accurate, and minimally invasive in predicting a follicular thyroid carcinoma. Methods: In this cross-sectional study, we included patients with thyroid mass who underwent treatment in Surgery Department, Dr. Soetomo Teaching Hospital between January 2012 and December 2020. In this study, we utilized the patients’ medical record to collect the necessary clinical data. The inclusion criteria in this study were patients with singular thyroid nodule, underwent thyroid ultrasound, and diagnosed as follicular nodular carcinoma by histopathology examination. Finally, a total of 53 patients were included for further analysis. Ethical approval was obtained from the Ethics Committee of Dr. Soetomo Teaching Hospital (Surabaya, Indonesia). Results: From a total of 53 research subjects, the subjects with the most age were more than 50 years old with a percentage of 52.8% or 28 patients and the rest, 47.2% or 25 patients. The results of this study indicates that nodule diameters less than 5 cm and more than 5 cm have almost the same number based on the number of data samples in this study, namely 53 patients. This can be seen from the number of respectively 27 (50.9%) and 26 (49%). In the TIRADS nodule score, the largest percentage obtained from medical data records in the form of a TIRADS score, namely a TIRADS score greater than TR 4 with a percentage of 60.4% or as many as 32 patients and the rest, namely a TIRADS score less than TR 4 of 39.6% or as much as 21 patients. In the third dependent variable, the authors looked for the odd ratio value for each variable on follicular carcinoma. The authors calculated the OR values ​​for each variable, obtaining results of 1.012 for age, 1.111 for nodule size, and 3.520 for TIRADS scores. Conclusion: There is a correlation between the TIRADS scores with the incidence of follicular thyroid carcinoma. Keywords: Thyroid cancer, TIRADS, Follicular Thyroid Carcinoma.

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

2017 ◽  
Vol 3 (4) ◽  
pp. 908 ◽  
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

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">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. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">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.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">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%. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">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.</span></p>

scholarly journals Papillary Thyroid Carcinoma With Cystic Changes in a Patient With Prior History of Toxic Nodule

2020 ◽  
Vol 8 ◽  
pp. 232470962094267
Author(s):  
Gliceida Maria Galarza Fortuna ◽  
Paola Rios ◽  
Ailyn Rivero ◽  
Gabriela Zuniga ◽  
Kathrin Dvir ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Molecular Testing ◽  
Papillary Thyroid ◽  
Thyroid Lobectomy ◽  
Cystic Changes ◽  
History Of

Thyroid nodules are palpable on up to 7% of asymptomatic patients. Cancer is present in 8% to 16% of those patients with previously identified thyroid nodules. Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, accounting for approximately 85% of thyroid cancers. Although most appear as solid nodules on ultrasound imaging, a subset of 2.5% to 6% has cystic components. The presence of cystic changes within thyroid nodules decreases the accuracy of fine needle aspiration (FNA) in the diagnosis of thyroid cancer, given the difficulty of obtaining appropriate cellular content. This becomes a diagnostic and therapeutic challenge. We present a case of a 31-year-old female with a 1-month history of palpitations, fatigue, and night sweats, who underwent evaluation, and was diagnosed with subclinical hyperthyroidism. She presented 4 years later with compressive symptoms leading to repeat FNA, showing Bethesda III-atypia of undetermined significance and negative molecular testing. Thyroid lobectomy revealed PTC with cystic changes. This case is a reminder that patients with hyperfunctioning thyroid nodule should have closer follow-up. It poses the diagnostic dilemma of how much is good enough in the evaluation and management of a thyroid nodule. Early detection and action should be the standard of care.

THE RISK OF THYROID CANCER IN PATIENTS WITH THYROID NODULE 3 CM OR LARGER

2020 ◽  
Vol 26 (11) ◽  
pp. 1286-1290
Author(s):  
Edy Kornelius ◽  
Shih-Chang Lo ◽  
Chien-Ning Huang ◽  
Yi-Sun Yang
Keyword(s):  
Thyroid Cancer ◽  
Positive Predictive Value ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Fine Needle

Objective: There are conflicting data on the risk of thyroid cancer in thyroid nodules 3 cm or larger, and few such studies on this issue have been conducted in Asia. This study aimed to examine the risk of thyroid cancer in patients with thyroid nodules 3 cm or larger. Methods: This was a 7-year retrospective study conducted in a tertiary referral hospital in Taiwan. All patients with a thyroid nodule measuring ≥3 cm who underwent thyroid operation with or without fine-needle aspiration biopsy (FNAB) were included. The prevalence rate of thyroid cancer, as well as the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and false-negative rate of FNAB for thyroid nodule ≥3 cm were also examined. Results: A total of 132 patients were included in this study. Thyroid cancer was detected in 19 of 132 (14.4%) thyroid nodules measuring ≥3 cm. The performance of FNAB for detecting cancer in nodules 3 cm or larger without considering other ultrasonography parameters was relatively poor with a sensitivity of 50%, but the specificity (100%), PPV (100 %), and NPV (93.4 %) were excellent. Conclusion: The risk of thyroid cancer for thyroid nodules ≥3 cm in this study was low. The PPV and NPV of FNAB were high for the detection of cancer in large nodules. The decision to perform thyroidectomy should not be solely based on nodule size and should include other factors, such as ultrasound characteristics and surgical risk. Abbreviations: ATA = American Thyroid Association; FNAB = fine-needle aspiration biopsy; mPTC = micropapillary thyroid carcinoma; NPV = negative predictive value; PPV = positive predictive value; PTC = papillary thyroid carcinoma

scholarly journals Will Real Time Visualization of Needle in Target Thyroid Nodules Minimize False Negative FNA Results?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A904-A905
Author(s):  
Vijaykumar Sekar ◽  
Panadeekarn Panjawatanan ◽  
Sofia Junaid Syed
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
False Negative ◽  
Thyroid Ultrasound ◽  
Papillary Thyroid ◽  
Ultrasound Guided ◽  
Real Time Visualization ◽  
The Right

Abstract Introduction: Prevalence of thyroid nodules in the adult population based on detection by ultrasonography is about 20-76% of which only 5% account for thyroid cancer. All patients with a suspected thyroid nodule either on physical examination or noted incidentally on other imaging should be evaluated with thyroid ultrasound. Any thyroid nodule &gt;= 1 cm on ultrasound should be investigated with FNAC. Ultrasound guided FNAC techniques are used to reduce false negative results. We present a patient with suspicious finding on initial thyroid ultrasound and subsequent negative FNAC presenting a few years later with papillary thyroid cancer. Case Presentation: A 32 y.o. female with history of thyroid nodule and thyroiditis presented to the endocrine clinic for follow-up of her thyroid nodule. 5 years ago, she was diagnosed with thyroid nodule, which was found on an ultrasound scan for workup of her dysphagia. The thyroid ultrasound then showed diffusely heterogeneous thyroid gland with an ill-defined area of decreased echogenicity in the right lobe and left superior lobe and possible nodule in the lower pole left thyroid. Blood work showed TSH of 1.71 (n 0.34-3.00 uIU/ml) and thyroid peroxidase antibody levels was 27.8 (n &lt; 9.0 IU/ml). A CT scan of neck with contrast was done and no concerning mass was seen. The patient had a follow-up ultrasound after 8 months which showed small bilateral thyroid lesions, somewhat ill-defined. The patient had an FNA biopsy of the right thyroid nodule: the results were consistent with a benign follicular nodule. A follow-up thyroid ultrasound was done in a year, and the findings were unchanged. The patient came back 3 years later for follow-up with complaints of a new palpable nodule in the neck. Ultrasound showed unchanged right thyroid nodule and some new cervical adenopathy. The ultrasound showed a 2.2 cm heterogeneous lymph node with punctate echogenic foci along the right lateral margin of the right internal jugular vein at the level of the thyroid gland, Subsequently FNA biopsy of the right cervical node and right thyroid node were done. The cells from lymph nodes were positive for malignancy and cells from the right thyroid nodule were atypical. Overall the appearance was consistent with papillary thyroid carcinoma. Subsequently the patient underwent total thyroidectomy and right modified lymph node dissection and the pathology results came back as multifocal papillary thyroid cancer right side 1.2 cm and left side 0.4 cm, with metastasis to 2 lymph nodes. Conclusion: The reported false negative rate of ultrasound-guided FNAC is variable. Success of US-FNA depends on experience of operator and cyto-pathologist and the intrinsic nature of the nodule. Malignancy rates of only 1-2% are reported with repeat FNA in prior benign nodules. Good FNA techniques and real-time visualization of needle in target nodules can further decrease false negatives.

scholarly journals A retrospective study correlating Ultrasound based Thyroid Imaging Reporting and Data System(TIRADS) with Bethesda System for Thyroid cytopathology in thyroid nodule risk stratification

2021 ◽  
Vol 03 ◽  
Author(s):  
Rajeev Chaturvedi ◽  
Ashok Kumar ◽  
Balaji Balasubramanian ◽  
Sreekala Sreehari
Keyword(s):  
Risk Stratification ◽  
Thyroid Nodule ◽  
Thyroid Nodules ◽  
Data System ◽  
Receiver Operating Curve ◽  
Thyroid Imaging ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
Thyroid Cytopathology ◽  
Undetermined Significance

Objective: To evaluate the efficacy of the ultrasound based Thyroid Imaging Reporting and Data System (TIRADS)in estimating risk of malignancy in thyroid nodules by correlating it with Bethesda system of thyroid cytopathology. Methods: A retrospective single center study was conducted in a specialty hospital in UAE from November 2017 to November 2019 on 259 thyroid nodules which underwent ultrasound and fine needle aspiration cytology (FNAC). Thyroid nodules were evaluated using American College of Radiology (ACR) TIRADS and categorized as benign (TR1), not suspicious (TR2), mildly suspicious (TR3), moderately suspicious (TR4), or highly suspicious (TR5) for malignancy. The risk of malignancy associated with each TIRADS category was evaluated by comparing it with the Bethesda system classification of cytopathology. Results: Ultrasound and FNAC data of 259 nodules was reviewed. Out of these 33 (12.7%) nodules were excluded because FNAC revealed atypia of undetermined significance or follicular lesion of undetermined significance. The estimated risk of malignancy in TR 3 was 13.6%, in TR4 was 27% and TR5 was 63.6%. There was statistically significant correlation between –TIRADS and Bethesda system using Chi-square test (p<0.001). The receiver operating curve (ROC) analysis revealed specificity of 81.3 % [95% CI, 74.9-86.6%], NPV of 91 % [95% CI, 87.1–93.8%] and accuracy of 77.9% [95% CI, 71.9–83.1%] in differentiating benign from malignant nodules. Conclusion: The ultrasound based ACR- TIRADS scoring correlates well with the Bethesda cytopathology in thyroid nodule risk stratification. Thus, it can be used as a simple and effective tool to decide further management and avoid unnecessary FNAC and surgeries in thyroid nodules.

GUIDELINE IMPLEMENTATION ON FINE-NEEDLE ASPIRATION FOR THYROID NODULES: FOCUSING ON MICRONODULES

2020 ◽  
Vol 26 (9) ◽  
pp. 1017-1025
Author(s):  
Si Eun Lee ◽  
Eun-Kyung Kim ◽  
Hee Jung Moon ◽  
Jung Hyun Yoon ◽  
Vivian Youngjean Park ◽  
...  
Keyword(s):  
Thyroid Nodule ◽  
Fine Needle Aspiration ◽  
Thyroid Surgery ◽  
Thyroid Nodules ◽  
Guideline Implementation ◽  
Needle Aspiration ◽  
Data System ◽  
American Thyroid Association ◽  
Fine Needle ◽  
Thyroid Imaging

Objective: We investigated patients who were referred to our institution after fine-needle aspiration (FNA) was performed at outside clinics to evaluate how many nodules satisfied the FNA indications of the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and compare that to the number of thyroid nodules that satisfy the FNA indications of the American College of Radiology (ACR)-TIRADS and American Thyroid Association (ATA) guidelines. Methods: Between January 2018 and December 2018, 2,628 patients were included in our study. The included patients were those referred for thyroid surgery after having a suspicious thyroid nodule. We retrospectively applied the three guidelines to each thyroid nodule and determined whether each nodule satisfied the FNA indications. We compared the proportion of nodules satisfying the FNA indications of each guideline using a generalized linear model and generalized estimating equation. Results: The median size of the 2,628 thyroid nodules was 0.9 cm (range, 0.2 to 9.5 cm). We found that FNA was not indicated for 54.1%, 47.7%, and 19.1% of nodules and 87.3%, 99.0%, and 97.8% among them were micronodules (<1 cm) according to the ACR-TIRADS, ATA guideline, and K-TIRADS, respectively. The proportion of micronodules which satisfied the FNA indications was significantly higher for the K-TIRADS (65.1%) compared to the ACR TIRADS (12.1%) and ATA guideline (12.1%) ( P<.001). Conclusion: Among patients referred for thyroid surgery to our institutions, about 35% of the micronodules underwent FNA despite not being appropriate for indications by the K-TIRADS. Systematic training for physicians as well as modifications to increase the sensitivity of the guideline may be needed to reduce the overdiagnosis of thyroid cancers, especially for micronodules. Abbreviations: ACR = American College of Radiology; ATA = American Thyroid Association; FNA = fine-needle aspiration; K-TIRADS = Korean Thyroid Imaging Reporting and Data System; LN = lymph node; TIRADS = Thyroid Imaging Reporting and Data System; US = ultrasound

McGill Thyroid Nodule Score in Differentiating Benign and Malignant Pediatric Thyroid Nodules: A Pilot Study

2017 ◽  
Vol 157 (4) ◽  
pp. 589-595 ◽  
Author(s):  
Michael Canfarotta ◽  
Douglas Moote ◽  
Christine Finck ◽  
Rebecca Riba-Wolman ◽  
Shefali Thaker ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Pilot Study ◽  
Thyroid Carcinoma ◽  
Thyroid Nodule ◽  
Differentiated Thyroid Cancer ◽  
Chart Review ◽  
Thyroid Nodules ◽  
Papillary Thyroid ◽  
Well Differentiated ◽  
Indeterminate Cytology

Objective The McGill Thyroid Nodule Score (MTNS) is a preoperative tool used to predict the risk for well-differentiated thyroid cancer given a specific nodule in adults. We evaluated the clinical utility of a modified pediatric MTNS with children and adolescents. Study Design Case series with chart review. Setting Tertiary care children’s hospital. Subjects and Methods This is a retrospective chart review of 46 patients ≤18 years of age presenting with a solitary or dominant thyroid nodule treated with surgical resection between September 2008 and December 2015. The cumulative MTNS for each nodule was calculated and compared with the final pathology. Results Of 46 patients, 10 (21.7%) were diagnosed with well-differentiated thyroid cancer (80% papillary thyroid carcinoma, 10% follicular variant of papillary thyroid carcinoma, 10% follicular thyroid carcinoma). Malignant nodules were associated with a greater mean MTNS (benign, 5.72 ± 3.03; malignant, 16 ± 3.13; P < .05). The sensitivity, specificity, and positive predictive value of malignancy were 100%, 94.4%, and 83.3% for scores ≥10 and 80%, 100%, and 100% for scores ≥11, respectively. In nodules with indeterminate cytology (Bethesda III and IV), the pediatric MTNS showed good differentiation between benign and malignant disease, with mean scores of 7.95 and 12.5, respectively ( P = .006). Conclusion This pilot study suggests that a comprehensive scoring system may help assess the risk of malignancy in pediatric thyroid nodules and differentiate nodules with indeterminate cytology into higher- and lower-risk categories. Given these findings, larger, multi-institutional studies are warranted.

On the Classification of TI-RADS and Stratification of Signs of Thyroid Cancer According to Ultrasound Data

2017 ◽  
pp. 29-38 ◽  
Author(s):  
E. P. Fisenko ◽  
J. P. Sich ◽  
N. N. Vetsheva
Keyword(s):  
Thyroid Cancer ◽  
Retrospective Analysis ◽  
Thyroid Nodules ◽  
Thyroid Ultrasound ◽  
High Reproducibility ◽  
System 1

Objective:a comparative “blind” assessment of the thyroid nodules identified by ultrasound, according to the TI-RADS scale in various modifications.Materials and methods.Retrospective analysis of 149 echograms  of thyroid nodules by three independent experts was performed (the  experience of ultrasound of thyroid ultrasound for more than 7 years).Results. In solid nodules, high-specific large (more than 94%) and  small (more than 90%) ultrasound signs of thyroid cancer have been identified. The nodes are stratified according to the TI-RADS system: 1 – in the modification J.Y. Kwak et al. (2011), 2 – according to the  proposed system, taking into account small ultrasound signs of  thyroid cancer. High reproducibility of both systems are obtained. In the first system 13.7% of cancer nodes fell into the category of TI- RADS 3 (benign formations), in the second system only 5% of  cancers fell into the category of TI-RADS 3, which is important for  biopsy selection. The sensitivity of the first system was TI-RADS  82.05%, of the second system – 94.87%.Conclusions.Classification of TI-RADS can be used to interpret the  ultrasound results of thyroid nodules, taking into account both the  main large and small ultrasound signs of cancer. For its validation in  our country, it is necessary to further broad discussion of the proposed TI-RADS system.

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