Comparison of Different Ultrasound Classification Systems of Thyroid Nodules for Identifying Malignant Potential: A Cross-sectional Study

Purpose. The present study aims to investigate the prevalence of single and multiple thyroid nodules and its association with metabolic diseases in subjects who participated in the heath examination in China. Methods. This is a cross-sectional study. The participants who attend the physical examination at the Health Management Center of Southwest Hospital, Army Military Medical University, between January 2014 and December 2018, were included. Thyroid nodules were diagnosed by thyroid ultrasound. Multivariable logistic regression was used to investigate the association between metabolic diseases and nodular thyroid disease. Results. A total of 9,146 subjects were included in this study; of them, 2,961 were diagnosed with thyroid nodules, with a prevalence of 32.4%. The prevalence in women was significantly higher than that in men (45.2% vs 26.0%; χ2 = 339.56, P<0.001), and the prevalence was gradually increased with age (Z = 20.05, P<0.001). Multivariable logistic regression analysis indicated that advanced age, female gender, and diabetes mellitus were positively associated with thyroid nodule in the general population. Additionally, the female gender, advanced age, and high LDL-C concentration were positively associated with high risk of multiple thyroid nodules, compared with patients of single thyroid nodule. Males and females showed heterogeneous associations with single and multiple thyroid nodule risk. Conclusions. The prevalence of thyroid nodules was relatively high. Age, female gender, and diabetes are positively associated with nodular thyroid disease. High LDL cholesterolemia is more likely to be associated with multiple thyroid sarcoidosis.

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The Effect of Iodine Status on the Risk of Thyroid Nodules: A Cross-Sectional Study in Zhejiang, China

International Journal of Endocrinology ◽

10.1155/2020/3760375 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Xiaoming Lou ◽

Xiaofeng Wang ◽

Zhifang Wang ◽

Guangming Mao ◽

Wenming Zhu ◽

...

Keyword(s):

Thyroid Nodules ◽

Adult Population ◽

Urinary Iodine ◽

Cross Sectional Study ◽

Urinary Iodine Concentration ◽

Sectional Study ◽

Percent Reduction ◽

Iodine Nutrition ◽

Cross Sectional ◽

Significant Difference

Objective. The aim of this study was to explore whether iodine nutrition is associated with the risk of thyroid nodules among adult population in Zhejiang Province, China. Methods. A cross-sectional study was conducted in the general population aged 18 years or older. A total of 2,710 subjects received physical examination, questionnaires, and thyroid ultrasonography. Urinary iodine concentration (UIC) and thyroid hormone levels were measured and documented for each subject. 4 multiple logistic regression models adjusted for other risk factors were applied to analyze the association between iodine nutrition and thyroid nodules. Results. The prevalence of thyroid nodules was 15.5% among all adults. As indicated by all 4 models, subjects with UIC varying from 200 μg l−1 to 399 μg l−1 had lower risk of thyroid nodules compared with those with relatively low UIC (<100 μg l−1), with approximately 37–57 percent reduction in risk. Moreover, subjects with UIC between 100 and 199 μg l−1 had a decreased risk of thyroid nodules in model 1 and 2 (OR = 0.75, 95% CI, 0.58–0.97; OR = 0.75, 95% CI, 0.58–0.97, respectively). However, there was no significant difference of risk in thyroid nodules between subjects with high UIC (≥400 μg l−1) and low UIC (<100 μg l−1). Furthermore, intake of iodized salt was inversely associated with risk of thyroid nodules, with approximately 69–77 percent reduction in risk. Conclusion. The relationship between UIC and the risk of thyroid nodules is U-shaped. Consumption of noniodized salt is an independent risk factor of thyroid nodules.

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Risk of thyroid nodules in subjects occupationally exposed to radiation: a cross sectional study.

Occupational and Environmental Medicine ◽

10.1136/oem.52.8.500 ◽

1995 ◽

Vol 52 (8) ◽

pp. 500-504 ◽

Cited By ~ 16

Author(s):

A Antonelli ◽

G Silvano ◽

F Bianchi ◽

C Gambuzza ◽

L Tana ◽

...

Keyword(s):

Thyroid Nodules ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Occupationally Exposed

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Solitary Thyroid Nodules - Validity of Ultrasonography, Fine Needle Aspiration Cytology and Sestamibi in Detecting Thyroid Malignancies - A Cross-Sectional Study in Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/527 ◽

2021 ◽

Vol 8 (31) ◽

pp. 2885-2889

Author(s):

Shilpa Suresh ◽

Riju R. Menon ◽

Pradeep Jacob ◽

Gopalakrishnan Nair C

Keyword(s):

Thyroid Nodules ◽

Needle Aspiration ◽

Cross Sectional Study ◽

Sectional Study ◽

Aspiration Cytology ◽

Cross Sectional ◽

Fine Needle ◽

Sestamibi Scintigraphy ◽

Needle Aspiration Cytology ◽

Thyroid Malignancies

BACKGROUND The diagnosis of thyroid malignancies continues to remain a challenge, due to lack of specificity with various modalities, and intrinsic variability with clinical examination. Although histopathological diagnosis is confirmatory, there is a need for pre-surgical assessment and confirmation, which will prove to be useful in decision making regarding the course of management. The present study was carried out to evaluate the validity of various modalities for detection of thyroid malignancies. METHODS This cross-sectional study was carried out among 40 patients who presented to the outpatient clinic with thyroid nodules. All the participants were evaluated by ultrasound, fine needle aspiration cytology (FNAC) and sestamibi scintigraphy. All the participants were taken up for surgery and the resected specimen was sent for histopathology for confirmatory diagnosis. RESULTS Ultrasound and FNAC detected malignancy in 25 % of the participants, while sestamibi scintigraphy detected malignancy in 30 % of the participants. Based on histopathology, the gold standard confirmatory test, malignancy was detected in 35 % of the participants. It was observed that the sensitivity was highest for FNAC (75 %) followed by TC methoxyisobutylisonitrile (TC MIBI) (50 %). Specificity was highest for FNAC (95 %) followed by ultrasound (88 %) (P < 0.0001). CONCLUSIONS FNAC has the highest sensitivity and specificity while ultrasound and sestamibi have comparable specificity. There is a high probability of malignancy when the delayed image in sestamibi scintigraphy shows retention. MIBI may prove to be useful in differentiating benign and malignant follicular lesions. KEYWORDS Papillary Carcinoma, Histopathology, Thyroid Nodule, Sestamibi, FNAC

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Comparison between the ATS/ERS/JRS/ALAT criteria of 2011 and 2018 for Usual Interstitial Pneumonia on HRCT: a cross-sectional study

British Journal of Radiology ◽

10.1259/bjr.20201159 ◽

2021 ◽

Vol 94 (1120) ◽

pp. 20201159

Author(s):

Laura L. Wuyts ◽

Michael Camerlinck ◽

Didier De Surgeloose ◽

Liesbet Vermeiren ◽

David Ceulemans ◽

...

Keyword(s):

Interstitial Pneumonia ◽

Usual Interstitial Pneumonia ◽

Cross Sectional Study ◽

Classification Systems ◽

Sectional Study ◽

Diagnostic Agreement ◽

Cross Sectional ◽

Radiological Criteria ◽

Diagnostic Certainty ◽

Rater Variability

Objectives: To determine whether the revised 2018 ATS/ERS/JRS/ALAT radiological criteria for usual interstitial pneumonia (UIP) provide better diagnostic agreement compared to the 2011 guidelines. Methods: Cohort for this cross-sectional study (single center, nonacademic) was recruited from a multidisciplinary team discussion (MDD) from July 2010 until November 2018, with clinical suspicion of fibrosing interstitial lung disease (n= 325). Exclusion criteria were technical HRCT issues, known connective tissue disease (rheumatoid arthritis, systemic sclerosis, poly-or dermatomyositis), exposure to pulmonary toxins or lack of working diagnosis after MDD. Four readers with varying degrees in HRCT interpretation independently categorized 192 HRCTs, according to both the previous and current ATS/ERS/JRS/ALAT radiological criteria. An inter-rater variability analysis (Gwet’s second-order agreement coefficient, AC2) was performed. Results: The resulting Gwet’s AC2 for the 2011 and 2018 ATS/ERS/JRS/ALAT radiological criteria is 0.62 (±0.05) and 0.65 (±0.05), respectively. We report only minor differences in agreement level among the readers. Distribution according to the 2011 guidelines is as follows: 57.3% ‘UIP pattern’, 24% ‘possible UIP pattern’, 18.8% ‘inconsistent with UIP pattern’ and for the 2018 guidelines: 59.6% ‘UIP’, 14.5% ‘probable UIP’, 15.9% ‘indeterminate for UIP’ and 10% ‘alternative diagnosis’. Conclusions: No statistically significant higher degree of diagnostic agreement is observed when applying the revised 2018 ATS/ERS/JRS/ALAT radiological criteria for UIP compared to those of 2011. The inter-rater variability for categorizing the HRCT patterns is moderate for both classification systems, independent of experience in HRCT interpretation. The major advantage of the current guidelines is the better subdivision in the categories with a lower diagnostic certainty for UIP. Advances in knowledge: - In 2018, a revision of the 2011 ATS/ERS/JRS/ALAT radiological criteria for UIP was published, part of diagnostic guidelines for idiopathic pulmonary fibrosis. - The inter-rater agreement among radiologist is moderate for both classification systems, without a significantly higher degree of agreement when applying the revised radiological criteria.

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Association of thyroid nodules with adiposity: a community-based cross-sectional study in China

BMC Endocrine Disorders ◽

10.1186/s12902-018-0232-8 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 4

Author(s):

Bin Song ◽

Zhihua Zuo ◽

Juan Tan ◽

Jianjin Guo ◽

Weiping Teng ◽

...

Keyword(s):

Thyroid Nodules ◽

Cross Sectional Study ◽

Sectional Study ◽

Community Based ◽

Cross Sectional

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Ultrasonographic and Pathological Features of Surgically Excised Thyroid Nodules- A cross-sectional study

Journal of the Bahrain Medical Society ◽

10.26715/jbms.31_23122018 ◽

2019 ◽

Keyword(s):

Thyroid Nodules ◽

Cross Sectional Study ◽

Pathological Features ◽

Sectional Study ◽

Cross Sectional

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The Relationship and Gender Disparity Between Thyroid Nodules and Metabolic Syndrome Components Based on a Recent Nationwide Cross-Sectional Study and Meta-Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2021.736972 ◽

2021 ◽

Vol 12 ◽

Author(s):

Fan Zhang ◽

Yongze Li ◽

Xiaohui Yu ◽

Xichang Wang ◽

Zheyu Lin ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Central Obesity ◽

Thyroid Nodules ◽

Meta Analysis ◽

Cross Sectional Study ◽

Cochrane Library ◽

Sectional Study ◽

Cross Sectional ◽

The Relationship

BackgroundMetabolic syndrome (MetS) has a potential connection with thyroid disease, but its relationship with thyroid nodules (TNs) is still controversial. This study aims to clarify the relationship between MetS and TNs, and this relationship in the subgroup of gender.MethodsThe recent nationwide cross-sectional study called Thyroid Disorders, Iodine Status, and Diabetes Epidemiological survey provided the newest data on the relationship between MetS and TNs from China and included 56,729 subjects. We also researched related literature in PubMed, EMBASE, Cochrane Library, and MEDLINE until Oct 30, 2020, in order to perform a meta-analysis. The relevant articles were examined, and the eligible studies were included to assess the association between MetS and TNs.ResultsThe meta-analysis included 15 studies (involving 468,845 subjects). Of these, 14 studies were from the databases, and one study was this cross-sectional data. The meta-analysis showed that TNs were associated with a higher prevalence of MetS (OR=1.87, 95% CI: 1.44–2.45) and the components of MetS, including central obesity (OR=1.41, 95% CI: 1.15–1.72), hypertriglyceridemia (OR=1.13, 95% CI: 1.10–1.15), low high-density lipoprotein cholesterolemia (OR=1.11, 95% CI: 1.02–1.20), abnormal blood pressure (OR=1.68, 95% CI: 1.62–1.75), and hyperglycemia (OR=1.59, 95% CI: 1.46–1.74). Central obesity displayed gender differences, being a risk factor in males (OR=1.38, 95% CI: 1.02–1.86) but not in females (OR=1.47, 95% CI: 0.97–2.23).ConclusionTNs were indeed associated with a higher prevalence of MetS. In addition, its component diseases, such as central obesity, hypertriglyceridemia, abnormal blood pressure, and hyperglycemia, were also associated with TNs. Females with MetS or its components had a higher risk of suffering from TNs than males.

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Diagnostic Accuracy of Fine needle Aspiration Cytology of Thyroid Nodules at two tertiary Hospitals in Zambia: a cross-sectional study

University of Zambia Journal of Agricultural and Biomedical Sciences ◽

10.53974/unza.jabs.4.2.388 ◽

2020 ◽

Vol 4 (2) ◽

pp. 6-13

Author(s):

Jackson Chipaila ◽

◽

Alex Makupe ◽

Evans Malyangu ◽

Daniel Maswahu ◽

...

Keyword(s):

Thyroid Nodules ◽

Needle Aspiration ◽

Cross Sectional Study ◽

Sectional Study ◽

Aspiration Cytology ◽

Cross Sectional ◽

Predictive Values ◽

Tertiary Hospitals ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity

Introduction: Thyroid nodules are one of the common surgical presentations in Africa and are of great concern because of their potential to be malignant. Zambia is not excluded from these common surgical conditions. However, there are no pre-operative cellular or intra-operative tissue diagnoses of the thyroid nodules done before thyroidectomy making it difficult to plan for an optimal and definitive management. Fine needle aspiration cytology (FNAC) is known to play a pivotal role in the screening and management of thyroid swellings. This study serves to assess the diagnostic accuracy of FNAC on thyroid nodules in patients at two tertiary hospitals in Zambia in order to establish a basis for introducing its use in the management of thyroid nodules at the institutions. Objectives: To evaluate the accuracy of FNAC, as compared to histopathology, in the diagnosis of thyroid nodules at University Teaching Hospital (UTH) and Ndola Central Hospital (NCH) in Zambia. Methods: This was a prospective cross-sectional study conducted in UTH and NCH surgery department from June 2014 to March 2015. Seventy-three patients, who presented with palpable thyroid nodules and underwent thyroidectomy, were enrolled in the study. The FNAC diagnosis of the patients was compared to the histopathology finding following thyroidectomy. Results: Females made up the majority of the patients (n=67, 91.8%). The ages of the patients ranged from 18 to 78 years. The mean age was 44.3 years and the peak age of incidence was in the fourth decade. All patients were clinically euthyroid at the time of enrolment. The FNAC findings included 23 cases reported as unsatisfactory (31.5%); 29 cases benign (39.7%); 2 cases atypical (2.7%); 6 cases suspicious (8.2%); and 13 cases malignant (17.8%). Histopathology findings were available from all 73 tissue samples of participants, of which 55 (75.3%) and 18 (24.7%) were reported as benign and malignant respectively. Of the 18 malignant cases identified by histology, the most common cancer was follicular carcinoma (n=9, 50%), followed by papillary carcinoma (n=6, 33.3%) and undifferentiated carcinoma (n=3, 16.7%). FNAC, in this study, had sensitivity, specificity, negative and positive predictive values, and accuracy of 83.33%, 89.09%, 94.23 and 71.42%, and 87.67% respectively. Conclusion: In this study, FNAC of thyroid nodules had a high sensitivity, specificity, predictive values and accuracy, and can therefore be recommended to be adopted as a pre-operative tool for screening of thyroid nodules.

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