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Approach to a thyroid nodule

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https://www.readbyqxmd.com/read/28898614/-fine-needle-aspiration-of-thyroid-nodules-is-it-worth-repeating
#1
Vera Fernandes, Tânia Pereira, Catarina Eloy
INTRODUCTION: The fine-needle aspiration has a significant role in assessing the malignancy risk of thyroid nodules. There is uncertainty regarding the value of repeat fine-needle aspiration in benign nodules. This study aims to evaluate the concordance of results in consecutive fine-needle aspiration and to study the relevance of repetition in benign results. MATERIAL AND METHODS: Retrospective study of the 4800 thyroid nodules fine-needle aspiration held in Instituto de Patologia e Imunologia Molecular da Universidade do Porto between January 1, 2014 and May 2, 2016...
June 30, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28872097/robot-assisted-thyroidectomy-using-a-gasless-transaxillary-approach-for-the-management-of-thyroid-lesions-indian-experience
#2
S P Somashekhar, K R Ashwin
AIM: Since last decades, more and more thyroidectomies have been performed by the minimally invasive method. Compared to conventional thyroidectomy, minimally invasive thyroidectomy has a superior cosmetic result. However, the outcome depends, in a large extent, on the skill of the operator and the learning curve is relatively long. Robotic thyroidectomy (RT) is a relatively new approach in treating thyroid lesions with improved ergonomics and surgical outcomes. PURPOSE: We performed a prospective study of robotic-assisted transaxillary approach for thyroidectomy in Indian patients to examine the feasibility of the procedure...
October 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28806881/cancer-risk-stratification-of-indeterminate-thyroid-nodules-a-cytological-approach
#3
Pablo Valderrabano, Laila Khazai, Zachary J Thompson, Marino E Leon, Kristen J Otto, Julie E Hallanger-Johnson, J Trad Wadsworth, Bruce M Wenig, Christine H Chung, Barbara A Centeno, Bryan McIver
BACKGROUND: Management recommendations for thyroid nodules rely primarily on the cytological diagnosis. However, 25% of biopsies render an indeterminate cytology for which management decision is more challenging due to heterogeneity of the specimens. This study aimed to stratify the cancer risk through subcategorization of indeterminate cytology. METHODS: The indeterminate cytological specimens (Bethesda-III or IV) of 518 thyroid nodules consecutively evaluated at our academic cancer center between October 2008 and September 2015, blinded to the histological outcome, were retrospectively reviewed...
September 14, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28762196/ultrasound-image-based-thyroid-nodule-automatic-segmentation-using-convolutional-neural-networks
#4
Jinlian Ma, Fa Wu, Tian'an Jiang, Qiyu Zhao, Dexing Kong
PURPOSE: Delineation of thyroid nodule boundaries from ultrasound images plays an important role in calculation of clinical indices and diagnosis of thyroid diseases. However, it is challenging for accurate and automatic segmentation of thyroid nodules because of their heterogeneous appearance and components similar to the background. In this study, we employ a deep convolutional neural network (CNN) to automatically segment thyroid nodules from ultrasound images. METHODS: Our CNN-based method formulates a thyroid nodule segmentation problem as a patch classification task, where the relationship among patches is ignored...
July 31, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28749104/platelet-distribution-width-and-serum-albumin-levels-for-discrimination-of-thyroid-cancer-from-benign-thyroid-nodules
#5
Na Li, Shuang Fu, Ming-Ming Cui, Ye Niu, Baoxin Li, Zhi-Ping Liu, Tiemin Liu, Rui-Tao Wang
Thyroid cancer is the most rapidly increasing cancer type among women and the second among men. Early detection greatly improves the prognosis. For this purpose, the platelet distribution width (PDW), an early indicator of platelet activation, might be useful. The aim of this study was to investigate the ability of PDW and serum albumin levels individually or in combination to distinguish between thyroid cancer and benign thyroid nodules. A total of 265 patients with thyroid cancer and 243 with benign thyroid nodules were included in a development set...
July 27, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28734529/ultrasound-based-differentiation-of-malignant-and-benign-thyroid-nodules-an-extreme-learning-machine-approach
#6
Jianfu Xia, Huiling Chen, Qiang Li, Minda Zhou, Limin Chen, Zhennao Cai, Yang Fang, Hong Zhou
BACKGROUND AND OBJECTIVES: It is important to be able to accurately distinguish between benign and malignant thyroid nodules in order to make appropriate clinical decisions. The purpose of this study was to improve the effectiveness and efficiency for discriminating the malignant from benign thyroid cancers based on the Ultrasonography (US) features. METHODS: There were 114 benign nodules in 106 patients (82 women and 24 men) and 89 malignant nodules in 81 patients (69 women and 12 men) included in this study...
August 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28726141/transoral-robotic-thyroidectomy-lessons-learned-from-an-initial-consecutive-series-of-24-patients
#7
Hoon Yub Kim, Young Jun Chai, Gianlorenzo Dionigi, Angkoon Anuwong, Jeremy D Richmon
BACKGROUND: Transoral thyroid surgery is an ideal method for minimally invasive thyroidectomy, as there is less flap dissection during the procedure and no postoperative scars. Nonetheless, technical obstacles have precluded the wide dissemination of this procedure. We present the surgical procedures and outcomes of transoral robotic thyroidectomy (TORT). METHODS: From September 2012 to June 2016, we performed TORT at Korea University Hospital. We used three intraoral ports and a single axillary port for the system's four robotic arms...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28717869/transoral-endoscopic-thyroidectomy-vestibular-approach-toetva-indications-techniques-and-results
#8
Angkoon Anuwong, Thanyawat Sasanakietkul, Pornpeera Jitpratoom, Khwannara Ketwong, Hoon Yub Kim, Gianlorenzo Dionigi, Jeremy D Richmon
INTRODUCTION: The Transoral Neck Surgery (TONS) Study Group was established at the 1st International Thyroid NOTES Conference in February 2016 with the intention of standardizing and refining thyroid NOTES techniques, including both transoral endoscopic and robotic thyroidectomy approaches. Herein, the authors report the modification of indications, preparation, and step-by-step explanations for operative techniques, as well as results and postoperative care for transoral endoscopic thyroidectomy vestibular approach (TOETVA)...
July 17, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28713699/transoral-thyroidectomy-why-is-it-needed
#9
REVIEW
Gianlorenzo Dionigi, Matteo Lavazza, Chei-Wei Wu, Hui Sun, Xiaoli Liu, Ralph P Tufano, Hoon Yub Kim, Jeremy D Richmon, Angkoon Anuwong
Transoral thyroidectomy (TOT) represents reasonably the desirable minimally invasive approach to the gland due to the scarless non-visible incisions, the limited distance between the gland and the access that minimize tissue dissection and respect of the surgical anatomical planes. Patients are routinely selected according to an extensive inclusion criteria: (I) ultrasonographically (US) estimated thyroid diameter not larger than 10 cm; (II) US gland volume ≤45 mL; (III) nodule size ≤50 mm; (IV) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter; (V) follicular neoplasm; (VI) papillary microcarcinoma without lymph node metastasis...
June 2017: Gland Surgery
https://www.readbyqxmd.com/read/28699306/strategies-for-building-a-successful-ultrasound-guided-fna-practice-in-department-of-pathology-experience-at-a-university-hospital
#10
Maoxin Wu, Kenneth R Shroyer
INTRODUCTION: Although pathology services focused on fine needle aspiration (FNA) biopsy of superficial palpable masses with on-site cytological evaluation are available in a wide range of clinical and academic settings, the addition of ultrasound (US) guidance into FNA practice by a cytopathologist group can be challenging. An US-FNA service provided by a cytopathologist in the department of Pathology is a relatively new practice in the field of medicine. This report summarizes our experience and strategies in achieving this objective and our successful preliminary results...
July 11, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28695342/thyroid-nodule-classification-in-ultrasound-images-by-fine-tuning-deep-convolutional-neural-network
#11
Jianning Chi, Ekta Walia, Paul Babyn, Jimmy Wang, Gary Groot, Mark Eramian
With many thyroid nodules being incidentally detected, it is important to identify as many malignant nodules as possible while excluding those that are highly likely to be benign from fine needle aspiration (FNA) biopsies or surgeries. This paper presents a computer-aided diagnosis (CAD) system for classifying thyroid nodules in ultrasound images. We use deep learning approach to extract features from thyroid ultrasound images. Ultrasound images are pre-processed to calibrate their scale and remove the artifacts...
July 10, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28689321/underestimated-risk-of-cancer-in-solitary-thyroid-nodules-%C3%A2-3%C3%A2-cm-reported-as-benign
#12
Sohail Bakkar, Anello Marcello Poma, Caterina Corsini, Mario Miccoli, Carlo Enrico Ambrosini, Paolo Miccoli
BACKGROUND: The study aims to assess the risk of cancer in solitary thyroid nodules ≥30 mm in size reported as Bethesda II, and its implications. METHOD: The clinical records of 202 patients, who underwent thyroid lobectomy for solitary nodules measuring ≥30 mm, reported as Bethesda II on preoperative FNAC between Jan 2015 and Apr 2016 were reviewed. Data collected included nodule size and consistency, and final histopathology results. The risk of cancer and the recommended management according to ATA guidelines were the outcomes of interest...
July 8, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28672797/integrity-and-quantity-of-total-cell-free-dna-in-the-diagnosis-of-thyroid-cancer-correlation-with-cytological-classification
#13
Francesca Salvianti, Corinna Giuliani, Luisa Petrone, Irene Mancini, Vania Vezzosi, Cinzia Pupilli, Pamela Pinzani
Cell-free DNA (cfDNA) quantity and quality in plasma has been investigated as a non-invasive biomarker in cancer. Previous studies have demonstrated increased cfDNA amount and length in different types of cancer with respect to healthy controls. The present study aims to test the hypothesis that the presence of longer DNA strands circulating in plasma can be considered a biomarker for tumor presence in thyroid cancer. We adopted a quantitative real-time PCR (qPCR) approach based on the quantification of two amplicons of different length (67 and 180 bp respectively) to evaluate the integrity index 180/67...
June 24, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28567694/a-novel-surgery-technique-non-visual-dissection-for-establishing-the-operating-space-during-total-endoscopic-thyroidectomy
#14
Chunxiao Yang, Yingluan Wang
BACKGROUND: Patients and surgeons are typically satisfied with the cosmetic results of total endoscopic thyroidectomy using the complete areola approach. However, the disadvantages of this approach include an excessive free flap and a longer operative time. METHODS: A retrospective analysis was conducted in 72 patients (64 women and 8 men) with a benign thyroid nodule who underwent non-unvisual dissection to establish the operating space for endoscopic surgery. RESULTS: The time needed to create the operating space in the chest was 6...
May 31, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28540810/minimally-invasive-local-ablative-therapies-in-combination-with-radioiodine-therapy-in-benign-thyroid-disease-preparation-feasibility-and-efficiency-preliminary-results
#15
Alexander Mader, Oscar Maximilian Mader, Daniel Gröner, Yücel Korkusuz, Shadi Ahmad, Frank Grünwald, W Tilman Kranert, Christian Happel
PURPOSE: Initial studies of combinations of radioiodine therapy (RIT) and local ablative procedures for the treatment of thyroid nodules have shown promising results. The goal of this study was to evaluate the effectiveness of RIT combined with radiofrequency ablation (RFA) in patients with goitres and to determine which ablative procedure is the most suitable for a combined therapy. METHODS: Thirty patients with goitres were divided into two subgroups. A test group of 15 patients received combined therapy (RIT + RFA) and a control group of 15 patients received RIT mono therapy...
May 5, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28537891/multiplex-pcr-approach-to-simultaneously-identify-several-mutations-in-fine-needle-cytology-thyroid-samples
#16
Emilia Vuttariello, Marco Borra, Elvira Mauriello, Celeste Calise, Barbara D'Andrea, Anna Capiluongo, Franco Fulciniti, Anna Cipolletta, Mario Monaco, Luciano Pezzullo, Gennaro Chiappetta
The most frequent initial manifestation of thyroid cancer is the appearance of a nodule. More than 20% of the general population has a palpable thyroid nodule and the percentage rises to 70% based on ultrasound identification. In 95% of cases the nodule is simply a hyperplastic or benign lesion. The most reliable diagnostic test for thyroid nodules is fine needle aspiration (FNA), but cytological discrimination between malignant and benign follicular neoplasms remains difficult. Cytological analysis is now, almost routinely, being combined with molecular genetics to enable the pathologist to make a more objective diagnosis...
July 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28523498/maldi-msi-analysis-of-cytological-smears-the-study-of-thyroid-cancer
#17
Niccolò Mosele, Andrew Smith, Manuel Galli, Fabio Pagni, Fulvio Magni
Fine needle aspiration (FNA) biopsies are the current gold-standard for the preoperative evaluation of thyroid nodules. However, a significant number of them (15-30%) are unable to be affirmatively diagnosed and are given an "indeterminate for malignancy" final report, meaning that the malignant nature of the thyroid nodule remains unknown and the recommended therapeutic approach is total thyroidectomy. Furthermore, cytomorphological evaluation of biopsies taken post-surgery indicates that approximately 80% of nodules within this group of patients are in fact benign, and the total thyroidectomy unwarranted...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28521616/a-10-gene-classifier-for-indeterminate-thyroid-nodules-development-and-multicenter-accuracy-study
#18
Hernán E González, José R Martínez, Sergio Vargas-Salas, Antonieta Solar, Loreto Veliz, Francisco Cruz, Tatiana Arias, Soledad Loyola, Eleonora Horvath, Hernán Tala, Eufrosina Traipe, Manuel Meneses, Luis Marín, Nelson Wohllk, René E Diaz, Jesús Véliz, Pedro Pineda, Patricia Arroyo, Natalia Mena, Milagros Bracamonte, Giovanna Miranda, Elsa Bruce, Soledad Urra
BACKGROUND: In most of the world, diagnostic surgery remains the most frequent approach for indeterminate thyroid cytology. Although several molecular tests are available for testing in centralized commercial laboratories in the United States, there are no available kits for local laboratory testing. The aim of this study was to develop a prototype in vitro diagnostic (IVD) gene classifier for the further characterization of nodules with an indeterminate thyroid cytology. METHODS: In a first stage, the expression of 18 genes was determined by quantitative polymerase chain reaction (qPCR) in a broad histopathological spectrum of 114 fresh-tissue biopsies...
August 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28506419/radioguided-thyroidectomy-for-follicular-tumors-multicentric-experience
#19
D Parmeggiani, C Gambardella, R Patrone, A Polistena, M De Falco, R Ruggiero, R Cirocchi, A Sanguinetti, V Cuccurullo, M Accardo, N Avenia, G Docimo, S Tolone, V Bassi, L Docimo, G Conzo
BACKGROUND: The diagnosis of thyroid nodular diseases requires an integrated approach that has been widely established over the past years. This strategy includes: ultrasonography (US) with; implemented Color-Power-Doppler, conventional scintigraphy also with positive indicators, specific pathological studies targeted by immunohistochemically-assays, and the fine needle; aspiration biopsy (FNAB), which, usually, in case of "Follicular Lesions" (10-20%) findings is; unable to distinguish carcinoma from follicular adenoma, then indicating the necessity of surgery to; obtain a correct diagnosis...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28506417/new-perspectives-in-the-diagnosis-of-thyroid-follicular-lesions
#20
REVIEW
Enke Baldini, Salvatore Sorrenti, Francesco Tartaglia, Antonio Catania, Andrea Palmieri, Daniele Pironi, Angelo Filippini, Salvatore Ulisse
Thyroid nodules are very common, affecting 19%-67% of the adult population. However, about 10% of them harbor a malignant lesion. Consequently, the first aim in their clinical evaluation is to exclude malignancy. Fine-needle aspiration cytology (FNAC) represents the main diagnostic tool for the evaluation of thyroid nodules. However, FNAC has a main diagnostic limit, namely cellular atypias of indeterminate significance, which require surgical excision and histological examination to differentiate benign from malignant lesions...
May 2017: International Journal of Surgery
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