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thyroid nodule guidelines

M Brimioulle, A Al-Lami, S Marzouk, H Emerson, A Balfour, V Dhar, I J Nixon
Introduction The aim of this study was to determine whether ultrasound alone is sufficient to safely exclude malignancy in thyroid nodules in a district general hospital setting, to comply with the latest British Thyroid Association guidelines. Methods This retrospective study investigated the quality of ultrasound reporting and the correlation between ultrasound report and histology for individual thyroid nodules. Cases were selected from the thyroid multidisciplinary meeting and included all patients having undergone surgery for a thyroid malignancy in a one-year period...
March 15, 2018: Annals of the Royal College of Surgeons of England
Andrew S Griffin, Jason Mitsky, Upma Rawal, Abraham J Bronner, Franklin N Tessler, Jenny K Hoang
PURPOSE: The aim of this study was to compare the description and management recommendations for thyroid nodules before and after implementing a structured reporting template based on the ACR Thyroid Imaging Reporting and Data System (TI-RADS). METHODS: Thyroid ultrasound reports for seven private practice radiologists were analyzed in three phases. In phase 1, radiologists dictated in a free-text format. In phase 2, they used a structured reporting template based on the ACR TI-RADS lexicon, but without the ACR TI-RADS recommendations for nodule management...
March 1, 2018: Journal of the American College of Radiology: JACR
Sean D Raj, Rohit Ram, David J Sabbag, Mark A Sultenfuss, Rebecca Matejowsky
OBJECTIVE: Thyroid nodules are prevalent in over half the general population. Several multidisciplinary societies have management recommendations. However, the majority of data to support these guidelines are derived from studies of predominantly younger and female populations. This study's aim was to evaluate characteristics of thyroid nodules in a largely older and male Veteran population and apply these findings prospectively to reduce unnecessary thyroid fine needle aspiration (FNA)...
January 6, 2018: Current Problems in Diagnostic Radiology
Eun Ju Ha, Dong Gyu Na, Jung Hwan Baek, Jin Yong Sung, Ji-Hoon Kim, So Young Kang
Purpose To compare the diagnostic performance of ultrasonography (US)-based fine-needle aspiration biopsy (FNAB) criteria from seven international societies in the detection of thyroid malignancy. Materials and Methods This study included a total of 2000 consecutive thyroid nodules (≥1 cm) in 1802 patients with final diagnoses from January 2010 to May 2011. US features of the thyroid nodules were retrospectively reviewed and were classified according to the categories defined by the seven international society guidelines...
February 21, 2018: Radiology
Pierpaolo Trimboli, Luca Giovanella
Purpose: This study was undertaken to summarize the published data and to provide more robust estimates regarding the issue of core needle biopsy (CNB) for discriminating thyroid nodules with indeterminate fine-needle aspiration (FNA) results. Methods: The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The sources comprised studies published through November 2017. Original articles that investigated CNB in indeterminate thyroid lesions were searched...
January 2, 2018: Ultrasonography
Maria Trovato, Giuseppe Giuffrida, Antonino Seminara, Simone Fogliani, Vittorio Cavallari, Rosaria Maddalena Ruggeri, Alfredo Campennì
Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. On the contrary, primary thyroid lymphoma (PTL) is a rare disease, accounting for 2% to 5% of all thyroid malignancies. Despite several cases in which both PTC and PTL arise in the setting of Hashimoto's thyroiditis (HT), the coexistence of both tumors in HT patients is very rare. Herein we report the case of a 66-year-old woman with long-standing nodular HT under replacement therapy, who presented with a fast, painless enlargement in the right anterior side of the neck...
December 2017: Archives of Endocrinology and Metabolism
Karl-Michael Derwahl
Whereas in regions with sufficient iodide intake treatment of thyroid nodules with levothyroxine has been almost completely abandoned and is also not further recommended by guidelines, medical treatment may be still indicated in Germany as recently demonstrated by randomized, placebo-controlled LISA study.A major reason for this is mild iodide deficiency in patients with thyroid nodules. In LISA study a combined therapy of levothyroxine and iodide resulted in an at least 50 % reduction of nodular volume in 21,6 % of treated patient compared to in only 5,2 % of placebo-treated patients...
February 2018: Laryngo- Rhino- Otologie
Xuan V Nguyen, Kingshuk Roy Choudhury, Franklin N Tessler, Jenny K Hoang
<b>Background: </b>In many risk-stratification systems, the decision to biopsy thyroid nodules is determined by their sonographic features and size. Nevertheless, even small, low-suspicion nodules are often biopsied because it is assumed that larger malignant nodules are associated with poorer outcomes. The aim of this study was to quantify the effect of thyroid cancer tumor size on survival and risk of T4 stage, nodal disease, and distant metastases. <b>Methods: </b>The Surveillance, Epidemiology, and End Results (SEER) 18 database was queried to obtain tumor size, staging information, and survival data for cases of differentiated thyroid cancer (DTC) and non-differentiated thyroid cancer reported between 2004 and 2014...
January 26, 2018: Thyroid: Official Journal of the American Thyroid Association
Detlef K Bartsch, Markus Luster, Heinz J Buhr, Dietmar Lorenz, Christoph-Thomas Germer, Peter E Goretzki
BACKGROUND: Thyroidectomy is still three to six times more common in Germany than in the USA, Great Britain, and the Scandinavian countries. Thus, the question is often asked whether thyroidectomy in Germany is being performed for the correct indications. METHODS: This review is based on studies and guidelines containing information on the indications for surgery in benign goiter and Graves' disease; these publications were retrieved by a systematic literature search in the Medline and Cochrane Library databases (1990-2016)...
January 8, 2018: Deutsches Ärzteblatt International
Yeun-Yoon Kim, Kyunghwa Han, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Vivian Y Park, Jin Young Kwak
OBJECTIVE: The purpose of this study is to investigate follow-up strategies for cytologically benign thyroid nodules according to size and ultrasound (US) pattern according to the 2015 American Thyroid Association (ATA) guidelines in the era of the Bethesda system. MATERIALS AND METHODS: This retrospective study included 1208 patients with 1230 nodules that were cytologically benign at initial fine-needle aspiration performed from June 2012 to December 2014. False-negative rates (FNRs) were calculated by considering nodule size and US pattern according to the 2015 ATA guidelines and were compared between nodules with the high-suspicion US pattern and nodules with the high- or intermediate-suspicion US patterns according to size...
January 11, 2018: AJR. American Journal of Roentgenology
Lili Zhang, Yujiang Liu, Xiaoqu Tan, Xi Liu, Hong Zhang, Linxue Qian
OBJECTIVES: To compare the adequacy of 23-, 25-, and 27-gauge needles in the fine-needle aspiration biopsy of thyroid nodules to develop guidelines for the collection of better specimens for cytologic diagnosis. METHODS: This randomized prospective study included 156 consecutively enrolled patients with 156 nodules. Each nodule was aspirated with a needle of each size. The obtained specimens were analyzed independently by 2 cytopathologists, and adequacy rates were calculated...
December 30, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Luying Gao, Ruyu Liu, Yuxin Jiang, Wenfeng Song, Ying Wang, Jia Liu, Juanjuan Wang, Dongqian Wu, Shuai Li, Aimin Hao, Bo Zhang
BACKGROUND: The purpose of this study was to compare the diagnostic efficiency of a thyroid ultrasound computer-aided diagnosis (CAD) system with that of 1 radiologist. METHODS: This study retrospectively reviewed 342 surgically resected thyroid nodules from July 2013 to December 2013 at our center. The nodules were assessed on typical ultrasound images using the CAD system and reviewed by 1 experienced radiologist. The radiologist stratified the risk of malignancy using the Thyroid Imaging Reporting and Data Systems (TIRADS) and the American Thyroid Association (ATA) guidelines...
December 29, 2017: Head & Neck
Jung Min Bae, Soo Yeon Hahn, Jung Hee Shin, Eun Young Ko
OBJECTIVE: To investigate the inter-exam agreement for thyroid nodule between real-time ultrasonography (US) assessment and retrospective US interpretation and to compare the diagnostic performance between two methods by using the most recently published guidelines for the US-based management of thyroid nodules, the Korean Thyroid Imaging Reporting and Data System (K-TIRADS). METHODS: The study included 253 nodules in 238 patients for the inter-exam agreement and 201 nodules in 190 patients for the diagnostic performance...
January 2018: European Journal of Radiology
C J Auernhammer, M Reincke
When investigating many endocrinological diseases, basal laboratory parameters are not sufficient to distinguish between physiological and pathological hormone secretion. Functional diagnostics plays a decisive role in this context. Stimulation and suppression tests are used depending on whether under- or over-function needs to be diagnosed. This review article discusses selected functional tests, each of which plays an important role in current guidelines. Indications and test principles, including their performance, reliability, and limitations, are discussed...
January 2018: Der Internist
Deborah Pencharz, Malavika Nathan, Thomas L Wagner
Focal incidental uptake, with or without CT abnormalities, is a common finding on FDG PET/CT and evidence based management for this type of uptake is lacking. This article reviews the evidence on focal incidental uptake including the incidence of malignancy, differential diagnosis and imaging criteria which can be used to further characterise it. The article focusses on PET rather than CT criteria. The strength of the evidence base is highly variable ranging from systematic reviews and meta-analyses to a virtual absence of evidence...
December 15, 2017: British Journal of Radiology
Jieun Koh, Soo-Yeon Kim, Hye Sun Lee, Eun-Kyung Kim, Jin Young Kwak, Hee Jung Moon, Jung Hyun Yoon
Background The differences regarding categorization of thyroid nodules among different guidelines may affect the diagnostic performances and agreement among observers. Purpose To compare the diagnostic performances and agreements between observers with various degree of experience when applying different guidelines for stratifying thyroid nodules using suspicious ultrasonography (US) features. Material and Methods This retrospective study included 370 thyroid nodules (≥10 mm). Four observers, grouped as experienced and inexperienced, evaluated the US features and made final assessments according to the Kim criteria, Thyroid Imaging Reporting and Data System (TIRADS) by Kwak et al...
January 1, 2017: Acta Radiologica
Manuel Penín, M Ángeles Martín, Beatriz San Millán, Juana García
BACKGROUND: Fine-needle aspiration biopsy (FNAB) is the reference procedure for thyroid nodule evaluation. Its main limitation are inadequate samples, which should be less than 20%. OBJECTIVE: To analyze the learning curve of the procedure by comparing the results of a non-experienced endocrinologist (endocrinologist 2) to those of an experienced one (endocrinologist 1). MATERIAL AND METHODS: Sixty FNABs were analyzed from February to June 2016...
December 2017: Endocrinología, Diabetes y Nutrición
Gilles Russ, Steen J Bonnema, Murat Faik Erdogan, Cosimo Durante, Rose Ngu, Laurence Leenhardt
Thyroid ultrasound (US) is a key examination for the management of thyroid nodules. Thyroid US is easily accessible, noninvasive, and cost-effective, and is a mandatory step in the workup of thyroid nodules. The main disadvantage of the method is that it is operator dependent. Thyroid US assessment of the risk of malignancy is crucial in patients with nodules, in order to select those who should have a fine needle aspiration (FNA) biopsy performed. Due to the pivotal role of thyroid US in the management of patients with nodules, the European Thyroid Association convened a panel of international experts to set up European guidelines on US risk stratification of thyroid nodules...
September 2017: European Thyroid Journal
Somboon Keelawat, Samreung Rangdaeng, Supinda Koonmee, Tikamporn Jitpasutham, Andrey Bychkov
Thyroid carcinoma is one of the leading malignancies in Thailand increasingly prevalent in the female population. Fine-needle aspiration (FNA) cytology is a widely used diagnostic tool for evaluation of thyroid nodules and thyroid cancer. Thyroid FNA is a routine procedure universally performed in Thai hospitals by a variety of clinical specialists. Manual guidance is the first-line choice complemented by ultrasound assistance in selected cases. Despite national guidelines recommendations, the diagnostic criteria and terminology of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was slowly adopted in the local settings...
November 2017: Journal of Pathology and Translational Medicine
Pablo Valderrabano, Laila Khazai, Zachary J Thompson, Susan C Sharpe, Valentina D Tarasova, Kristen J Otto, Julie E Hallanger-Johnson, J Trad Wadsworth, Bruce M Wenig, Christine H Chung, Barbara A Centeno, Bryan McIver
BACKGROUND: Indeterminate categories of thyroid cytopathology (categories B-III and B-IV of the Bethesda system) are integrated by a heterogeneous spectrum of cytological scenarios that are generally clustered for analysis and management recommendations. It has been suggested that aspirates exhibiting nuclear atypia have a higher risk of malignancy. This study aimed to assess whether cytologically indeterminate thyroid nodules with nuclear atypia have a significantly higher cancer risk than those without nuclear atypia...
February 2018: Thyroid: Official Journal of the American Thyroid Association
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