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Thyroid nodule management

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https://www.readbyqxmd.com/read/28537891/multiplex-pcr-approach-to-simultaneously-identify-several-mutations-in-fine-needle-cytology-thyroid-samples
#1
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...
May 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28534687/role-of-molecular-markers-in-thyroid-nodule-management-then-and-now
#2
Yuri E Nikiforov
OBJECTIVE: To describe the evolution and clinical utility of molecular testing for thyroid nodules and cancer achieved over the last two decades. METHODS: Scientific reports on thyroid cancer genetics and molecular diagnostics in thyroid nodules. RESULTS: Over the last two decades, our understanding of the genetic mechanisms of thyroid cancer has dramatically expanded, such that most thyroid cancers now have known gene driver events. This knowledge provides the basis for establishing and further improving molecular tests for thyroid nodules and cancer and for the introduction of new entities such as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)...
May 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28506415/risk-of-malignancy-in-thyroid-nodules-classified-as-tir-3a-what-therapy
#3
Fabio Medas, Enrico Erdas, Luca Gordini, Giovanni Conzo, Claudio Gambardella, Gian Luigi Canu, Giuseppe Pisano, Angelo Nicolosi, Pietro Giorgio Calò
BACKGROUND: The aim of the present study was to assess the clinical applicability of the TIR3A category in managing thyroid nodules, to examine the malignancy rates of TIR 3A and TIR 3B nodules, and to suggest management guidelines for these nodules. MATERIALS AND METHODS: Thyroid cytologies performed in patients referred to our Department between January 2014 and August 2016 were classified according to the guidelines published by the SIAPEC. 102 cases were included in this retrospective study and were divided into two groups: 19 TIR3A were included in group A and 83 TIR3B in group B...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28481909/the-thyroid-cancer-policy-model-a-mathematical-simulation-model-of-papillary-thyroid-carcinoma-in-the-u-s-population
#4
Carrie Lubitz, Ayman Ali, Tiannan Zhan, Curtis Heberle, Craig White, Yasuhiro Ito, Akira Miyauchi, G Scott Gazelle, Chung Yin Kong, Chin Hur
BACKGROUND: Thyroid cancer affects over ½ million people in the U.S. and the incidence of thyroid cancer has increased worldwide at a rate higher than any other cancer, while survival has remained largely unchanged. The aim of this research was to develop, calibrate and verify a mathematical disease model to simulate the natural history of papillary thyroid cancer, which will serve as a platform to assess the effectiveness of clinical and cancer control interventions. METHODS: Herein, we modeled the natural pre-clinical course of both benign and malignant thyroid nodules with biologically relevant health states from normal to detected nodule...
2017: PloS One
https://www.readbyqxmd.com/read/28476228/molecular-genetics-of-thyroid-cancer-in-children-and-adolescents
#5
REVIEW
Andrew J Bauer
There has been a steady incorporation of powerful new molecular tools into the evaluation and management of thyroid nodules and thyroid cancer. With an increasing incidence of nodules and differentiated thyroid cancer (DTC) being diagnosed in children and adolescents, oncogene data are providing insight into the clinical differences between pediatric and adult patients with histologically similar DTC. However, additional investment and efforts are needed to define the genomic landscape for pediatric DTC with the goal of improving preoperative diagnostic accuracy as well as stratifying treatment in an effort to reduce complications of therapy...
June 2017: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/28463597/cytology-ultrasonography-risk-stratification-scoring-system-based-on-fine-needle-aspiration-cytology-and-the-korean-thyroid-imaging-reporting-and-data-system
#6
Min Ji Hong, Dong Gyu Na, Jung Hwan Baek, Jin Yong Sung, Ji-Hoon Kim
BACKGROUND: The malignancy risk of a cytology diagnosis may depend on the ultrasonography (US) patterns of thyroid nodules, and management should be determined by the combined malignancy risk of fine-needle aspiration (FNA) cytology and US patterns. This study was performed to develop a clinically applicable cytology-ultrasonography (CU) scoring system for malignancy risk stratification based on FNA cytology and US patterns, according to the Korean-Thyroid Imaging Reporting and Data System (K-TIRADS)...
May 19, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28448992/bethesda-made-it-clearer-a-review-of-542-patients-in-a-single-institution
#7
Yunus Acar, Lütfi Doğan, H Erhan Güven, Bülent Aksel, Niyazi Karaman, Cihangir Özaslan, M Ali Gülçelik
BACKGROUND: It is essential to interpret fine needle aspiration biopsy (FNAB) material correctly to create a common language among pathologists and surgeons, leading to a uniform approach to thyroid nodule management. We aimed to compare FNAB reports of patients at our institution who were treated with total thyroidectomy, before and after the Bethesda classification system. PATIENTS AND METHODS: Patients who underwent total thyroidectomy for thyroid nodules are reviewed...
2017: Oncology Research and Treatment
https://www.readbyqxmd.com/read/28441815/-the-interpretation-of-2015-american-thyroid-association-management-guidelines-for-adult-patients-with-thyroid-nodules-and-differentiated-thyroid-cancer
#8
X Y Li, B Zhang, Y S Lin
The prevalence of thyroid nodules, especially differentiated thyroid cancer, has increased during the past decades. With the consideration of increasing prevalence of the diseases, American Thyroid Association (ATA) updated the guidelines for adult patients with thyroid nodules and differentiated thyroid carcinoma (DTC) in 2015. The aim of the new guidelines was to minimize potential harm from overtreatment in majority of patients at low risk for diseasespecific mortality and morbidity while appropriately treat and monitor those patients at higher risk...
April 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28426843/understanding-the-risks-and-harms-of-management-of-incidental-thyroid-nodules-a-review
#9
Jenny K Hoang, Xuan V Nguyen
Importance: Incidental thyroid nodules are defined as nodules originally detected in a patient with no thyroid-related clinical symptoms, examination findings, or suspected thyroid disease. Medical imaging for diseases in the neck, chest, and spine is a common source of incidental thyroid nodules. They are easily detected but poorly characterized. The next step is to decide whether the incidental thyroid nodule should be further evaluated with ultrasonography. Observations: Indiscriminate workup of incidental thyroid nodules with ultrasonography is not cost-effective and is potentially harmful...
April 20, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28423960/the-role-of-molecular-diagnostic-testing-in-the-management-of-thyroid-nodules
#10
Maureen D Moore, Suraj Panjwani, Katherine D Gray, Brendan M Finnerty, Rasa Zarnegar, Thomas J Fahey
Fine needle aspiration (FNA) with cytologic examination remains the standard of care for investigation of thyroid nodules. However, as many as 30% of FNA samples are cytologically indeterminate for malignancy, which confounds clinical management. To reduce the burden of repeat diagnostic testing and unnecessary surgery, there has been extensive investigation into molecular markers that can be detected on FNA specimens to more accurately stratify a patient's risk of malignancy. Areas covered: In this review, the authors discuss recent evidence and progress in molecular markers used in the diagnosis of thyroid cancer highlighting somatic gene alterations, molecular technologies and microRNA analysis...
April 28, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28422844/ultrasound-is-helpful-to-differentiate-bethesda-class-iii-thyroid-nodules-a-prisma-compliant-systematic-review-and-meta-analysis
#11
REVIEW
Lu-Ying Gao, Ying Wang, Yu-Xin Jiang, Xiao Yang, Ru-Yu Liu, Xue-Hua Xi, Shen-Ling Zhu, Rui-Na Zhao, Xing-Jian Lai, Xiao-Yan Zhang, Bo Zhang
BACKGROUND: Fine-needle aspiration (FNA) is the most dependable tool to triage thyroid nodules for medical or surgical management. However, Bethesda class III cytology, namely "follicular lesion of undetermined significance" (FLUS) or "atypia of undetermined significance" (AUS), is a major limitation of the US-FNA in assessing thyroid nodules. As the most important imaging method, ultrasound (US) has a high efficacy in diagnosing thyroid nodules. This meta-analysis aimed to assess the role of US in evaluating Bethesda class III thyroid nodules...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421812/the-frequency-of-incidental-findings-and-subsequent-evaluation-in-low-dose-ct-scans-for-lung-cancer-screening
#12
Lillie Morgan, Humberto Choi, Michal Reid, Ali Khawaja, Peter J Mazzone
RATIONALE: The USPSTF recommends lung cancer screening with low-dose chest CT scans (LDCT) for a well-defined high-risk population. Data on the frequency and impact of incidental findings on LDCT scans performed within a centralized lung cancer screening program has not been reported. OBJECTIVES: Previous studies have reported IFs in the setting of clinical trials. We present our findings in a real clinical setting where the decision to manage these findings may depend on factors that are not captured in a research trial such as disclosing IFs, patient preferences, severity of comorbidities, and physician expertise...
April 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28402167/multiinstitutional-analysis-of-thyroid-nodule-risk-stratification-using-the-american-college-of-radiology-thyroid-imaging-reporting-and-data-system
#13
William D Middleton, Sharlene A Teefey, Carl C Reading, Jill E Langer, Michael D Beland, Margaret M Szabunio, Terry S Desser
OBJECTIVE: Guidelines for managing thyroid nodules are highly dependent on risk stratification based on sonographic findings. The purpose of this study is to evaluate the risk stratification system used by the American College of Radiology Thyroid Imaging Reporting and Data System (TIRADS). MATERIALS AND METHODS: Patients with thyroid nodules who underwent sonography and fine-needle aspiration were enrolled in a multiinstitutional study. The sonographic nodule features evaluated in the study were composition, echogenicity, margins, and echogenic foci...
April 12, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28397856/1-5-2%C3%A2-cm-tumor-size-was-not-associated-with-distant-metastasis-and-mortality-in-small-thyroid-cancer-a-population-based-study
#14
Kyunghwa Han, Eun-Kyung Kim, Jin Young Kwak
Most guidelines for the diagnosis and management of thyroid nodules have suggested fine-needle aspiration as a diagnostic tool, with some of these previously published guidelines suggesting a cutoff size of 1.5 cm. In thyroid cancers (1-2 cm), we hypothesized that tumors 1.5 cm or larger had more unfavorable clinical outcomes than ones smaller than 1.5 cm nodules. Using the Surveillance, Epidemiology, and End Results database, we identified 14,117 patients diagnosed with only primary thyroid cancer between 1988 and 2007...
April 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28397450/bethesda-system-in-the-evaluation-of-thyroid-nodules-review
#15
REVIEW
Marta Wesoła, Michał Jeleń
Fine needle aspiration (FNA) biopsy is an important and widely accepted method used in the diagnosis of patients with thyroid nodules.The lack of consistency in reporting FNA taken from the thyroid gland has led to divergences in the calculation of the sensitivity and specificity of the method. Discrepancies depend on what was considered to be true or false negative/positive. This resulted in confusion among doctors, who had to decide how to manage the patient with constantly changing positive or negative results of the FNA...
January 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28389487/what-is-the-care-pathway-of-patients-who-undergo-thyroid-surgery-in-france-and-its-potential-pitfalls-a-national-cohort
#16
Muriel Mathonnet, Anne Cuerq, Christophe Tresallet, Jean-Christophe Thalabard, Elisabeth Fery-Lemonnier, Gilles Russ, Laurence Leenhardt, Claude Bigorgne, Philippe Tuppin, Bertrand Millat, Anne Fagot-Campagna
CONTEXT: The rate of thyroid cancer is increasing in France, as well as concerns about overdiagnosis and treatment. OBJECTIVES: To examine the care pathway of patients who undergo thyroid surgery in France and detect potential pitfalls. DESIGN: A large observational study based on medical reimbursements, 2009-2011. SETTING: Data from the Sniiram (National Health Insurance Information System). PATIENTS: Patients with thyroid surgery in 2010, classified into 4 groups: thyroid cancer, benign nodule, goitre or multiple nodules, other (hyperthyroidism, head-neck cancer)...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28387647/management-of-childhood-thyroid-nodules-surgical-and-endocrinological-experience-in-more-than-one-hundred-cases
#17
Emre Divarcı, Ülgen Celtik, Zafer Dökümcü, Orkan Ergün, Geylani Özok, Samim Özen, Damla Gökşen Şimşek, Şükran Darcan, Nazan Çetingül, Aylin Oral, Yeşim Ertan, Bengü Demirağ, Ahmet Çelik
OBJECTIVE: The management of childhood thyroid nodules is still a big challenge for clinicians. In this study, we aimed to present our surgical and endocrinological experience in more than one hundred cases as a large experience in children. METHODS: Retrospective analysis of patients admitted with a thyroid nodule between 2006-2014 was performed. Detailed ultrasonography and fine needle aspiration biopsy(FNAB) were the corner stones of the diagnostic approach. RESULTS: One hundred-three children(72F,31M) with a mean age of 13...
April 7, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28372962/acr-thyroid-imaging-reporting-and-data-system-ti-rads-white-paper-of-the-acr-ti-rads-committee
#18
Franklin N Tessler, William D Middleton, Edward G Grant, Jenny K Hoang, Lincoln L Berland, Sharlene A Teefey, John J Cronan, Michael D Beland, Terry S Desser, Mary C Frates, Lynwood W Hammers, Ulrike M Hamper, Jill E Langer, Carl C Reading, Leslie M Scoutt, A Thomas Stavros
Thyroid nodules are a frequent finding on neck sonography. Most nodules are benign; therefore, many nodules are biopsied to identify the small number that are malignant or require surgery for a definitive diagnosis. Since 2009, many professional societies and investigators have proposed ultrasound-based risk stratification systems to identify nodules that warrant biopsy or sonographic follow-up. Because some of these systems were founded on the BI-RADS(®) classification that is widely used in breast imaging, their authors chose to apply the acronym TI-RADS, for Thyroid Imaging, Reporting and Data System...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28372589/the-first-canadian-experience-with-the-afirma%C3%A2-gene-expression-classifier-test
#19
Emily Kay-Rivest, Jamie Tibbo, Sarah Bouhabel, Michael Tamilia, Rebecca Leboeuf, Veronique-Isabelle Forest, Michael P Hier, Loren Savoury, Richard J Payne
BACKGROUND: Thyroid nodules are common and often benign, although prove to be malignant upon surgical pathology in 5-15% of cases. When assessed with ultrasound-guided fine-needle aspiration (USFNA), 15-30% of the nodules yield an indeterminate result. The Afirma® gene expression classifier (AGEC) was developed to improve management of indeterminate thyroid nodules (ITNs) by classifying them as "benign" or "suspicious." Objectives were (1) to assess the performance of the AGEC in two Canadian academic medical centres (2), to search for inter-institutional variation and (3) to compare AGEC performance in Canadian versus American institutions...
April 4, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28348589/thyroid-imaging-reporting-and-data-system-score-combined-with-the-new-italian-classification-for-thyroid-cytology-improves-the-clinical-management-of-indeterminate-nodules
#20
Salvatore Ulisse, Daniela Bosco, Francesco Nardi, Angela Nesca, Eleonora D'Armiento, Valeria Guglielmino, Corrado De Vito, Salvatore Sorrenti, Daniele Pironi, Francesco Tartaglia, Stefano Arcieri, Antonio Catania, Massimo Monti, Angelo Filippini, Valeria Ascoli
The new Italian cytological classification (2014) of thyroid nodules replaced the TIR3 category of the old classification (2007) with two subclasses, TIR3A and TIR3B, with the aim of reducing the rate of surgery for benign diseases. Moreover, thyroid imaging reporting and data system (TI-RADS) score appears to ameliorate the stratification of the malignancy risk. We evaluated whether the new Italian classification has improved diagnostic accuracy and whether its association with TI-RADS score could improve malignancy prediction...
2017: International Journal of Endocrinology
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