American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules - 2016 Update Appendix

Gharib, Hossein; Papini, Enrico; Garber, Jeffrey R.; Duick, Daniel S.; Harrell, R. Mack; Hegedűs, László; Paschke, Ralf; Valcavi, Roberto; Vitti, Paolo

doi:10.4158/ep161208.gl

Cited by 1,046 publications

(1,383 citation statements)

References 332 publications

Supporting

Mentioning

1,238

Contrasting

Unclassified

130

Order By: Relevance

“…Autonomously functioning nodules were treated accordingly or monitored at the discretion of the attending physician. Based on criteria for thyroid ultrasound proposed by the American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, European Thyroid Association (AACE/AME/ETA) guidelines,14 nodules were classified as low risk, intermediate risk or high risk of malignancy. Nodules at high risk and those at low‐to‐intermediate risk larger than 20 mm underwent cytological analysis of specimens gained by FNAC.…”

Section: Methodsmentioning

confidence: 99%

“…Besides, the more recent AACE, AME and ETA's common document declared that routine measurement of basal CT may be useful and strongly recommended its measurement in certain high‐risk groups 14. Finally, the ATA's guidelines panel decided to not recommend either for or against routine measurement of serum CT in patients with thyroid nodules8 but recommend that physicians decide whether the technique is useful in the management of patients in their clinic 9.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Procalcitonin measurement to screen medullary thyroid carcinoma: A prospective evaluation in a series of 2705 patients with thyroid nodules

Giovanella

Imperiali

Piccardo

et al. 2018

Eur J Clin Investigation

View full text Add to dashboard Cite

BackgroundTo prospectively evaluate the role of procalcitonin (PCT) in screening of patients with thyroid nodules for medullary thyroid carcinoma (MTC).Materials and methodsWe measured PCT in 2705 patients with thyroid nodules referred to our centre between January 2011 and December 2017. Those with a positive PCT were operated after positive confirmatory tests such as fine‐needle aspiration, measurement of calcitonin (CT) in serum and fine‐needle aspiration washouts or CT stimulation testing. Patients with a negative PCT were operated based on the results of further diagnostics. The diagnostic performance of PCT was evaluated, and the best cut‐off level was selected by ROC curve analysis.ResultsAmong 2705 patients, 9 with positive serum PCT (ie, above 0.1 μg/L) and 370 with negative PCT underwent thyroid surgery. MTC was histologically confirmed in all patients with positive PCT but not found in patients with negative PCT. Serum PCT levels were significantly higher in patients with MTC (median 0.64 μg/L, range 0.16‐12.9 μg/L) than in those without (median 0.075 μg/L, range 0.075‐0.16 μg/L; P < .0001). ROC curves were plotted to calculate the optimal PCT value separating patients with MTC from those without. The best cut‐off was 0.155 μg/L with sensitivity, specificity, positive and negative predictive values as well as accuracy of 100%, 99.7%, 91.7%, 100% and 99.7%, respectively. Positive and negative likelihood ratios were 329 and zero, respectively.ConclusionsMeasurement of PCT is a sensitive and accurate method for detecting MTC in patients with thyroid nodules and can thus be a reliable alternative to CT measurement.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Procalcitonin measurement to screen medullary thyroid carcinoma: A prospective evaluation in a series of 2705 patients with thyroid nodules

Giovanella

Imperiali

Piccardo

et al. 2018

Eur J Clin Investigation

View full text Add to dashboard Cite

show abstract

“…These features were included in a multiple logistic regression analysis to determine whether they were (or not) independently associated with the likelihood of malignancy (4,5,(8)(9)(10)(11)(24)(25)(26)(28)(29)(30)34). Among all ultrasound features, 13 were likely to be associated with malignancy, as previously described: (i) solid appearance, (ii) …”

Section: Thyroid Ultrasound and Fnab Evaluationsmentioning

confidence: 99%

“…All nodules were evaluated and classified according to the presence of 20 predefined ultrasound features, mostly retrieved from a literature review (4,5,(7)(8)(9)(10)(11)21,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) and detailed in Table 1. These features were included in a multiple logistic regression analysis to determine whether they were (or not) independently associated with the likelihood of malignancy (4,5,(8)(9)(10)(11)(24)(25)(26)(28)(29)(30)34).…”

Section: Thyroid Ultrasound and Fnab Evaluationsmentioning

confidence: 99%

See 1 more Smart Citation

Likelihood of malignancy in thyroid nodules according to a proposed Thyroid Imaging Reporting and Data System (TI-RADS) classification merging suspicious and benign ultrasound features

Delfim

Veiga

Vidal

et al. 2017

Arch. Endocrinol. Metab.

View full text Add to dashboard Cite

Objective: The aim of this study was to describe the ultrasound features of benign and malignant thyroid nodules and evaluate the likelihood of malignancy associated with each feature according to the Bethesda System for Reporting Thyroid Cytopathology and histopathology. With this analysis, we propose a new TI-RADS classification system. Materials and methods: The likelihood of malignancy from ultrasound features were assessed in 1413 thyroid nodules according to the Bethesda System for Reporting Thyroid Cytopathology and histopathological findings. A score was established by attributing different weights to each ultrasound feature evaluated. Results: Features positively associated with malignancy in bivariate analysis received a score weight of +1. We attributed a weight of +2 to features which were independently associated with malignancy in a multivariate analysis and +3 for those associated with the highest odds ratio for malignancy (> 10.0). Hence, hypoechogenicity (graded as mild, moderate or marked, according to a comparison with the overlying strap muscle), microcalcification and irregular/microlobulated margin received the highest weights in our scoring system. Features that were negatively associated with malignancy received weights of -2 or -1. In the proposed system a cutoff score of 2 (sensitivity 97.4% and specificity 51.6%) was adopted as a transition between probably benign (TI-RADS 3) and TI-RADS 4a nodules. Overall, the frequency of malignancy in thyroid nodules according to the categories was 1.0% for TI-RADS 3, 7.8% for TI-RADS 4a, 35.3% for TI-RADS 4b, and 84.7% for TI-RADS 5. Conclusion: A newly proposed TI-RADS classification adequately assessed the likelihood of malignancy in thyroid nodules. Arch Endocrinol Metab. 2017;61(3):211-21.

show abstract

Screening for Thyroid Cancer

Force¹,

Bibbins‐Domingo

Grossman

et al. 2017

JAMA

235

View full text Add to dashboard Cite

he US Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for patients without obvious related signs or symptoms.It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment.The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms. Summary of Recommendation and EvidenceThe USPSTF recommends against screening for thyroid cancer in asymptomatic adults (D recommendation) (Figure 1). Rationale ImportanceIn 2013, the incidence rate of thyroid cancer in the United States was 15.3 cases per 100 000 persons, which represents a significant increase from 1975, when the incidence rate was 4.9 cases per 100 000 persons. 1 The increase in thyroid cancer incidence was 6.7% IMPORTANCE The incidence of thyroid cancer detection has increased by 4.5% per year over the last 10 years, faster than for any other cancer, but without a corresponding change in the mortality rate. In 2013, the incidence rate of thyroid cancer in the United States was 15.3 cases per 100 000 persons. Most cases of thyroid cancer have a good prognosis; the 5-year survival rate for thyroid cancer overall is 98.1%. OBJECTIVE To update the US Preventive Services Task Force (USPSTF) recommendation on screening for thyroid cancer. EVIDENCE REVIEWThe USPSTF reviewed the evidence on the benefits and harms of screening for thyroid cancer in asymptomatic adults, the diagnostic accuracy of screening (including neck palpation and ultrasound), and the benefits and harms of treatment of screen-detected thyroid cancer.FINDINGS The USPSTF found inadequate direct evidence on the benefits of screening but determined that the magnitude of the overall benefits of screening and treatment can be bounded as no greater than small, given the relative rarity of thyroid cancer, the apparent lack of difference in outcomes between patients who are treated vs monitored (for the most common tumor types), and observational evidence showing no change in mortality over time after introduction of a mass screening program. The USPSTF found inadequate direct evidence on the harms of screening but determined that the overall magnitude of the harms of screening and treatment can be bounded as at least moderate, given adequate evidence of harms of treatment and indirect evidence that overdiagnosis and overtreatment are likely to be substantial with population-based screening. The USPSTF therefore determined that the net benefit of screening for thyroid cancer is negative. CONCLUSIONS AND RECOMMENDATIONThe USPSTF recommends against screening for thyroid cancer in asymptomatic adults. (D recomme...

show abstract

American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules - 2016 Update Appendix

Cited by 1,046 publications

References 332 publications

Procalcitonin measurement to screen medullary thyroid carcinoma: A prospective evaluation in a series of 2705 patients with thyroid nodules

Procalcitonin measurement to screen medullary thyroid carcinoma: A prospective evaluation in a series of 2705 patients with thyroid nodules

Likelihood of malignancy in thyroid nodules according to a proposed Thyroid Imaging Reporting and Data System (TI-RADS) classification merging suspicious and benign ultrasound features

Screening for Thyroid Cancer

Contact Info

Product

Resources

About