American Thyroid Association Statement on Preoperative Imaging for Thyroid Cancer Surgery

Yeh, Michael W.; Bauer, Andrew J.; Bernet, Victor A.; Ferris, Robert L.; Loevner, Laurie A.; Mandel, Susan J.; Orloff, Lisa A.; Randolph, Gregory W.; Steward, David L.

doi:10.1089/thy.2014.0096

Cited by 198 publications

(175 citation statements)

References 61 publications

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“…4,6 More than 30 studies in the last year alone have examined the utility of thyroid nodule ultrasonography to predict malignancy based on different features. 4,[7][8][9][10] In a recent meta-analysis, Brito and colleagues 11 documented substantial heterogeneity across studies; the typical reporting schemes for thyroid ultrasounds are unclear, as is the practical utility of using ultrasounds to perform risk stratification of thyroid nodules. 11 The Thyroid Imaging and Reporting System (TI-RADS) was developed to provide a minimum common data set for standardized risk stratification of thyroid nodules.…”

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confidence: 99%

“…13 The reality facing many physicians is that the reporting of thyroid ultrasounds originates from multiple sites and is dictated by physicians of varying experience, practice volumes and styles of documentation. 9,[18][19][20] There is very little research on the content of the actual ultrasound reports that radiologists provide to physicians. Thus, the value of ultrasound reports, regardless of whether they have used the TI-RADS reporting scheme or not, remains unclear.…”

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confidence: 99%

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The utility of thyroid ultrasonography in the management of thyroid nodules

Gamme

Parrington

Wiebe

et al. 2017

CJS

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Background: Ultrasonography for thyroid nodules is one of the most common imaging tests performed in the general population. Details from ultrasound reports guide biopsies and surgery. This study quantifies the completeness of these reports based on Thyroid Imaging and Reporting System (TI-RADS) criteria and considers their utility in predicting malignant disease. Methods:We retrospectively reviewed ultrasound reports for 329 thyroidectomy patients and extracted data elements using the TI-RADS criteria: nodule size, echogenicity, margins, vascularity, solid/cystic composition and the presence or absence of microcalcifications and the halo sign. We assessed the reports to determine whether individual or multiple criteria were associated with malignancy.Results: More than 97% of reports document nodule size; however, more than 90% of the reports noted only 3 or fewer of the 6 remaining TI-RADS criteria. The presence of microcalcifications was the most sensitive marker of malignancy (> 90%), whereas the documentation of irregular margins was the most specific indicator of malignancy (88%). Overall it was clear that microcalcifications, hypoechogenicity, irregular margins and solid nodules were significantly more likely to be found in malignant neoplasms; their absence predicted benign disease. Because so few reports consistently documented all criteria, the overall ability of thyroid ultrasonography to discriminate between lowerand higher-risk nodules is limited. Conclusion:Although the accuracy of thyroid ultrasonography is good, few ultrasound reports contain the necessary information, as defined by TI-RADS, to predict malignancy and guide management. When reported, microcalcifications and/or irregular margins are the best predictors of malignancy.Contexte : L'échographie des nodules thyroïdiens est l'une des épreuves d'imagerie les plus souvent effectuées dans la population générale. Les détails fournis par l'échographie guident les biopsies et la chirurgie. Cette étude quantifie l'exhaustivité des rapports d'échographie selon les critères TI-RADS (Thyroid Imaging and Reporting System) et en mesure l'utilité pour prédire les cancers.Méthodes : Nous avons passé en revue de façon rétrospective les rapports d'échographie de 329 patients ayant subi une thyroïdectomie et nous en avons extrait les éléments sous l'angle des critères TI-RADS : taille des nodules, échogénicité, marges, vascularité, composition solide c. kystique, présence ou absence de microcalcifications et signe du halo. Nous avons évalué les rapports afin de déterminer si certains critères individuels ou multiples pouvaient être associés au cancer.Résultats : Plus de 97 % des rapports mentionnent la taille des nodules; mais, plus de 90 % des rapports ne font état que de 3 critères ou moins sur les 6 autres critères TI-RADS. La présence de microcalcifications a été le marqueur tumoral le plus sensible (> 90 %), tandis que la présence de marges irrégulières a été le marqueur tumoral le plus spécifique (88 %). Dans l'ensemble, les microcalcifications, l'...

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confidence: 99%

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confidence: 99%

The utility of thyroid ultrasonography in the management of thyroid nodules

Gamme

Parrington

Wiebe

et al. 2017

CJS

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“…Humanization of Gal-3 mAb and structural modifications of the probe (i.e., radiolabeled Fab-fragments) are in progress and may facilitate translation in the clinical setting. The proposed approach integrates the diagnostic procedure available so far and promises to improve the clinical management of patients bearing thyroid nodules, reducing unnecessary surgery, and social costs (49,50). …”

Section: Discussionmentioning

confidence: 99%

Noninvasive In Vivo Imaging and Biologic Characterization of Thyroid Tumors by ImmunoPET Targeting of Galectin-3

D’Alessandria

Braesch‐Andersen

Bejo³

et al. 2016

Cancer Research

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The high prevalence of thyroid nodules in the adult population and the relatively low incidence of thyroid cancer make the preoperative identification of malignant lesions challenging. The b-galactoside-binding protein galectin-3 is widely expressed in well-differentiated thyroid carcinomas, but not in normal thyrocytes and benign thyroid nodules. This molecule offers a candidate biomarker to improve thyroid cancer diagnosis. Here we report the development of an immunoPET approach for noninvasive imaging of thyroid cancer. The method employs a 89 Zrlabeled mAb to galectin-3, which shows high specificity and binding affinity in vitro. Reliable and specific immunoPET imaging was obtained of thyroid cancer in vivo in murine xenograft models of human thyroid cancer. Our findings provide a method to improve the clinical management of patients with thyroid nodules while reducing unnecessary surgery and social costs.

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“…2,3 This is further supported by Kocharyan and colleagues who demonstrated that lymph node disease identified on pre-operative ultrasound accurately corresponds to postoperative lymph node pathology. Ensuring Quality in Thyroid Cancer Surgery Pre-operative ultrasound evaluation primarily determines the extent of surgery performed and assists in determining prognosis.…”

Section: Quality Surgery Starts With a Good Pre-operative Evaluationmentioning

confidence: 71%

Ensuring Quality in Thyroid Cancer Surgery

Bates¹,

Long²,

Sippel³

2017

US Endocrinology

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T hyroid cancer incidence is increasing worldwide. Though long-term survival rates are excellent, recurrence remains a significant problem, which highlights potential areas of needed improvement, including the surgical care of these patients. This review paper identifies tools and markers that can be used to improve surgical quality in thyroid cancer. Preoperative surgical planning starts with an adequate ultrasound evaluation of the cervical lymph node basins. Postoperatively, thyroglobulin and radioactive iodine uptake scans can track adequacy of resection. In addition, lymph node yield and lymph node ratios serve as indirect markers for assessing the quality of lymph node dissections. Current research also suggests that high-volume surgeons have improved oncological outcomes. Surgeons can use these tools and information to follow and potentially improve the care provided to patients. KeywordsThyroid cancer, surgical quality, ultrasound, thyroglobulin, nodal dissection Disclosure: Maria F Bates, Kristin L Long, and Rebecca S Sippel have nothing to declare in relation to this article. No funding was received in the publication of this article. This study involves a review of the literature and did not involve any studies with human or animal subjects performed by any of the authors.Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. Thyroid carcinoma is one of the most common solid tumors worldwide. The incidence of thyroid cancer is increasing, with an estimated 57,000 newly diagnosed cases in the US in 2017. Approximately three-quarters of these patients are female, with the majority being between 20 and 34 years of age. Though five-year survival rates are greater than 98% overall, the disease still inflicts significant morbidity on those affected.1 At present, surgery represents the mainstay for treatment and the only option for a definitive cure. Performing the appropriate operation for thyroid carcinoma is the first step towards achieving optimal outcomes. Current quality markers in thyroid surgery are predominately based on morbidity from often transient complications, such as temporary hypoparathyroidism or recurrent laryngeal nerve palsy. In order to improve the surgical care of patients with thyroid cancer, it is important that we focus not just on safety, but also on oncologic outcomes. Given the time delay to disease recurrence, surgeons are often not aware that disease recurrence has been identified or that the recurrence may have been due to inadequate initial surgical management. In a recent retrospective view of our institutional data, we...

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American Thyroid Association Statement on Preoperative Imaging for Thyroid Cancer Surgery

Cited by 198 publications

References 61 publications

The utility of thyroid ultrasonography in the management of thyroid nodules

The utility of thyroid ultrasonography in the management of thyroid nodules

Noninvasive In Vivo Imaging and Biologic Characterization of Thyroid Tumors by ImmunoPET Targeting of Galectin-3

Ensuring Quality in Thyroid Cancer Surgery

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