An Old Tool for an Effective Diagnosis of Thyroid Autonomy

Ianni, Francesca; Perotti, Germano; Paragliola, Rosa Maria; Ricciato, Maria Pia; Castellino, Laura; Prete, Alessandro; Luotto, Valentina; Pontecorvi, Alfredo; Corsello, Salvatore Maria

doi:10.1210/endo-meetings.2011.part3.p13.p2-698

Cited by 2 publications

(5 citation statements)

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“…Furthermore in the present study, 51.5% of the patients with AFTN were euthyroid, corroborating knowledge that subnormal serum TSH alone cannot effectively rule out the presence of AFTN, especially in geographic regions with previous or current iodine deficiency ( 11 , 13 , 14 ). Fifteen of the enrolled patients had TSH ≥1 mU/L, five patients had TSH ≥1.5 mU/L, and only three patients had TSH >2 mU/L.…”

Section: Discussionsupporting

confidence: 90%

“…In the literature, AFTN are frequently synonymous to hyperfunctioning nodules; the term hyperfunctioning refers to the scintigraphic appearance of AFTN, while autonomy refers to their pathogenesis ( 10 , 11 ). AFTN’s cellular density and degree of cellular activity, iodine organification capacity, patient’s iodine intake, and disease natural history are crucial determinants of serum TSH ( 10 , 11 , 12 , 13 , 14 ). When scintigraphy is routinely performed in thyroid nodule workup, it allows detection of AFTN at early stages before progression to subclinical and/or overt hyperthyroidism.…”

Section: Introductionmentioning

confidence: 99%

“…Thyroid scintigraphy is recommended only in patients with subnormal serum TSH by the American Thyroid Association (ATA) and European Thyroid Association (ETA) and may be considered in patients with low normal TSH (0.5–1 mU/L) in iodine-deficient regions by the joint American–Italian endocrinology association American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi (AACE/ACE/AME) guidelines ( 3 , 15 , 19 ). A clear TSH threshold for optimal detection of AFTN has not yet been adopted ( 11 , 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

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Autonomously functioning thyroid nodules present intermediate malignancy risk according to European Thyroid Imaging Reporting and Data System (EU-TIRADS) and yield indeterminate cytology results

Kyrilli,

Tacelli,

Russo

et al. 2023

European Thyroid Journal

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Objectives The aim was to evaluate the clinical, ultrasound (US) and, when indicated, the cytological and histological characteristics of autonomously functioning thyroid nodules (AFTN) in consecutive patients. Methods A prospective, single-centre study was conducted between March 2018 and September 2021. In total, 901 consecutive patients were referred for thyroid workup and of 67 AFTN were evaluated. All enrolled patients underwent 99mTcO4 − scintigraphy, additional 123I scintigraphy only in case of normal serum TSH, evaluation of thyroid function, US examination using European Thyroid Imaging and Reporting Data System (EU-TIRADS), and US-guided fine needle aspiration (FNA) cytology when indicated. All indeterminate FNA samples were subjected to DNA sequencing analysis. Results More than half of the evaluated patients with AFTN were euthyroid; median serum TSH was 0.41 (IQR: 0.03–0.97) mU/L. The median AFTN size measured by US was 27.0 (IQR: 21.1–35.0) mm. 28.4% of AFTN were classified as EU-TIRADS score 3 and 71.6% as EU-TIRADS score 4, indicating that the majority of AFTN had intermediate risk for malignancy according to US. Out of the 47 AFTN subjected to cytological evaluation, 24 (51%) yielded indeterminate FNA results. DNA sequencing revealed pathogenic TSHR and GNAS mutations in 60% of cases. No malignancy was detected at final histology in surgically excised AFTN (n = 12). Conclusions Of the 67 AFTN evaluated in this study, 50% presented with normal serum TSH, 70% displayed ultrasound features suggesting an intermediate malignancy risk and 50% of the AFTN submitted to cytology yielded indeterminate results. No malignant AFTN was detected.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Autonomously functioning thyroid nodules present intermediate malignancy risk according to European Thyroid Imaging Reporting and Data System (EU-TIRADS) and yield indeterminate cytology results

Kyrilli,

Tacelli,

Russo

et al. 2023

European Thyroid Journal

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“…Our study showed that US images of HNs demonstrated higher proportions of partially cystic nodule, isoechoic echogenicity, increased vascularity, and the presence of a halo than cold nodules. Ianni et al 6) reported that HNs showed isoechoic echogenicity and the others also reported that HNs showed partially cystic contend in thyroid US. 10,11) Previous studies have attempted to identify HNs with other diagnostic tool, such as US-elastography 12) and computed tomography (CT).…”

Section: Discussionmentioning

confidence: 98%

“…However, a few studies have accurate analyzed US characteristics of HNs. 6,7) For this reason, it was necessary to identify the US characteristics of HNs and to analyze the characteristics of the nodule with TSH suppression.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic Characteristics of the Hyperfunctioning Thyroid Nodule and Predictive Factors for Thyroid Stimulating Hormone Suppression

Yoo

Choi

2019

Int J Thyroidol

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Background and Objectives: Thyroid scan is a good tool for diagnosis of hyperfunctioning thyroid nodules (HNs), however it has been limited in use in a primary clinical practice, because of its inconvenience and low accessibility. This study aimed to analyze ultrasonographic (US) characteristics of HNs and to predict HNs by US. Materials and Methods: We included 114 patients who exhibited results of 'hot' nodule in the thyroid scan from 2008 to 2017. Analysis for US characteristics included 73 patients without unclear US images and other inevitable reasons. We compared US characteristics of HNs with cold nodules that showed "cold" in the thyroid scan. Additionally, we compared US characteristics of HNs between suppressed thyroid-stimulating hormone (TSH) (＜0.25 uIU/mL) or normal TSH, and analysis receiver operating characteristics (ROC) curve for prediction of suppressed TSH among HNs. Results: The HNs showed more partially cystic nodule, isoechoic echogenicity, hypervascularity and presence of halo in the US finding than the cold nodule. In subgroup analysis of nodules with TSH suppression among HNs, the TSH suppression nodules was lager in max size and volume than the normal TSH nodules. In ROC analyses for prediction of the TSH suppression among HNs, area under receiver operating characteristics curves was 0.736 in max size, 0.761 in volume. Conclusion: HNs showed more frequently partially cystic contents, isoechoic echogenicity, hypervascularity, and peripheral halo sign in US finding. Thyroid nodule size and volume were associated with suppressed TSH level of HNs, and optimal cutoff levels for prediction of TSH suppression among HNs were 2.6 cm and 1.13 cm 3 , respectively.

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An Old Tool for an Effective Diagnosis of Thyroid Autonomy

Cited by 2 publications

References 0 publications

Autonomously functioning thyroid nodules present intermediate malignancy risk according to European Thyroid Imaging Reporting and Data System (EU-TIRADS) and yield indeterminate cytology results

Autonomously functioning thyroid nodules present intermediate malignancy risk according to European Thyroid Imaging Reporting and Data System (EU-TIRADS) and yield indeterminate cytology results

Ultrasonographic Characteristics of the Hyperfunctioning Thyroid Nodule and Predictive Factors for Thyroid Stimulating Hormone Suppression

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