Combined clinical, thyroid ultrasound and cytological features help to predict thyroid malignancy in follicular and Hϋrthle cell thyroid lesions: results from a series of 505 consecutive patients

Rago, Teresa; Coscio, G Di; Basolo, Fulvio; Scutari, M; Elisei, Rossella; Berti, Piero; Miccoli, Paolo; Romani, Rossana; Faviana, Pinuccia; Pinchera, Aldo; Vitti, Paolo

doi:10.1111/j.1365-2265.2006.02677.x

Cited by 160 publications

(154 citation statements)

References 44 publications

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“…However, we emphasize that the PTC accounts for up to 95% of differentiated thyroid carcinomas. In recent large series, even in nodules with "follicular neoplasm" or "follicular lesion of undetermined significance" cytology, 85% of malignant nodules were PTC (26,27). The classical and limited differential diag nosis between adenoma and follicular carcinoma is no longer appropriate for current cases of indeterminate cytology.…”

Section: Discussionmentioning

confidence: 99%

Is Doppler ultrasound of additional value to gray-scale ultrasound in differentiating malignant and benign thyroid nodules?

Rosário

Silva

Borges

et al. 2015

Arch. Endocrinol. Metab.

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SUMMARYThe objective of this study was to evaluate whether Doppler ultrasound (DUS) is of additional value to gray-scale ultrasound (GSUS) in predicting the benign or malignant nature of thyroid nodules. A total of 1,502 solid thyroid nodules ≥ 10 mm were evaluated. Suspicious vascularity (predominantly or exclusively central blood flow) was observed in only 5% of the nodules. This finding showed 96% specificity, but only 15% sensitivity. GSUS alone showed sensitivity and specificity of 88.7% and 68.2%, respectively, which did not improve with the addition of DUS (sensitivity of 89.4% and specificity of 66.4%). In non-suspicious nodules on GSUS, the type of vascularity on DUS did not modify the risk of malignancy, which was low. In suspicious nodules on GSUS, suspicious vascularity on DUS increased the risk of malignancy, but non-suspicious vascularity did not reduce this risk. DUS provided no additional value to GSUS in predicting the benign or malignant nature of thyroid nodules. Arch Endocrinol Metab. 2015;59(1):79-83

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Section: Discussionmentioning

confidence: 99%

Is Doppler ultrasound of additional value to gray-scale ultrasound in differentiating malignant and benign thyroid nodules?

Rosário

Silva

Borges

et al. 2015

Arch. Endocrinol. Metab.

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“…In the UK, cytology results are reported using the THY classification (The Royal College of Pathologists 2009), whereas in the US, the Bethesda scoring system (Bongiovanni et al 2012) is used. Despite accuracy of diagnosis in the majority of thyroid nodules, FNAC has drawbacks including the sometimes high rate of insufficient/inadequate samples, the inability to distinguish between benign and malignant follicular lesions and difficulties in detecting follicular variant papillary carcinomas (Sangalli et al 2006, Rago et al 2007.…”

Section: Current Diagnostic Approaches and Limitationsmentioning

confidence: 99%

WOMEN IN CANCER THEMATIC REVIEW: Thyroid-stimulating hormone in thyroid cancer: does it matter?

Nieto¹,

Boelaert²

2016

Endocrine-Related Cancer

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Differentiated thyroid cancer is the most common endocrine malignancy and the incidence is increasing rapidly worldwide. Appropriate diagnosis and post-treatment monitoring of patients with thyroid tumours are critical. Fine needle aspiration cytology remains the gold standard for diagnosing thyroid cancer, and although there have been significant refinements to this technique, diagnostic surgery is often required for patients suspected to have malignancy. Serum thyroid-stimulating hormone (TSH) is higher in patients with malignant thyroid nodules than in those with benign disease, and TSH is proportionally increased in more aggressive tumours. Importantly, we have shown that the pre-operative serum TSH concentration independently predicts the presence of malignancy in subjects presenting with thyroid nodules. Establishing the use of TSH measurements in algorithms identifying high-risk thyroid nodules in routine clinical practice represents an exciting, cost-efficient and non-invasive approach to optimise thyroid cancer diagnosis. Binding of TSH to receptors on thyrocytes stimulates a number of growth promoting pathways both in normal and malignant thyroid cells, and TSH suppression with high doses of levothyroxine is routinely used after thyroidectomy to prevent cancer recurrence, especially in high-risk tumours. This review examines the relationship between serum TSH and thyroid cancer and reflects on the clinical potential of TSH measurements in diagnosis and disease monitoring.

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“…2010;54/1 Malignancy in nodules with indeterminate cytology nical practice (2). Ultrasonographic findings have shown to be good predictors of malignancy in these lesions (3)(4)(5).…”

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confidence: 99%

Contribution of scintigraphy and ultrasonography to the prediction of malignancy in thyroid nodules with indeterminate cytology

Rosário

Salles

Bessa

et al. 2010

Arq Bras Endocrinol Metab

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Objective: To evaluate the contribution of 131 I scintigraphy and ultrasonography to the prediction of malignancy in thyroid nodules with indeterminate cytology in euthyroid patients. Subjects and methods: The sample consisted of 102 patients with thyroid nodules, submitted to FNAC and presenting an indeterminate cytological diagnosis (follicular neoplasm). Results: Malignancy was observed in 19/25 (76%) nodules with suspicious ultrasonographic characteristics versus 5/77 (6.5%) without suspicious findings. When 131 I scintigraphy showed a cold or hot nodule, the chance of malignancy was 38.5% and 2.5%, respectively. This exam was inconclusive in 10% of the patients. Conclusions: Surgery is indicated when a thyroid nodule with indeterminate cytology exhibits suspicious ultrasonographic characteristics. Otherwise, 131 I scintigraphy can exclude thyroidectomy when reveals uptake in the nodule, which is observed in half the cases. Arq Bras Endocrinol Metab. 2010;54(1):56-9 Keywords Thyroid nodule; indeterminate cytology; radionuclide imaging; ultrasonography resumo Objetivo: Avaliar a contribuição da cintilografia com 131 I e da ultrassonografia na predição de malignidade em nódulos tireoidianos com citologia indeterminada em pacientes eutireoidianos. Sujeitos e Métodos: A amostra foi composta por 102 pacientes com nódulos tireoidianos submetidos à punção aspirativa com agulha fina (PAAF), apresentando citologia indeterminada (neoplasia folicular). Resultados: Malignidade foi encontrada em 19/25 (76%) nódulos suspeitos na ultrassonografia versus 5/77 (6,5%) naqueles sem características suspeitas. Quando a cintilografia com 131 I mostrou nódulo hipo-ou hipercaptante, a chance de malignidade foi 38,5% e 2,5%, respectivamente, e em 10% dos pacientes esse exame foi inconclusivo. Conclusões: Cirurgia está indicada quando um nódulo tireoidiano com citologia indeterminada exibe características ultrassonográficas suspeitas. Quando não as exibe, a cintilografia com 131 I pode dispensar a tireoidectomia se revelar captação correspondente ao nódulo, o que ocorre em metade dos casos. Arq Bras Endocrinol Metab. 2010;54(1):56-9

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Combined clinical, thyroid ultrasound and cytological features help to predict thyroid malignancy in follicular and Hϋrthle cell thyroid lesions: results from a series of 505 consecutive patients

Cited by 160 publications

References 44 publications

Is Doppler ultrasound of additional value to gray-scale ultrasound in differentiating malignant and benign thyroid nodules?

Is Doppler ultrasound of additional value to gray-scale ultrasound in differentiating malignant and benign thyroid nodules?

WOMEN IN CANCER THEMATIC REVIEW: Thyroid-stimulating hormone in thyroid cancer: does it matter?

Contribution of scintigraphy and ultrasonography to the prediction of malignancy in thyroid nodules with indeterminate cytology

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