Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy in Malignant Thyroid Nodules: Utility for Micronodules

Ünal, Betül; Sezer, Cem

doi:10.7314/apjcp.2014.15.20.8613

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…This may result from the known pitfalls in thyroid aspiration, including inappropriate target selection [ 13 ], inadequate sampling [ 13 , 15 ], gray zones in thyroid cytology interpretation [ 13 , 27 ], and newly-developed tumor. In a retrospective study, 46.7% of the aspirated thyroid cancers were initially concluded as benign or insufficient for diagnosis [ 28 ]. The initially non-diagnostic rates may be as high as 10–20% [ 29 ], and the proportion of non-diagnostic specimens increased with greater cystic components of the nodules [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Thyroid Fine-Needle Aspiration Biopsy and Thyroid Cancer Diagnosis: A Nationwide Population-Based Study

Huang

Lee

Chou³

et al. 2015

PLoS ONE

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BackgroundThyroid cancer is the most common endocrine gland malignancy and fine-needle aspiration biopsy is widely used for thyroid nodule evaluation. Repeated aspiration biopsies are needed due to plausible false-negative results. This study aimed to investigate the overall relationship between aspiration biopsy and thyroid cancer diagnosis, and to explore factors related to shorter diagnostic time.MethodsThis nationwide retrospective cohort study retrieved data from the Longitudinal Health Insurance Database in Taiwan. Subjects without known thyroid malignancies and who received the first thyroid aspiration biopsy after 2004 were followed-up from 2004 to 2009 (n = 7700). Chi-square test, Kaplan-Meier survival analysis, and Cox proportional hazards model were used for data analysis.ResultsOf 7700 newly-aspirated patients, 276 eventually developed thyroid cancer (malignancy rate 3.6%). Among the 276 patients with thyroid cancer, 61.6% underwent only one aspiration biopsy and 81.2% were found within the first year after the initial aspiration. Cox proportional hazards model revealed that aspiration frequency (HR 1.07, 95% CI 1.06–1.08), ultrasound frequency (HR 1.02, 95% CI 1.01–1.03), older age, male sex, and aspiration biopsies arranged by surgery, endocrinology or otolaryngology subspecialties were all associated with shorter time to thyroid cancer diagnosis.ConclusionsAbout 17.4% of thyroid cancer cases received more than two aspiration biopsies and 18.8% were diagnosed one year after the first biopsy. Regular follow-up with repeated aspiration or ultrasound may be required for patients with clinically significant thyroid nodules.

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Section: Discussionmentioning

confidence: 99%

Thyroid Fine-Needle Aspiration Biopsy and Thyroid Cancer Diagnosis: A Nationwide Population-Based Study

Huang

Lee

Chou³

et al. 2015

PLoS ONE

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“…28 However, current recommendations justify the use of FNA to assess nodules ≤1 cm with worrisome features such as hypoechogenicity, irregular margins, and microcalcifications on ultrasound imaging. [9][10] Regardless of size, thyroid nodules with suspicious findings can be subjected to preoperative evaluation with fine-needle aspiration. Our analysis highlights the incidence of microcarcinoma and its correlation with each FNA category.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

“…It is a safe and minimally invasive modality, separating nodules into well-defined diagnostic tiers to steer appropriate patient care. 9 Nevertheless, there is little known about the relationship between microcarcinoma and cytologic categories on FNA.…”

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confidence: 99%

Fine-needle aspirates of thyroid microcarcinoma

Partyka

2017

Journal of the American Society of Cytopathology

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Precis:In our experience, indeterminate diagnoses (FLUS+FN+SM) accounted for the majority (60%) of preoperative FNAs for incidental microcarcinoma (size ≤0.5 cm) when compared to 27% for those of non-incidental microcarcinoma (size >0.5 cm and ≤1 cm) (p<0.05, chi-square test). ABSTRACT: INTRODUCTION:Widespread use of ultrasound allows for detection of smaller thyroid nodules and preoperative evaluation with fine-needle aspiration (FNA). Both incidental and non-incidental microcarcinoma can be found, leading to uncertainty with clinical management. MATERIALS AND METHODS:A retrospective analysis of thyroid FNAs performed at our institution was conducted for the 5year period from 2010 to 2014. Aspirates were categorized using the Bethesda System for Reporting Thyroid Cytopathology. Cytologic diagnoses were then correlated with final histopathology. Among samples with malignancy on surgical resection, nodules were stratified by size. RESULTS:A total of 2531 thyroid FNAs were identified. 587 samples had histologic correlation, and 259 malignancies were reported. They were separated into nodules >1 cm (n=144, 56%) and ≤1 cm (n=115, 44%). Microcarcinoma was further subdivided into incidental (size ≤0.5 cm, n=55, 48%) and non-incidental (size >0.5 cm and ≤1 cm, n=60, 52%). The preoperative cytologic diagnoses for incidental microcarcinoma were: benign (B, n=11, 20%), follicular lesion of undetermined significance (FLUS, n=15, 27%), follicular neoplasm (FN, n=11, 20%), suspicious for malignancy (SM, n=7, 13%), malignant (M, n=8, 15%), and non-diagnostic (ND, n=3, 5%). The FNA categories for non-incidental microcarcinoma were: B (n=13, 22%), FLUS (n=3, 5%), FN (n=3, 5%), SM (n=10, 17%), M (n=29, 48%) and ND (n=2, 3%). CONCLUSIONS:Incidental microcarcinoma is not an uncommon entity, making up 21% (55/259) of malignant nodules on thyroidectomy. Indeterminate diagnoses (FLUS+FN+SM) accounted for the majority

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“…Ultrasound guided FNAB may increase the success rate of biopsy for micronodules and is applicable in patients with risk factors for thyroid cancer or thyroid nodules larger than 1 cm or suspected malignant, having a high sensitivity [5]. For thyroid nodules highly suspected malignant, FNAB is not recommended [6], and radionuclide scanning is infeasible during pregnancy. To assure the reliability of FNAB, sample collection should be conducted at the suspected sites by ultrasonography, especially at the solid lesions.…”

Section: Biomedical Research 2018; 29 (1): 213-217mentioning

confidence: 99%

Clinical therapy and management of differentiated thyroid cancer in pregnant women

Zou¹,

Han²,

Gao³

et al. 2018

biomedicalresearch

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Differentiated thyroid cancer (DTC) is frequently found in mid-aged and young women. DTC has been the second common malignancy diagnosed during pregnancy. The clinical therapy of DTC has involvement of both mother's health and fetal safety and thus is usually difficult. Currently, there are still controversies in the therapy of DTC in pregnant women. Herein we summarize the advance in the surgical therapy, radioactive iodine therapy and thyroid hormone replacement therapy in pregnancy and after delivery and explore more effective strategies which are beneficial for the mother and fetus, which willprovide more evidence for the selection of strategies for the clinical management of DTC in pregnant women.

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Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy in Malignant Thyroid Nodules: Utility for Micronodules

Cited by 10 publications

References 17 publications

Thyroid Fine-Needle Aspiration Biopsy and Thyroid Cancer Diagnosis: A Nationwide Population-Based Study

Thyroid Fine-Needle Aspiration Biopsy and Thyroid Cancer Diagnosis: A Nationwide Population-Based Study

Fine-needle aspirates of thyroid microcarcinoma

Clinical therapy and management of differentiated thyroid cancer in pregnant women

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