Medullary thyroid carcinoma: Application of Thyroid Imaging Reporting and Data System (TI-RADS) Classification

Yun, Gabin; Kim, Yeo Koon; Choi, Sang Il; Kim, Ji-Hoon

doi:10.1007/s12020-018-1594-4

Cited by 24 publications

(26 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the interobserver agreement was better for PTC than MTC using the two guidelines (kappa = 0.88 and 0.85, respectively), both guidelines are generally applicable for the evaluation of MTC nodules with good interobserver agreement. Other studies have shown similar results …”

Section: Discussionsupporting

confidence: 83%

The KWAK TI‐RADS and 2015 ATA guidelines for medullary thyroid carcinoma: Combined with cell block‐assisted ultrasound‐guided thyroid fine‐needle aspiration

Yang

et al. 2019

Clinical Endocrinology

View full text Add to dashboard Cite

Objective: To compare the value of the thyroid imaging reporting and data system proposed by Kwak (KWAK TI-RADS) and the 2015 American Thyroid Association (ATA) guidelines for diagnosis of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC). To confirm the role of cell block (CB)-assisted fine-needle aspiration (FNA) in final diagnosis of MTC. Design: Retrospective hospital-based cohort study. Patients: Ninety-three patients with 29 MTCs, 31 PTCs and 33 thyroid adenomas (TAs) who underwent thyroidectomy from January 2010 to May 2019 were retrospectively reviewed. The KWAK TI-RADS and ATA guidelines were used to assess each thyroid nodule. FNA, CB-assisted FNA and core needle biopsy (CNB) were performed in final diagnosis. Results: Age and ultrasound features (composition, echogenicity and shape) were significantly different between MTC and PTC. Sex and ultrasound features (echogenicity, margin and calcification) were significantly different between MTC and TA.The KWAK TI-RADS and ATA guidelines showed no significant difference for MTC (area under the curve [AUC]: 0.812 and 0.808; P = .37-.85) or PTC (AUC: 0.883 and 0.885; P = .25-.96). The KWAK TI-RADS and ATA guidelines showed high specificity and sensitivity for MTC (93.9% and 62.1%, 87.9% and 65.5%) and PTC (93.9% and 67.7%, 87.9% and 77.4%), respectively. For suspicious MTC (7 cases), CB-assisted FNA provide accuracy preoperative diagnosis. Conclusions:Although the diagnostic performance of the TI-RADS and ATA guidelines is worse for MTC than PTC, the difference is not statistically significant. CBassisted FNA should be performed in thyroid nodules with 4a or lower suspicion to avoid misdiagnosis of MTC. K E Y W O R D S 2015 American Thyroid Association management guideline, medullary thyroid carcinoma, papillary thyroid carcinoma, thyroid imaging reporting and data system, ultrasound | 451 LI et aL. How to cite this article: Li J, Li H, Yang Y, Zhang X, Qian L. The KWAK TI-RADS and 2015 ATA guidelines for medullary thyroid carcinoma: Combined with cell block-assisted ultrasound-guided thyroid fine-needle aspiration. Clin Endocrinol (Oxf). 2020;92:450-460. https ://doi.

show abstract

Section: Discussionsupporting

confidence: 83%

The KWAK TI‐RADS and 2015 ATA guidelines for medullary thyroid carcinoma: Combined with cell block‐assisted ultrasound‐guided thyroid fine‐needle aspiration

Yang

et al. 2019

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

“…MTC had no capsule, infiltrated and grew extensively, so the boundary was not clear, and it was easy to invade the thyroid envelope and metastasize to adjacent lymph nodes. (4) Calcification was common in MTC, of which microcalcification accounts for 44.92% (53/118), and this result was similar with Yun et al, 18 while microcalcification in benign nodular was rare, accounting for 11.21% (141/1258). Microcalcification was a specific manifestation of thyroid cancer.…”

Section: Comparative Analysis Of Ultrasound Characteristics Of Mtc supporting

confidence: 80%

The application value of modified thyroid imaging report and data system in diagnosing medullary thyroid carcinoma

Zhu

Wei

et al. 2019

Cancer Medicine

View full text Add to dashboard Cite

Medullary thyroid carcinoma (MTC) is highly malignant and quite different from the most common papillary thyroid carcinoma (PTC). However, most of the ultrasonic evaluation systems mainly aim at PTC at present. This study aims to evaluate the applicability of modified TI‐RADS in diagnosing MTC and compare the sonographic differences of MTC, PTC, and benign nodules. Three thousand two hundred and forty‐two thyroid nodules images confirmed by pathology were categorized according to modified TI‐RADS and ACR TI‐RADS classification. The performances of two TI‐RADS were assessed by ROC curves. The correlations between classifications with the pathology and the consistency of different doctors were evaluated. The ultrasonic differences of MTC, PTC, and benign nodules were analyzed. As a result, the number of high suspicious US features increased, the malignant risk of nodules also increased of two classifications, with significant differences between categories ( P < 0.001). Spearman correlation coefficients were 0.751 (modified TI‐TADS) and 0.744 (ACR TI‐RADS). Areas under the ROC curve of the modified TI‐RADS and ACR TI‐RADS were 0.960 and 0.872 ( P < 0.001). At Best cut off points, the diagnostic value of modified TI‐RADS was higher than that of ACR TI‐RADS with a higher specificity, PPV, accuracy, and Youden index). By using modified TI‐RADS to diagnose MTC and PTC, the sensitivity, specificity, NPV, accuracy, and Youden index were higher in MTC than PTC. The Kendall's correlation coefficients were 0.962, 0.930, and 0.987. MTC had special ultrasonography characters compared with PTC and benign nodules. These results suggest that modified TI‐RADS is better than ACR TI‐RADS in diagnosing thyroid carcinomas. Diagnostic value to MTC of modified TI‐RADS is slightly higher than that to PTC, and the categorical results of different doctors were consistent. MTC had several particular features contrast to PTC and benign nodules.

show abstract

“…Approximately 95 % of MTC correspond to nodules with an intermediate or high suspicion sonographic pattern according to the ATA classification or to nodules categories 4 and 5 of TI-RADS [12][13][14][15]. FNA is recommended for non-autonomous nodules > 1 cm with this ultrasonographic appearance.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, only patients who had nodules with two or more suspicious features (solid or predominantly solid, hypoechogenicity, microcalcifications, irregular margins, anteroposterior diameter larger than transverse diameter) were included. Using this criterion, the nodules would currently be classified as intermediate or high suspicion by ATA or TI-RADS 4 or 5 [12][13][14][15].…”

Section: Patientsmentioning

confidence: 99%

“…Considering that approximately 95 % of MTC correspond to nodules defined as intermediate or high suspicion by the sonographic classification of the American Thyroid Association (ATA) or as category 4 or 5 of the Thyroid Imaging, Reporting and Data System (TI-RADS) [12][13][14][15], the lack of diagnosis of microMTC would be a matter of concern primarily in the case of thus classified nodules measuring ≤ 1 cm.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Usefulness of Serum Calcitonin in Patients with Thyroid Nodules ≤ 1 cm Without an Indication for Fine-Needle Aspiration

2020

View full text Add to dashboard Cite

Fine-needle aspiration (FNA) is not necessary in adults with nodules ≤ 1 cm without apparent extrathyroidal extension (ETE) or lymph node (LN) involvement on ultrasonography (US). In the absence of FNA and serum calcitonin (Ctn) measurement, medullary thyroid microcarcinomas (microMTC) are not diagnosed. The aim of this prospective study was to evaluate Ctn levels in adults with a low clinical risk of MTC and nodules ≤ 1 cm without ETE or LN involvement on US. A total of 506 consecutively seen adults who had nodules with two or more suspicious features were included. Patients with elevated basal Ctn underwent a calcium stimulation test and FNA. Basal Ctn was normal in 490 patients (96.8%). In the 16 patients with elevated basal Ctn, FNA revealed MTC in only one patient and MTC was not suspected in the 15 patients with elevated basal Ctn. Three patients with stimulated Ctn<100 pg/ml and benign cytology were not submitted to surgery. MTC was excluded by histology in three patients with stimulated Ctn<100 pg/ml and indeterminate or suspicious cytology and in eight patients with stimulated Ctn>100 pg/ml. One patient with stimulated Ctn>100 pg/ml had MTC. Ctn was undetectable 6 months after surgery in two patients with MTC. Although uncommon, even subjects without a suspicious history and with nodules ≤ 1 cm without ETE or LN involvement on US, but with suspicious findings, can have microMTC. The measurement of Ctn permits the diagnosis of these cases.

show abstract

Medullary thyroid carcinoma: Application of Thyroid Imaging Reporting and Data System (TI-RADS) Classification

Abstract: TI-RADS is applicable for the evaluation of MTC nodules with good inter-observer agreement.

Cited by 24 publications

References 28 publications

The KWAK TI‐RADS and 2015 ATA guidelines for medullary thyroid carcinoma: Combined with cell block‐assisted ultrasound‐guided thyroid fine‐needle aspiration

The KWAK TI‐RADS and 2015 ATA guidelines for medullary thyroid carcinoma: Combined with cell block‐assisted ultrasound‐guided thyroid fine‐needle aspiration

The application value of modified thyroid imaging report and data system in diagnosing medullary thyroid carcinoma

Usefulness of Serum Calcitonin in Patients with Thyroid Nodules ≤ 1 cm Without an Indication for Fine-Needle Aspiration

Contact Info

Product

Resources

About