Power Doppler US patterns of vascularity and spectral Doppler US parameters in predicting malignancy in thyroid nodules

Several guidelines on diagnosis and treatment of thyroid nodules and cancer have recently been published. However, recommended practices are not always appropriate to different settings or countries. The aim of this consensus was to develop Clinical Guidelines for evaluation and management of patients with thyroid nodules applicable to Latin American countries. The panel was composed by 13 members of the Latin American Thyroid Society involved with research and management of thyroid nodules and cancer from different medical centers in Latin America. The consensus was produced based on the expert opinion of the panel with use of principles of evidence-based medicine. Following a group meeting, a first draft based on the expert opinion of the panel was elaborated and later circulated among panel members for further revision. After revision, this document was submitted to all LATS members for commentaries and considerations and finally revised and refined by the authors. The final recommendations represent state of the art on management of thyroid nodules applied to all Latin American countries. Arq Bras Endocrinol Metab. 2009;53(9):1167-75 Keywords Thyroid nodule; thyroid ultrasonography; thyroid aspiration biopsy; radioactive iodine therapy resumo Vários consensos têm sido publicados acerca do diagnóstico e do tratamento de nódulos e cân-cer da tireoide. Entretanto, as recentes recomendações nem sempre são apropriadas para diferentes regiões ou países. O objetivo deste trabalho foi oferecer uma série de recomendações para a avaliação e conduta de pacientes portadores de nódulos tireoideos aplicáveis a todos os países da América Latina. O trabalho foi realizado por um comitê composto por 13 membros da Sociedade Latino-Americana de Tireoide envolvidos com pesquisa e manejo de pacientes portadores de nódulos e carcinoma diferenciado da tireoide, de diferentes centros médicos da América Latina. As recomendações foram estabelecidas, após consenso, utilizando as opiniões especializadas de cada membro e os princípios da medicina baseada em evidência. Após a primeira reunião do grupo, um primeiro documento foi elaborado e encaminhado a todos os membros para revisão. Posteriormente, o documento foi enviado aos membros da Sociedade Latino-Americana de Tireoide para avaliação, sugestões e comentários. A versão final, elaborada após refinada revisão de todos os autores, representa o estado da arte no diagnóstico e na conduta de nódulos tireoideos, aplicáveis a todos os países da América Latina.

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“…These characteristics, therefore, should not be used as diagnostic tools to determine which nodules should undergo FNAB (27).…”

Section: Thyroid Ultrasonographymentioning

confidence: 99%

Latin American Thyroid Society recommendations for the management of thyroid nodules

Camargo

Corigliano

Friguglietti

et al. 2009

Arq Bras Endocrinol Metab

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“…Ultrasound (US) is an accepted standard diagnostic method for the detection of thyroid nodules worldwide (8). However, previous studies found extreme variations in the assessment of thyroid nodules by US (9)(10)(11). Conventional US has a moderate accuracy for characterizing the nature of thyroid nodules, thus supplementary diagnostic methods, including radionuclide scanning and fine-needle aspiration (FNA) biopsy, are employed for improved clinical evaluation of thyroid nodules (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasound and real-time elastography in the differential diagnosis of malignant and benign thyroid nodules

Xin

Liu

Jia

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The diagnostic value of contrast-enhanced ultrasound (CEUS) or real-time elastography (RTE) alone, as well as a combination of CEUS and RTE, in distinguishing benign from malignant thyroid nodules was investigated. Between August 2012 and June 2014, a total of 97 consecutive patients (50 male and 47 female patients; mean age, 48.6±12.4; age range, 27-70 years) with thyroid nodules referred for surgical treatment were examined by CEUS and RTE. The final diagnosis was obtained based on histological findings. Image analysis of the CEUS and RTE scans was performed. Considering the postoperative pathological results as the golden standard, a receiver operating characteristic (ROC) curve was constructed. Subsequently, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CEUS alone, RTE alone and CEUS + RTE combination were calculated. Pathological examination showed 66 papillary carcinomas and 43 benign lesions, including 21 adenomas and 22 nodular goiters. The sensitivity, specificity, PPV, NPV and accuracy of CEUS were 81.82, 90.70, 93.10, 90.70 and 85.32%, respectively. In the case of RTE, the sensitivity, specificity, PPV, NPV and accuracy were 80.30, 88.37, 91.38, 88.37 and 83.49%, respectively. Furthermore, the combination of CEUS + RTE had a sensitivity of 95.45%, specificity of 95.35%, PPV of 96.92%, NPV of 95.35% and accuracy of 95.41%. Therefore, the CEUS + RTE combination showed a significantly higher sensitivity and specificity compared with CEUS or RTE alone (all P<0.05). Based on ROC analysis, the area under the curve (AUC) for CEUS, RTE and CEUS + RTE combination was 0.883, 0.863 and 0.959, respectively. The AUC of RTE alone was significantly lower compared with that of the CEUS + RTE combination. In conclusion, our results demonstrate that CEUS + RTE combination significantly increases the diagnostic performance for differential diagnosis of malignant and benign thyroid nodules compared with CEUS or RTE alone.

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“…Outros estudos não encontraram utilidade para tal recurso (29,30). Essa técnica não é sequer citada nos consensos especializados (13,25) e, por ser de execução mais difícil, demorada e de reprodutibilidade questionável, acredita-se que es- tudos futuros ainda são necessários antes que possa ser incorporada à prática clínica.…”

Section: Resultsunclassified

Comparação das classificações dos nódulos de tireoide ao Doppler colorido descritas por Lagalla e Chammas

Faria¹,

Casulari²

2009

Arq Bras Endocrinol Metab

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Power Doppler US patterns of vascularity and spectral Doppler US parameters in predicting malignancy in thyroid nodules

Cited by 85 publications

References 18 publications

Latin American Thyroid Society recommendations for the management of thyroid nodules

Latin American Thyroid Society recommendations for the management of thyroid nodules

Contrast-enhanced ultrasound and real-time elastography in the differential diagnosis of malignant and benign thyroid nodules

Comparação das classificações dos nódulos de tireoide ao Doppler colorido descritas por Lagalla e Chammas

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