Radiologic and Pathologic Findings of Nonpalpable Thyroid Carcinomas Detected by Ultrasonography in a Medical Screening Center

Kim, Ji Yang; Lee, Young Moo; Kim, Soo Young; Jeon, Woochan; Kang, Joohyun; An, So Young; Jun, Woo Sun

doi:10.7863/jum.2008.27.2.215

Cited by 71 publications

(62 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The result is generally similar to several earlier studies (Kang et al, 2004;Kim et al, 2008;Cavaliere et al, 2009;Vinayak and Sande., 2012;Wang et al, 2012;Kim et al, 2013a;Kim et al, 2013c). However, there was little standardization among authors of the vascularization pattern, which was statistically significant in present result.…”

Section: Discussionsupporting

confidence: 81%

“…US is commonly used as an effective noninvasive technique for the diagnosis of benign and malignant thyroid nodules. Many scholars have focused on the valuable role of US features as predictors of malignancy (Iannuccilli et al, 2004;Kang et al, 2004;Kim et al, 2008;Lee et al, 2011;Vinayak et al, 2012;Kim et al, 2013a;Kim et al, 2013b). Currently, there is no internationally acknowledged guideline of selecting which thyroid nodules for biopsy, especially for the subcentimeter-sized ones (Iannuccilli et al, 2004;Grani et al, 2013;Kim et al, 2013a;Nixon et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China

Cheng

Chen²,

Zheng³

et al. 2013

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ≥1 were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ≤2 favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China

Cheng

Chen²,

Zheng³

et al. 2013

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

“…By ultrasonography, the suspicion of malignancy in a thyroid nodule may arise in the presence of hypo-reflecting nodes having inhomogeneous texture and calcifications, although these features are by no means pathognomonic [8][9][10][11][12]. It has to be kept in mind that a similar US pattern may also be observed in benign conditions, namely in longstanding infarcted goiter nodules.…”

Section: Distinction Between Benign and Malignant Vascular Lesionsmentioning

confidence: 99%

Diagnostic Controversies in Vascular Proliferations of the Thyroid Gland

et al. 2008

View full text Add to dashboard Cite

Vascular lesions are one of the most controversial issues in thyroid pathology. The differential diagnosis includes benign lesions on one side, i.e., endothelial reactive hyperplasia (Masson's "hemangioma") in goiter and hemangioma, and malignant tumors on the other, i.e., angiosarcomas and undifferentiated (angio)sarcomatoid carcinomas. Benign reactive endothelial hyperplasia with atypias mimicking malignant tumors may occur in long-standing nodular goiter, as a result of spontaneous hemorrhage followed by granulation tissue and fibrous organization. Alternatively, it may follow a fine-needle aspiration biopsy (FNAB) procedure. Angiosarcoma is a rare primary malignant thyroid tumor, mainly observed in endemic goiter areas displaying morphologic and phenotypical similar to those typical of angiosarcomas in other locations (including focal cytokeratin expression). The distinction between angiosarcoma and (angio)sarcomatoid anaplastic carcinoma is difficult and the true existence of angiosarcoma has been challenged. Other extremely rare vascular lesions or mimics in the thyroid include benign hemangioma and pseudo-angiosarcomatous variant of medullary carcinoma. The differential diagnosis between benign and malignant vascular conditions in FNAB material is extremely challenging, and the cytopathology report should be remarkably cautious, especially in poorly cellular and highly hemorrhagic cases: atypias in endothelial cells are not per se indicative of malignancy, being a common feature of reactive endothelial hyperplasia in infracted goiter nodules as well.

show abstract

Radiologic and Pathologic Findings of Nonpalpable Thyroid Carcinomas Detected by Ultrasonography in a Medical Screening Center

Abstract: Ultrasonographic findings suggesting malignancy should be preferentially considered as indicators for FNA, regardless of size, in nonpalpable thyroid nodules. However, extracapsular invasion and lymph node metastasis are closely related to the size of the thyroid nodule.

Cited by 71 publications

References 26 publications

Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China

Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China

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

Diagnostic Controversies in Vascular Proliferations of the Thyroid Gland

Contact Info

Product

Resources

About