The Trapping-Only Nodules of the Thyroid Gland: Prevalence Study

Reschini, Eugenio; Ferrari, C; Castellani, Massimo; Matheoud, Roberta; Paracchi, A.; Marotta, Giorgio; Gerundini, Paolo

doi:10.1089/thy.2006.16.757

Cited by 50 publications

(32 citation statements)

References 19 publications

(23 reference statements)

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“…This discordance is observed in only 5% of patients and therefore could not explain our results (24). In the same way, thyroid hormone suppression tests were not done; therefore, we cannot exclude the possibility that some nodules with increased 99m technetium uptake are not autonomously functioning.…”

Section: Tco4mentioning

confidence: 73%

TSH measurement is not an appropriate screening test for autonomous functioning thyroid nodules: a retrospective study of 368 patients

Chami

Moreno‐Reyes

Corvilain

2014

European Journal of Endocrinology

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Objective: Based on the assumption that normal TSH concentration rules out the presence of autonomous functioning thyroid nodules (AFTNs), clinical guidelines on the management of thyroid nodules only recommend a thyroid scan if TSH concentration is subnormal. However, the proportion of AFTN presenting with a normal TSH is unknown. Our objective is therefore to determine the proportion of AFTNs with a normal TSH level to ascertain whether a normal TSH really rules out an AFTN. Design: Retrospective study on 368 patients with an AFTN. Methods: Thyroid scans with a diagnosis of AFTN were reviewed retrospectively by one of us (R Moreno-Reyes), blinded to the clinical data. The diagnosis of solitary AFTN was confirmed in 368 patients. Among them, we selected 217 patients based on the absence of another thyroid nodule O10 mm, the absence of medical conditions able to interfere with thyroid function, and the completeness of the data. Results: The proportion of AFTNs with normal TSH was 49%. This proportion increased to 71% in patients for whom thyroid scan was performed in the workup of a thyroid nodule. Conclusions: Our data suggest that serum TSH is not an effective screening tool to diagnose AFTNs. Using 'TSH-only' screening, as recommended by the majority of guidelines, the diagnosis of AFTN would have been missed in 71% of our patients in the workup of a thyroid nodule. Thyroid scan remains the gold standard for detecting AFTN and should be considered before performing fine-needle aspiration cytology (FNAC), as the reliability of FNAC in an unsuspected AFTN remains unclear.

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Section: Tco4mentioning

confidence: 73%

TSH measurement is not an appropriate screening test for autonomous functioning thyroid nodules: a retrospective study of 368 patients

Chami

Moreno‐Reyes

Corvilain

2014

European Journal of Endocrinology

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“…The full text of six eligible articles was retrieved and two additional studies were found screening the references of the selected articles. Finally, eight articles including series of patients with AFTN were selected for the meta-analysis [16,[21][22][23][24][25][26][27] (Fig. 1).…”

Section: Literature Searchmentioning

confidence: 99%

“…studies [22,24] were found, while the remaining studies were retrospective and monocentric. Concerning the geographic distribution, studies from Europe, Asia and America were included.…”

Section: Qualitative and Quantitative Analysis (Meta-analysis)mentioning

confidence: 99%

“…Concerning the geographic distribution, studies from Europe, Asia and America were included. AFTN was defined as a focal increased uptake on TS corresponding to a thyroid nodule larger than 10 mm detected by thyroid ultrasound (US) in six papers [21,[23][24][25][26][27], to a palpable nodule in one study [16] and to a palpable nodule confirmed by thyroid US in the remaining one [22]. Most of the studies enrolled patients in whom TS was performed using 99m Tc-pertechnetate as radiopharmaceutical while both 99m Tcpertechnetate and 123 I were employed by Iwata et al [21] and…”

Section: Qualitative and Quantitative Analysis (Meta-analysis)mentioning

confidence: 99%

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Prevalence of normal TSH value among patients with autonomously functioning thyroid nodule

Treglia

Trimboli

Verburg

et al. 2015

Eur J Clin Investigation

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Background International guidelines significantly diverge on the effectiveness of thyroid scintigraphy (TS) in the initial work-up of thyroid nodules. In particular, the role of TS to detect or exclude the presence of autonomously functioning thyroid nodules (AFTN) in patients with normal serum thyrotropin (TSH) is still a matter to debate. Here, we aimed to review the literature on the prevalence of normal TSH value among patients with AFTN and meta-analyse data of the retrieved eligible papers.

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“…The SNM guidelines list the advantages and disadvantages of 99m Tc-pertechnetate and 123 I-iodide for thyroid imaging (Table 3) (2). In addition to those items (Table 3), many publications have reported discordant results for thyroid nodules when imaged with these 2 different agents (8)(9)(10)(11). Cold thyroid nodules seen on a 123 I scan sometimes appear to accumulate 99m Tc-pertechnetate.…”

Section: Discussionmentioning

confidence: 99%

A Survey of Thyroid Gland Scintigraphy

Crawford¹,

Guarasci²,

Larson³

2009

Journal of Nuclear Medicine Technology

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The Society of Nuclear Medicine (SNM) published procedure guidelines for thyroid imaging in 1999. We wished to determine how many clinics performing thyroid imaging follow the guidelines and to what extent. Of particular interest to us was the choice of collimator. Methods: We developed a 10-question survey to obtain information on how hospitals perform thyroid imaging. The questions were designed to cover the procedure recommendations of the SNM guidelines. The survey was sent to 350 hospitals randomly selected from 11 states in the northeastern United States. Results: One hundred sixty-five surveys (47%) were returned. Most of the clinics that responded obtain a history, hyperextend the neck, and obtain anterior and anterior oblique views. Twenty-five percent of the respondents obtain all their images with a parallel-hole collimator. Seventy-five percent use a pinhole collimator or a combination of parallel-hole and pinhole collimators. The number of counts and time used for acquiring the images vary greatly. Less than half the respondents palpate the neck for correlation with the scan. Conclusion:The survey results indicated that many clinics do not follow the recommendations of the SNM guidelines. The major deviations from the guidelines were in the choice of collimator, the number of counts or amount of time used to acquire images, and the lack of neck palpation for correlation with the scan.

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The Trapping-Only Nodules of the Thyroid Gland: Prevalence Study

Cited by 50 publications

References 19 publications

TSH measurement is not an appropriate screening test for autonomous functioning thyroid nodules: a retrospective study of 368 patients

TSH measurement is not an appropriate screening test for autonomous functioning thyroid nodules: a retrospective study of 368 patients

Prevalence of normal TSH value among patients with autonomously functioning thyroid nodule

A Survey of Thyroid Gland Scintigraphy

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