Thyroid gland: US screening in a random adult population.

Brander, Antti; Viikinkoski, P; Nickels, Juha; Kivisaari, Leena

doi:10.1148/radiology.181.3.1947082

Cited by 454 publications

(264 citation statements)

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“…In a study including 635 volunteers who presented for a preventive health checkup, thyroid nodules were found by ultrasonography in 68% (1). In another study of 253 volunteers selected from a random sample of the population in Finland, thyroid nodules were found by ultrasound in 21% (2). Moreover, the prevalence of thyroid nodules in autopsy studies of patients without known thyroid disease varies between 30% and 50% (3).…”

Section: Introductionmentioning

confidence: 99%

Risk of Malignancy in Thyroid Nodules with Non-Diagnostic Fine-Needle Aspiration: A Retrospective Cohort Study

Ycaza

Lowe

Dean

et al. 2016

Thyroid

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Background: Fine-needle aspiration (FNA) of thyroid nodules is commonly performed, and despite the use of ultrasound (US) guidance, the rate of non-diagnostic FNAs is still significant. The risk of malignancy of thyroid nodules with a non-diagnostic FNA is not clearly defined. However, most studies exclude the majority of patients without a repeat biopsy or surgery, thus increasing the likelihood of selection bias. The aims of this study were to determine the malignancy risk in nodules with an initial non-diagnostic FNA, and to identify the factors associated with malignancy. Methods: This was a retrospective cohort study of patients with thyroid nodules who underwent US-guided FNA between 2004 and 2010 and had a non-diagnostic result. Patients were followed until confirmatory diagnosis of the nature of the nodule was made. The outcome of malignant or benign disease was based on one of the following: (i) final surgical pathology following thyroidectomy; (ii) repeat biopsy; (iii) clinically, based on repeat ultrasound performed at least three years following biopsy; or (iv) report of thyroid status for patients without follow-up visits contacted by mail. Results: There were 699 nodules from 665 patients included. The mean age was 59 -15 years, and 71.7% were women. There was complete follow-up of 495 nodules. After a median follow-up of 2.7 years, thyroid cancer was found in 15 nodules. The prevalence of malignancy was 3% (15/495). The presence of nodular calcifications was the strongest predictor of thyroid malignancy (odds ratio 5.03 [confidence interval 1.8-14.7]). Initial nodule size was inversely associated with malignancy (odds ratio 0.55 [confidence interval 0.28-0.93]). However, the 193 patients without follow-up had smaller nodules compared with those included in the analysis. None of the patients with repeatedly non-diagnostic results were diagnosed with thyroid cancer at follow-up. Conclusion: The prevalence of thyroid cancer in nodules with non-diagnostic results is lower than the malignancy rate in thyroid nodules in general, but not negligible. They should be followed as per guidelines with heightened suspicion for nodules containing calcifications. Nodules with repeatedly non-diagnostic FNA results especially in the absence of calcifications have a low risk of malignancy and may be observed.

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Section: Introductionmentioning

confidence: 99%

Risk of Malignancy in Thyroid Nodules with Non-Diagnostic Fine-Needle Aspiration: A Retrospective Cohort Study

Ycaza

Lowe

Dean

et al. 2016

Thyroid

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“…The number of thyroid incidentalomas is increasing due to widely use of highly sensitive ultrasonography for routine health examinations [4]. Previous studies have reported that incidental thyroid nodules are commonly detected at a rate of 30-50% on sonography [5,6] with a malignancy rate of about 7-15% [7][8][9][10]. Fine needle aspiration cytology (FNAC) is now established as a reliable and safe method to distinguish between benign and malignant thyroid nodules [8,11,12].…”

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confidence: 99%

High Prevalence of Carcinoma in Ultrasonography-guided Fine Needle Aspiration Cytology of Thyroid Nodules

2008

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Abstract. Objective: The purpose of this study was to assess the rate of malignancy in thyroid nodules incidentally detected at sonography and to determine the diagnostic value of ultrasonography-guided fine needle aspiration cytology (USgFNAC) in thyroid nodules. Methods: Five hundred patients (84 men and 416 women) who had thyroid incidentalomas underwent USgFNAC at Konkuk University Hospital between August 2005 and July 2006. Thyroid sonography and guided aspiration was performed on all single nodules and on dominant nodules with suspected malignancy in cases of multinodular goiter. Results: Five hundred fifty-eight nodules from 500 patients were aspirated using ultrasonography guidance. The USgFNAC results for all patients were as follows: 307 (61.4%) benign, 108 (21.6%) suggestive of malignancy, 56 (11.2%) indeterminate, and 29 (5.8%) inadequate for cytologic diagnosis. The rate of malignancy was significantly higher in women than in men (23.6% in women vs 11.9% in men, p<0.01). Ultrasonographic characteristics that had a significant association with thyroid malignancy included solid echocomponent, hypoechogenecity, ill defined margin, and presence of microcalcifications (p<0.05). Eighty-eight patients underwent surgical resection. The positive predictive value of USgFNAC was 90.2% (74/82), and the accuracy index was 84.1% (74/ 88). In 80 patients with well-differentiated thyroid carcinoma after surgery, 49% (39/80) had lesions smaller than 1 cm. Conclusion: The rate of malignancy in incidental thyroid nodules on USgFNAC was 21.6%. Ultrasonographic features could be useful in differentiating between benign and malignant nodules.

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“…detected, intensifying the need for better prognostic information. [3][4][5][6][7][8] A number of investigators have identified prognostic factors for …”

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confidence: 99%