Ultrasound-guided fine needle aspiration cytology and ultrasound examination of thyroid nodules in the UAE: A comparison

Al‐Salam, Suhail; Sharma, Charu; Sa’a, Maysam T. Abu; Afandi, Bachar; Aldahmani, Khaled M.; Dhaheri, Alia Al; Yahya, Hayat; Naqbi, Duha Al; Zuraiqi, Esraa Al; Mohamed, Baraa Kamal; Almansoori, Shamsa Ahmed; Zaabi, Meera Al; Derei, Aysha Al; Shamsi, Amal Al; Kaabi, Juma Al

doi:10.1371/journal.pone.0247807

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…Thyroid USG was very accurate when combined with FNAB by Salam et al, although, unlike the current study, that study did not employ any reference standards (morphological properties of the nodule) to limit the chances of FN results. 4 The positive and negative probability ratios were 6.90 (95% CI: [2. the combined effect of sensitivity and specificity, with an inclination of the curve towards the upper left, showing high quality of thyroid US diagnostic accuracy. Azizi et al investigated the hypothesis stating that three-dimensional ultrasound (3-D-US) allows for distinguishing benign from malignant thyroid nodules with better sensitivity and specificity than two-dimensional ultrasound (2-D-US).…”

Section: Discussionmentioning

confidence: 99%

“…Currently, different TIRADS guidelines [4][5][6][7][8] are available, including American College of Radiology (ACR) -TIRADS, American Thyroid Association (ATA) -TIRADS, American Association of Clinical Endocrinology/American Clinical Endocrinology/American Medical Endocrinology (AACE/ACE/AME) -TIRADS, Korean Society of Thyroid Radiology (KSR)/(KSThR) -TIRADS, and European Thyroid Association (ETA)/(EU) -TIRADS. These TIRADS provide a list of notable morphological features reported in the US images as a gold standard to classify a suspected nodule as malignant or benign.…”

Section: Introductionmentioning

confidence: 99%

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Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system

Nie¹,

Zhu²,

Yan³

et al. 2022

Adv Clin Exp Med

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Background. A frequent prevalence of thyroid nodules in patients prioritizes the need for an accurate method that characterizes them as benign or malignant. Fine-needle aspiration biopsy (FNAB) and thyroid ultrasonography (USG) are currently used for this purpose. However, since FNAB is complicated, time-consuming and expensive, thyroid USG, a fast and highly sensitive method, is preferably used. Although USG is reported as a suitable method for characterization of thyroid nodules, there are some contrasting studies available which report its limited use in the differentiation of benign and malignant thyroid nodules.Objectives. This meta-analysis aims to assess the accuracy of ultrasound in predicting thyroid cancer in terms of sensitivity, specificity and diagnostic odds ratios (ORs) for positive and negative results. Materials and methods.Systematic and extensive literature search on the use of ultrasound (US) to predict thyroid cancer was conducted in the databases of Scopus, CINAHL (via EBSCO), MEDLINE (via PubMed), and Web of Science, covering the period from 2010 till 2021. The morphological features of thyroid nodules observed during the USG were analyzed based on Thyroid Imaging Reporting And Data System (TIRADS) guidelines. The accuracy of thyroid US was determined using parameters such as sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic ORs. Moreover, the respective forest plot and hierarchical summary receiver operating characteristics (HSROC) curve were plotted.Results. A total of 2765 reference studies were examined, and among them, 15 relevant references were selected. The selected studies were heterogeneous and included retrospective and prospective studies. The risk of publication bias is low as the p-value for both Egger's and Begg's tests is >0.05. The overall sensitivity of 92.53% (95% confidence interval (95% CI): [84.55%; 96.33%]), specificity of 33.88% (95% CI: [23. 16%; 45.53%]) and diagnostic OR of 12.36 (95% CI: [3.90%; 54. 11%]) are achieved. These results were statistically significant with a p-value < 0.001 and are predictive of US accuracy in detecting cancer.Conclusions. The present meta-analysis, on the basis of statistically significant results, demonstrated the high accuracy of thyroid ultrasound in detection of malignant nature of nodules in patients suspected with a worrisome thyroid nodule.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system

Nie¹,

Zhu²,

Yan³

et al. 2022

Adv Clin Exp Med

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“…However, the ratios stabilizing after 2012, probably due to the UAE adopting more sensitive thyroid cancer diagnostic testing including genetic testing. 17,18 The differences between Emirati and expats ratio may be due to a mixture of the population pyramid of expats arriving to the UAE for economic purposes and possibly medical tourism. 19 In addition, the analysis showed that another risk factor for thyroid cancer in the UAE is age, where the highest frequency (17.5%) of thyroid cancer patients tends to be between 35-39 years of age and around 47.8% of the patients tend to be between 30-44 years of age.…”

Section: Discussionmentioning

confidence: 99%

Thyroid cancer incidences in the United Arab Emirates: a retrospective study on association with age and gender

Almansoori

Busch²,

Bendardaf

et al. 2022

F1000Res

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Background: Thyroid cancer is the ninth most common malignancy worldwide, but the third most common malignancy in the United Arab Emirates (UAE). To our knowledge, this is the first UAE nationwide study aimed at presenting incidence rates of thyroid cancer at the national level of UAE based upon data from the national cancer registry and GLOBOCAN. Methods: Between 2011 and 2017, a total of 2036 thyroid cancer cases from UAE patients were registered, of which 75.3% were female and 24.7% male patients. Results: The results showed 6.6% increase in thyroid cancer cases in the UAE from 2011 to 2017 (p < 0.001) with a rise of approximately 400 cases per year from 2011 to 2040. Age standardized rate calculations showed increase in prevalence from 1.18 in 2011 to 4.32 in 2017 but decreases in incidence from 1.05 in 2011 to 0.15 in 2017. This trend is confirmed by the predictive model showing increase in incidence from 0.15 in 2017 to 0.64 by 2040. Gender was shown to be significantly associated with thyroid cancer. The female to male ratio was significantly higher in Emirati patients (4.86:1) (p < 0.001) than expat patients (2.47:1) (p < 0.01). Interestingly, expat patients contributed to the majority of thyroid cancer cases despite having lower female to male ratio. The age at diagnosis was significantly associated with thyroid cancer (p = 0.03) with the highest frequency diagnosed at 35-39 years of age. Globally, data from the predictive model showed that Asia had the highest rate of increase per year and UAE the lowest. Conclusions: The slight increase in thyroid cancer prevalence and incidence, together with the different female to male ratio and diagnosis at younger age warrants further investigation at the molecular level from UAE thyroid cancer patients to elucidate the molecular basis of thyroid cancer.

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“…It is especially valuable in cases of undetermined biopsy results. Al-Salam et al estimated that UG-FNAB and ultrasonography are key tools in predicting malignancy in TNs [ 30 ]. The authors suggest that because TNs with Bethesda III and IV diagnoses may present a higher risk of malignancy, greater US vigilance is required [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Atypia and Follicular Lesions of Undetermined Significance in Subsequent Biopsy Result: What Clinicians Need to Know

Kaliszewski

Diakowska

Rzeszutko

et al. 2021

JCM

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Atypia and follicular lesions of undetermined significance (AUS/FLUS) is the most controversial category of The Bethesda System. The risk of malignancy (ROM) in this group is estimated as 5–15%, however, the occurrence of two or more subsequent biopsy results with AUS/FLUS diagnosis makes these clinical situations more complex. We evaluated the ROM and prognostic value of aggressive ultrasound (US) features in 342 patients with thyroid nodules (TNs) with subsequent biopsy results of AUS/FLUS. We assessed US features and compared them with the final histopathological diagnosis. Overall, 121 (35.4%) individuals after first AUS/FLUS diagnosis underwent surgery and 221 (64.6%) patients had repeated biopsies. The ROM after first, second, and third biopsies with subsequent AUS/FLUS diagnosis were 7.4%, 18.5%, and 38.4% respectively. We demonstrated significantly higher rates of occurrence of aggressive US features in patients with malignancy (p < 0.0001). The age <55 years old was also a significant risk factor for TC (p = 0.044). Significant associations were found between aggressive US features and malignancy in patients after first diagnosis of AUS/FLUS (p < 0.05). The juxtaposition of US features with the number of biopsy repetitions of TN with consecutive AUS/FLUS diagnoses may simplify the decision-making process in surgical management. Two or three consecutive biopsy results with AUS/FLUS diagnosis increases the ROM.

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Ultrasound-guided fine needle aspiration cytology and ultrasound examination of thyroid nodules in the UAE: A comparison

Cited by 7 publications

References 27 publications

Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system

Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system

Thyroid cancer incidences in the United Arab Emirates: a retrospective study on association with age and gender

Atypia and Follicular Lesions of Undetermined Significance in Subsequent Biopsy Result: What Clinicians Need to Know

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