Ultrasound‐guided <scp>fine‐needle</scp> aspiration biopsy of thyroid nodules

Todsen, Tobias; Bennedbæk, Finn Noe; Kiss, Katalin

doi:10.1002/hed.26598

Cited by 23 publications

(14 citation statements)

References 10 publications

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“…For more than three decades, the cornerstones in the clinical management of patients with thyroid nodules have been ultrasound (US) and fine-needle aspiration cytology (FNA) ( 1 , 2 , 3 ). Robust evidence demonstrates that the risk of malignancy (primarily papillary cancer) in thyroid lesions is significantly correlated to the presence of specific US features, which include hypoechogenicity, microcalcifications, taller than wide shape, irregular margins, and extrathyroidal extension (ETE) ( 4 , 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Considerable interobserver variation calls for unambiguous definitions of thyroid nodule ultrasound characteristics

Solymosi

Bonnema

Frasoldati³

et al. 2023

European Thyroid Journal

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OBJECTIVE: Thyroid nodule ultrasound characteristics are used as indication for FNA, usually as the basis for Thyroid Imaging Reporting and Data System (TIRADS) score calculation. Few studies on inter-observer variation are available, all of which are based on analysis of preselected still ultrasound images and often lack surgical confirmation. METHODS: After the blinded online evaluation of video-recordings of the ultrasound examinations of 47 consecutive malignant and 76 consecutive benign thyroid lesions, 7 experts from 7 thyroid centers answered 17 TIRADS-related questions. Surgical histology was the reference standard. Inter-observer variations of each ultrasound characteristic were compared using Gwet's AC1 inter-rater coefficients; higher values mean better concordance, the maximum being 1.0. RESULTS: On a scale from 0.0 to 1.0, the Gwet's AC1 values were 0.34, 0.53, 0.72, 0.79 for the four most important features in decision making, i.e. irregular margins, microcalcifications, echogenicity and extrathyroidal extension, respectively. The concordance in the discrimination between mildly/moderately and very hypoechogenic nodules was 0.17. The smaller the nodule size the better the agreement in echogenicity, and the larger the nodule size the better the agreement on the presence of microcalcifications. Extrathyroidal extension, was correctly identified in just 45.8% of the cases. CONCLUSIONS: Examination of video recordings, closely simulating the real-world situation, revealed substantial inter-observer variation in the interpretation of each of the four most important ultrasound characteristics. In view of the importance for management of thyroid nodules, unambiguous and widely accepted definitions of each nodule characteristic are warranted, although it remains to be investigated whether this diminishes observer-variation.

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Section: Introductionmentioning

confidence: 99%

Considerable interobserver variation calls for unambiguous definitions of thyroid nodule ultrasound characteristics

Solymosi

Bonnema

Frasoldati³

et al. 2023

European Thyroid Journal

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“…Currently, ultrasound-guided fine-needle aspiration biopsy (US-FNAB), due to its low cost and ease of operation, is the cornerstone for the evaluation of thyroid nodular lesions (9)(10)(11). However, there is a possibility of bleeding and hematoma formation during biopsy (12). Therefore, how to reduce the incidence of misdiagnosis by ultrasound technology is of great significance to clinical treatment.…”

Section: Introductionmentioning

confidence: 99%

Conventional ultrasonography and elastosonography in diagnosis of malignant thyroid nodules: A systematic review and meta-analysis

Zhang¹,

Wang²,

Jiang³

et al. 2023

Front. Endocrinol.

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PurposeTo evaluate the diagnostic value of conventional ultrasound and elastosonography in malignant thyroid nodules by meta-analysis.MethodsThe literature included in the Cochrane Library, PubMed, and Embase were searched by using “elastosonography, ultrasonography, thyroid nodules” as the keywords. The clinical studies using elastosonography and conventional ultrasound to diagnose thyroid nodules were selected, and histopathology of thyroid nodules was used as reference standards. The quality evaluation and heterogeneity test were performed on the literature that met the requirements, the combined specificity and sensitivity were pooled, and a comprehensive ROC curve analysis was performed. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool was utilized to evaluate the quality of each included study. Meta-DiSc version 1.4, StataSE 12 and Review Manager 5.4 were used.ResultsA total of nine studies assessed 3066 thyroid nodules (2043 benign and 1023 malignant). The pooled sensitivity, specificity, PLR, NLR, and DOR of conventional ultrasound for the diagnose of malignant thyroid nodules were 0.833 (95% CI 0.809-0.855), 0.818 (95% CI 0.801-0.835), 4.85 (95% CI 4.36-5.39), 0.20 (95% CI 0.17-0.23), and 29.38 (95% CI 23.28-37.08), respectively, with an AUC of 0.9068. Also, the pooled sensitivity, specificity, PLR, NLR, and DOR of elastosonography were 0.774 (95% CI 0.741-0.804), 0.737 (95% CI 0.715-0.758), 3.14(95% CI 2.85-3.47), 0.29 (95% CI 0.25-0.34), and 9.35 (95% CI 7.63-11.46), respectively, with an AUC of 0.8801. Three studies provided data regarding the conventional ultrasound and elastosonography. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.902 (95% CI 0.870-0.928), 0.649 (95% CI 0.616-0.681), 2.72 (95% CI 2.46-3.00), 0.14 (95% CI 0.11-0.19), 25.51 (95%CI 17.11–38.03), and 0.9294.ConclusionThe existing evidence shows that elastosonography cannot completely replace conventional ultrasound in the diagnosis of malignant thyroid nodules, and the combination of elastosonography and conventional ultrasound gives a better diagnostic precision.Systematic review registrationwww.crd.york.ac.uk, identifier PROSPERO CRD42022375808.

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“…Diagnosis of thyroid nodules aims to accurately identify malignancy and avoid overtreatment. Fine needle aspiration biopsy (FNAB) is used as the principal method for preoperative diagnosis of TC in clinical practice, which has the advantages of little damage to the body and avoiding tumor cell dissemination [7]. The Bethesda System for Reporting Thyroid Cytopathology categorizes the FNAB results into six groups (Ⅰ-Ⅵ) according to the cytological features [8].…”

Section: Introductionmentioning

confidence: 99%

Discovery and Validation ofRUNX1DNA Methylation in Differentiating Papillary Thyroid Cancer from Benign Nodules

Yin

Huang

et al. 2023

Preprint

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Although most thyroid nodules can be diagnosed preoperatively by thyroid ultrasonography and fine-needle aspiration biopsy, it remains a challenge to accurately identify malignancy of thyroid nodules when the biopsy is indeterminate. This study aims to explore a novel biomarker to distinguish benign and malignant thyroid nodules. Tissue samples from patients with Stage I&II papillary thyroid carcinoma (PTC) and benign thyroid nodules (BTN) were collected for genome profiling by methylation EPIC 850K array and RNA-Sequencing. Genes with significantly differential DNA methylation and inverse mRNA expression were filtered out. The altered methylation ofRUNX1gene was validated in two independent case-control studies with a total of 699 formalin fixed paraffin-embedded (FFPE) samples using mass spectrometry and calculated by binary logistic regression analysis. Hypomethylation ofRUNX1gene in PTC patients compared to BTN subjects was verified in Validation I (140 PTC vs. 189 BTN, ORs ≥ 1.50 per-10% methylation,P≤ 4.40E-05, for all measurable CpG sites) and Validation II (184 PTC vs. 186 BTN, ORs ≥ 1.72 per-10% methylation,P≤ 2.38E-11, for all measurable CpG sites). Besides,RUNX1methylation achieved good accuracy in differentiating early-stage PTC from BTN in Validation I (AUC: 0.74) and Validation II (AUC: 0.79). Gender- and age-stratified analysis revealedRUNX1hypomethylation as an important risk factor for thyroid disease in younger women. We disclosed a significant association betweenRUNX1hypomethylation and PTC, suggestingRUNX1methylation based on FFPE tissue samples as a potential biomarker for predicting malignancy of thyroid nodules.

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Ultrasound‐guided fine‐needle aspiration biopsy of thyroid nodules

Cited by 23 publications

References 10 publications

Considerable interobserver variation calls for unambiguous definitions of thyroid nodule ultrasound characteristics

Considerable interobserver variation calls for unambiguous definitions of thyroid nodule ultrasound characteristics

Conventional ultrasonography and elastosonography in diagnosis of malignant thyroid nodules: A systematic review and meta-analysis

Discovery and Validation ofRUNX1DNA Methylation in Differentiating Papillary Thyroid Cancer from Benign Nodules

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