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Petersen M, Schenke SA, Seifert P, Stahl AR, Görges R, Grunert M, Klemenz B, Kreissl MC, Zimny M. Correct and Incorrect Recommendations for or against Fine Needle Biopsies of Hypofunctioning Thyroid Nodules: Performance of Different Ultrasound-based Risk Stratification Systems. Nuklearmedizin 2024; 63:21-33. [PMID: 37871628 DOI: 10.1055/a-2178-6739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
PURPOSE To evaluate the recommendations for or against fine needle biopsy (FNB) of hypofunctioning thyroid nodules (TNs) using of five different Ultrasound (US) -based risk stratification systems (RSSs). METHODS German multicenter study with 563 TNs (≥ 10 mm) in 534 patients who underwent thyroid US and surgery. All TNs were evaluated with ACR TI-RADS, EU-TIRADS, ATA, K-TIRADS 2016 and modified K-TIRADS 2021. A correct recommendation was defined as: malignant TN with recommendation for FNB (appropriate) or benign TN without recommendation for FNB (avoided). An incorrect recommendation was defined as: malignant TN without recommendation for FNB (missed) or benign TN with recommendation for FNB (unnecessary). RESULTS ACR TI-RADS demonstrated the highest rate of correct (42.3 %) and lowest rate of incorrect recommendations (57.7 %). The other RRSs showed similar results for correct (26.5 %-35.7 %) and incorrect (64.3 %-73.5 %) recommendations. ACR TI-RADS demonstrated the lowest rate of unnecessary (73.4 %) and the highest rate of appropriate (26.6 %) FNB recommendation. For other RSSs, the rates of unnecessary and appropriate FNB were between 75.2 %-77.1 % and 22.9 %-24.8 %. The lowest rate of missed FNB (14.7 %) and the highest rate of avoided FNB (85.3 %) was found for ACR TI-RADS. For the other RSSs, the rates of missed and avoided FNB were between 17.8 %-26.9 % and 73.1 %-82.2 %. When the size cutoff was disregarded, an increase of correct recommendations and a decrease of incorrect recommendations was observed for all RSSs. CONCLUSION The RSSs vary in their ability to correctly recommend for or against FNB. An understanding of the impact of nodule size cutoffs seems necessary for the future of TIRADS.
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Affiliation(s)
- Manuela Petersen
- Department of General, Visceral, Vascular and Transplant Surgery, University Hospital Magdeburg, Germany
| | - Simone A Schenke
- Department and Institute of Nuclear Medicine, Hospital Bayreuth, Germany
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Germany
| | - Philipp Seifert
- Clinic of Nuclear Medicine, University Hospital Jena, Germany
| | | | - Rainer Görges
- Clinic for Nuclear Medicine, University Hospital Essen, Germany
| | - Michael Grunert
- Department of Nuclear Medicine, German Armed Forces Hospital Ulm, Germany
- Department of Nuclear Medicine, University Hospital Ulm, Germany
| | - Burkhard Klemenz
- Department of Nuclear Medicine, German Armed Forces Hospital Ulm, Germany
| | - Michael C Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Germany
- Research Campus STIMULATE, Otto-von-Guericke University, Magdeburg, Germany
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Partsalaki I, Markantes GK, Michalaki MA. Low-Glycemic Load Diets and Thyroid Function: A Narrative Review and Future Perspectives. Nutrients 2024; 16:347. [PMID: 38337632 PMCID: PMC10857036 DOI: 10.3390/nu16030347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Nutrition and calorie intake are associated with subtle changes of thyroid function tests in subjects with an intact Hypothalamic-Pituitary-Thyroid axis. Iodine deficiency and extreme fluctuations in calorie intake, such as those that occur during periods of starvation or overfeeding could lead to alterations in thyroid hormones. The dietary macronutrient and micronutrient composition could also influence the thyroid function. Recently, Low-Glycemic Load (LGL) diets have become very popular and are effective in the treatment and/or prevention of several medical conditions, including diabetes, obesity, cardiovascular disease, and epilepsy. In this review, we report on the available data from the literature regarding the association between LGL diets and thyroid function or dysfunction. Several studies conducted in this field to date have yielded inconsistent results.
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Affiliation(s)
- Ioanna Partsalaki
- Department of Nutrition and Dietetics, University Hospital of Patras, 26504 Rio, Greece;
| | - Georgios K. Markantes
- Division of Endocrinology, Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Rio, Greece;
| | - Marina A. Michalaki
- Division of Endocrinology, Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Rio, Greece;
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Møllehave LT, Eliasen MH, Strēle I, Linneberg A, Moreno-Reyes R, Ivanova LB, Kusić Z, Erlund I, Ittermann T, Nagy EV, Gunnarsdottir I, Arbelle JE, Troen AM, Pīrāgs V, Dahl L, Hubalewska-Dydejczyk A, Trofimiuk-Müldner M, de Castro JJ, Marcelino M, Gaberšček S, Zaltel K, Puig-Domingo M, Vila L, Manousou S, Nyström HF, Zimmermann MB, Mullan KR, Woodside JV, Völzke H, Thuesen BH. Register-based information on thyroid diseases in Europe: lessons and results from the EUthyroid collaboration. Endocr Connect 2022; 11:e210525. [PMID: 35044931 PMCID: PMC8942317 DOI: 10.1530/ec-21-0525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/19/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Registers of diagnoses and treatments exist in different forms in the European countries and are potential sources to answer important research questions. Prevalence and incidence of thyroid diseases are highly dependent on iodine intake and, thus, iodine deficiency disease prevention programs. We aimed to collect European register data on thyroid outcomes to compare the rates between countries/regions with different iodine status and prevention programs. DESIGN Register-based cross-sectional study. METHODS National register data on thyroid diagnoses and treatments were requested from 23 European countries/regions. The provided data were critically assessed for suitability for comparison between countries/regions. Sex- and age-standardized rates were calculated. RESULTS Register data on ≥1 thyroid diagnoses or treatments were available from 22 countries/regions. After critical assessment, data on medication, surgery, and cancer were found suitable for comparison between 9, 10, and 13 countries/regions, respectively. Higher rates of antithyroid medication and thyroid surgery for benign disease and lower rates of thyroid hormone therapy were found for countries with iodine insufficiency before approx. 2001, and no relationship was observed with recent iodine intake or prevention programs. CONCLUSIONS The collation of register data on thyroid outcomes from European countries is impeded by a high degree of heterogeneity in the availability and quality of data between countries. Nevertheless, a relationship between historic iodine intake and rates of treatments for hyper- and hypothyroid disorders is indicated. This study illustrates both the challenges and the potential for the application of register data of thyroid outcomes across Europe.
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Affiliation(s)
- Line Tang Møllehave
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- Correspondence should be addressed to L T Møllehave:
| | - Marie Holm Eliasen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Ieva Strēle
- The Institute of Occupational Safety and Environmental Health, Riga Stradiņš University, Riga, Latvia
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rodrigo Moreno-Reyes
- Nuclear Medicine Department, Erasme Hospital, Brussels, Belgium
- Université Libre de Bruxelles, Bruxelles, Belgium
| | - Ludmila B Ivanova
- Faculty of Medicine, Sofia University St. Kl. Ohridski, Sofia, Bulgaria
| | - Zvonko Kusić
- Croatian Academy of Sciences and Arts, Zagreb, Croatia
- School of Medicine, Zagreb, Croatia
| | - Iris Erlund
- Department of Government Services, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Endre V Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ingibjorg Gunnarsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Department of Clinical Nutrition, Landspitali-National University Hospital, Reykjavik, Iceland
| | - Jonathan Eli Arbelle
- Division of Medicine, Maccabi Healthcare Services, Tel Aviv, Israel
- Goldman School of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Aaron Milton Troen
- The Institute of Biochemistry Food Science and Nutrition, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Valdis Pīrāgs
- Internal Medicine, University of Latvia, Riga, Latvia
| | - Lisbeth Dahl
- Seafood, Nutrition and Environmental State, Institute of Marine Research (IMR), Bergen, Norway
| | | | | | | | | | - Simona Gaberšček
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Zaltel
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Manuel Puig-Domingo
- Department of Endocrinology and Nutrition, Germans Trias Research Institute and Hospital, Badalona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lluis Vila
- Endocrinology and Nutrition Service, Hospital Moisés Broggi, Sant Juan Despi, Barcelona, Spain
| | - Sofia Manousou
- Sahlgrenska Academy, Institute of Medicine, Gothenburg, Sweden
- Frölunda Specialist Hospital, Västra Frölunda, Sweden
| | - Helena Filipsson Nyström
- Department of Endocrinology, Specialist Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre of Molecular and Translational Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Karen R Mullan
- Regional Centre for Endocrinology and Diabetes, Belfast Health and Social Care Trust, Belfast, UK
| | | | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Betina Heinsbæk Thuesen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
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Ruggeri RM, Trimarchi F. Iodine nutrition optimization: are there risks for thyroid autoimmunity? J Endocrinol Invest 2021; 44:1827-1835. [PMID: 33683664 DOI: 10.1007/s40618-021-01548-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/01/2021] [Indexed: 12/21/2022]
Abstract
Iodine deficiency is still the main cause of preventable thyroid disorders, worldwide. To optimize iodine intake, programs of voluntary or mandatory iodization of salt have been implemented in several iodine-deficient countries and iodine sufficiency has been achieved in many. Despite the clear beneficial effects on thyroid health, some concerns have been raised on the presumed detriment of iodine prophylaxis on thyroid autoimmunity. Very recent studies aimed at evaluating the long-term consequences of iodine supplementation on thyroid autoimmunity and related dysfunction, have clearly demonstrated that the early post-iodization increase in thyroid antibody positivity is largely transient and not clinically relevant, since the prevalence of overt thyroid dysfunction has remained reassuring low over two decades. The recommended iodine intake is therefore safe with regard to thyroid autoimmunity, the benefits largely outweighing the risks in a population with a stable median iodine concentration not exceeding 300 μg/L. Thus, a possible increase in thyroid autoimmunity should not represent a limitation to promoting iodine supplementation in the general population, also taking into account the steady rise in prevalence of autoimmune disorders which has occurred in the last few decades because of environmental factors other than iodine.
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Affiliation(s)
- R M Ruggeri
- Department of Clinical and Experimental Medicine, University of Messina, via Consolare Valeria, 1, 98125, Messina, Italy.
- Endocrine Unit At University Hospital "AOU Policlinico G.Martino", Messina, Italy.
| | - F Trimarchi
- Department of Clinical and Experimental Medicine, University of Messina, via Consolare Valeria, 1, 98125, Messina, Italy
- Accademia Peloritana Dei Pericolanti at the University of Messina, Messina, Italy
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