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Duman E, Aslan A, Buz A, Sancak S, Aslan M, Kabaalioglu A, Fersahoglu AT, Okuroglu N, Onur E. Interobserver and Intraobserver Reliability in Sonoelastographic Assessment of Thyroid Nodules. Ultrasound Q 2023; 39:53-60. [PMID: 35943395 DOI: 10.1097/ruq.0000000000000616] [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: 11/25/2022]
Abstract
BACKGROUND Thyroid ultrasonography is the first and perhaps most fundamental step for the radiological distinction of benign and malignant nodules. In this study, 2 radiologists reviewed the sonoelastographic and Doppler images of thyroid nodules and evaluated for the intraobserver and interobserver reliability. PURPOSE We aimed to determine confusing nodule identifiers and sonographic features differently defined by observers. METHODS A total of 157 nodules in 91 patients (male/female, 72:19) with ages ranging from 18 to 72 years old were included in the study. Ultrasonographic images and video clips of the nodules were obtained and presented to 2 reviewers unaware of the cytopathology results. Two observers defined the characteristics of the nodules based on previously determined criteria. Then, intraobserver and interobserver correlation coefficients were calculated for each subcategory. RESULTS In the grayscale ultrasonographic examination, varying degrees from low to high interobserver correlation coefficients were obtained for different subcategories (between κ = 0.359 and κ = 0.821). In color Doppler examination, we obtained medium correlation coefficients ( κ = 0.493 and κ = 0.553). On the other hand, there was a high correlation coefficient in tissue compression elastography ( κ = 0.617 and κ = 0.638).According to our study results, elastographic pattern, shape of the nodule, presence of echogenic foci, and pathological lymph nodes are better predictors to determine the malignant potential of thyroid nodule with higher interobserver correlation. Therefore, these criteria may be used primarily for the evaluation of thyroid nodules. The intraobserver correlation coefficient was higher in the practitioner with longer experience, suggesting the importance of professional practice period on the decision-making process.
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Affiliation(s)
- Emrah Duman
- Department of Radiology, Göztepe Training and Research Hospital, Faculty of Medicine, Istanbul Medeniyet University Medical School, İstanbul, Turkey
| | | | - Aysenur Buz
- Department of Radiology, Vezirkopru State Hospital, Samsun
| | - Seda Sancak
- Department of Internal Medicine, Endocrinology and Metabolism Disorders, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | | | | | - Ayse Tuba Fersahoglu
- Department of General Surgery, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital
| | - Nalan Okuroglu
- Department of Internal Medicine, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Ender Onur
- Department of General Surgery, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital
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Zhang X, Chen L, Zhang H, Nong L, Wang F. Ultrasonic Characterization of Primary Squamous Cell Carcinoma of the Thyroid. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2317-2322. [PMID: 34927280 DOI: 10.1002/jum.15918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/29/2021] [Accepted: 12/05/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To identify the ultrasonographic characteristics of primary squamous cell carcinoma of the thyroid (PSCCT), and to assess the value of the 2015 American Thyroid Association (ATA) guideline and 2017 American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) in the evaluation of this disease. METHODS Eight patients with 9 PSCCTs over a 20-year study period were enrolled. Ultrasonic characteristics including nodule echogenicity, composition, shape, margin, calcification, size, vascularity, and cervical lymphadenopathy were reviewed. All nodules were then evaluated by 2017 ACR TI-RADS and 2015 ATA guidelines. RESULTS The average size of PSCCTs was 3.87 ± 1.41 cm. All PSCCTs were hypoechoic or very hypoechoic, solid nodules with intranodular vascularity. The average resistive index (RI) was 0.84 ± 0.18. Near half of PSCCTs (44.4%) demonstrated extrathyroidal extension. Taller-than-wide signs and cervical lymphadenopathy were observed in 33.3% of PSCCTs, and microcalcification was observed in 11.1% of them. All PSCCTs were classified as high suspicion patterns by 2015 ATA and recommended for fine-needle aspiration (FNA). Six PSCCTs (66.7%) were classified as grade 5 by 2017 ACR TI-RADS, while the remaining were grade 4. 88.9% of PSCCTs were recommended for FNA based on 2017 ACR TI-RADS. CONCLUSION PSCCT has certain ultrasonic features, including relatively large, hypoechoic, or very hypoechoic solid nodules with intranodular vascularity and extrathyroidal extension. Both 2015 ATA and 2017 ACR TI-RADS could identify PSCCT as suspicious for malignancy.
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Affiliation(s)
- Xiumei Zhang
- Department of Ultrasound, Peking University First Hospital, Beijing, China
| | - Lei Chen
- Department of Ultrasound, Peking University First Hospital, Beijing, China
| | - Hong Zhang
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Lin Nong
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Fumin Wang
- Department of Ultrasound, Peking University First Hospital, Beijing, China
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Haghpanah S, Pishdad P, Zarei T, Shahsavani A, Amirmoezi F, Ilkhanipoor H, Ilkhanipoor H, Safaei S, Setoodegan F, De Sanctis V, Karimi M. Frequency of thyroid nodules in patients with β-thalassemias in Southern Iran. ACTA ENDOCRINOLOGICA-BUCHAREST 2020; 16:68-73. [PMID: 32685041 DOI: 10.4183/aeb.2020.68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Although thyroid nodules are a common finding in the general population, determining the clinically important nodules is essential. We investigated thyroid nodules or cysts by thyroid ultrasonography (US) in patients with β-thalassemia major (β-TM) and intermedia (β-TI). We also report a β-TI patient who was diagnosed with thyroid cancer six months before our screening. Methods In this cross-sectional study, 178 patients with β-thalassemias referred to the Thalassemia Clinic in a tertiary hospital affiliated to Shiraz University of Medical Sciences were investigated, from January to June 2016, by US. Results Thyroid nodules or cysts were detected in 11 patients [total: 6.17 %; 8 patients with β-TM (8.2%) and 3 patients with β-TI (3.7%)]. All nodules were < 1 cm in diameter and were not suspicious of malignancy. All patients, after 1 year of thyroid US follow-up, did not show any significant change in favor of malignancy. Conclusion Based on our results, the frequency of thyroid nodules was similar to what was reported in the general population. However, a long-term follow-up of these patients is recommended because of the potential carcinogenic effects of iron and hepatitis C infection (HCV). To achieve more precise information, collaborative multicenter studies should be considered.
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Affiliation(s)
- S Haghpanah
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - P Pishdad
- Shiraz University of Medical Sciences, Medical Imaging Research Center - Shiraz, Iran
| | - T Zarei
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - A Shahsavani
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - F Amirmoezi
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - H Ilkhanipoor
- Shiraz University of Medical Sciences, Pediatric Endocrinologist, Shiraz, Iran
| | - H Ilkhanipoor
- Shiraz University of Medical Sciences, Medical Imaging Research Center - Shiraz, Iran
| | - S Safaei
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - F Setoodegan
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - V De Sanctis
- Quisisana Hospital, Pediatric and Adolescent Outpatient Clinics, Ferrara, Italy
| | - M Karimi
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
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Rahemi Karizaki S, Alamdaran SA, Bonakdaran S, Morovatdar N, Jafarain AH, Sharifi Hadad A, Hadadzade A. NEW PROPOSED FORMULA OF TI-RADS CLASSIFICATION BASED ON ULTRASOUND FINDINGS. ACTA ENDOCRINOLOGICA-BUCHAREST 2020; 16:199-207. [PMID: 33029237 DOI: 10.4183/aeb.2020.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Introduction The present study aimed to introduce a new formula for classification of nodules in TI-RADS and describe ultrasonography features of benign and malignant thyroid nodules. Methods This study was conducted on thyroid mass in 1033 patients. The incidence of malignancy for thyroid nodules was determined by selecting malignancy coefficients. Then the patients were first classified using conventional TI-RADS classification criteria and once again according to a new proposed formula. Results Among ultrasonography features of thyroid nodules, the irregular shape (46.7%), unclear margin (47.3%), extension to the capsule (irregular and infiltrative margin) (85%), the marked hypo-echoic nodules (63.8%), micro-calcification (49%), and to have vertical axis (74.0%) were associated with high incidence of malignancy. Conclusion According to the proposed new formula for TI-RADS, there are four coefficients of 7, 3, 1 and 0 for incidence of malignancy of each one of ultrasound findings that help to standardization and unifying of TI-RADS classification. The incidence of malignancy in TI-RADS classification according to the new proposed formula was achieved as follows: group 2: 0.0%, group 3: 0.7%, groups 4a, 4b, 4c: 16.7%, 43.4%, 68.5%, and group 5: 95.2%, respectively.
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Affiliation(s)
- S Rahemi Karizaki
- Mashhad University of Medical Sciences, Omid Hospital - Radiology - Mashhad, Iran
| | - S A Alamdaran
- Mashhad University of Medical Sciences, Omid Hospital - Radiology - Mashhad, Iran
| | - S Bonakdaran
- Mashhad University of Medical Sciences, Omid Hospital - Endocrine Research Center-Ghaem Hospital, Mashhad, Iran
| | - N Morovatdar
- Mashhad University of Medical Sciences, Omid Hospital - Social Medicine, Mashhad, Iran
| | - A H Jafarain
- Mashhad University of Medical Sciences, Omid Hospital - Pathology, Mashhad, Iran
| | - A Sharifi Hadad
- Mashhad University of Medical Sciences, Omid Hospital - Radiology - Mashhad, Iran
| | - A Hadadzade
- Mashhad University of Medical Sciences, Omid Hospital - Radiology - Mashhad, Iran
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Kardelen Al AD, Yılmaz C, Poyrazoglu S, Tunca F, Bayramoglu Z, Bas F, Bundak R, Gilse Senyurek Y, Ozluk Y, Yegen G, Yeşil S, Darendeliler F. THE ROLE OF THYROID FINE-NEEDLE ASPIRATION CYTOLOGY IN THE TREATMENT AND FOLLOW-UP OF THYROID NODULES IN THE PEDIATRIC POPULATION. ACTA ENDOCRINOLOGICA-BUCHAREST 2019; 15:333-341. [PMID: 32010352 DOI: 10.4183/aeb.2019.333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective Thyroid fine-needle aspiration (FNA) and cytology is a reliable diagnostic method used in the assessment of malignancy when evaluating thyroid nodules, in conjunction with clinical and ultrasonographic findings. The aim of this study is to compare clinical, ultrasonographic, cytological and histopathological findings in children who underwent thyroid FNA. Methods Subjects comprised 80 patients (52 female) aged 13.7±2.8 years at the time of FNA who where evaluated for thyroid nodules. Clinical, ultrasonographic and cytological findings of patients were evaluated retrospectively. Results Autoimmune thyroiditis was present in 30% and history of radiotherapy to the head or neck in 10%. The cytological diagnosis of patients included: inadequate or hemorrhagic sample in 10%; benign in 42.5%; atypia or follicular lesion of undetermined significance (AUS/FLUS) in 15%; suspicion of follicular neoplasia (SFN) in 7.5%; suspicion of malignancy (SM) in 8.8%; and malignant in 16.3%. Thirty-seven patients underwent thyroidectomy. Malignancy rates for histopathologic follow-up were 75%, 85.7% and 100% for SFN, SM and malignant categories, respectively. Only one benign and two AUS/FLUS FNAs were found to be malignant on histopathological examination. Among patients who had received radioiodinetherapy, 87.5% had malignancy. In this study, the sensitivity of FNA was 96%, specificity 50%, positive predictive value 90.9%, negative predictive value 75%, and diagnostic value of FNA was 89.2%. Conclusion Thyroid FNA results were highly compatible with histopathological examination. Sensitivity, positive predictive value and diagnostic value of FNA were high.
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Affiliation(s)
- A D Kardelen Al
- Istanbul University - Pediatric Endocrinology, Istanbul, Turkey
| | - C Yılmaz
- Istanbul University - Pediatrics, Istanbul, Turkey
| | - S Poyrazoglu
- Istanbul University - Pediatric Endocrinology, Istanbul, Turkey
| | - F Tunca
- Istanbul University - General Surgery, Istanbul, Turkey
| | - Z Bayramoglu
- Istanbul University - Radiology, Istanbul, Turkey
| | - F Bas
- Istanbul University - Pediatric Endocrinology, Istanbul, Turkey
| | - R Bundak
- Istanbul University - Pediatric Endocrinology, Istanbul, Turkey
| | | | - Y Ozluk
- Istanbul University - Pathology, Fatih, Istanbul, Turkey
| | - G Yegen
- Istanbul University - Pathology, Fatih, Istanbul, Turkey
| | - S Yeşil
- Istanbul University - Pathology, Fatih, Istanbul, Turkey
| | - F Darendeliler
- Istanbul University - Pediatric Endocrinology, Istanbul, Turkey
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Larg MI, Barbus E, Gabora K, Pestean C, Cheptea M, Piciu D. 18F-FDG PET/CT IN DIFFERENTIATED THYROID CARCINOMA. ACTA ENDOCRINOLOGICA-BUCHAREST 2019; 15:203-208. [PMID: 31508177 DOI: 10.4183/aeb.2019.203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Aim Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) become an important tool in oncology by combining the metabolic information from 18F-FDG PET with the morphological information of CT. The main objective of this study was to assess the diagnostic value of PET/CT in patients with differentiated thyroid carcinoma (DTC). Material and Methods We analyzed 173 PET/CT scans of patients with DTC presenting elevated thyroglobulin (Tg) levels, negative Tg-antibodies levels, negative Iodine-131 whole-body scanning (I-131 WBS) and without any signs of clinical or other imaging technique for tumor recurrence/metastases. Results PET/CT scans were positive in 38% of cases (65/173). The sensitivity, specificity, positive predictive values and the accuracy of PET/CT imaging were 88.09%, 98.6%, 93.1% respectively 96.53%. After the PET/CT scan 29 patients underwent surgery, 24 of them continued radio-iodine therapy, 5 patients initiated tyrosine kinase inhibitors treatment and external radiotherapy. Conclusion 18F-FDG PET/CT is a valuable imaging technique which has the capability of identifying those cases of thyroid recurrence/metastases with elevated Tg levels and negative I-131 WBS. The treatment strategy was changed in 89.2% cases of positive PET/CT scans which shows us that 18F-FDG PET/CT imaging should be integrated into the follow-up programs for DTC patients.
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Affiliation(s)
- M I Larg
- "Prof. Dr. Ion Chiricuta" Oncology Institute - Nuclear Medicine Department, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - E Barbus
- "Prof. Dr. Ion Chiricuta" Oncology Institute - Nuclear Medicine Department, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - K Gabora
- "Prof. Dr. Ion Chiricuta" Oncology Institute - Nuclear Medicine Department, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C Pestean
- "Prof. Dr. Ion Chiricuta" Oncology Institute - Nuclear Medicine Department, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - M Cheptea
- "Prof. Dr. Ion Chiricuta" Oncology Institute - Nuclear Medicine Department, Cluj-Napoca, Romania
| | - D Piciu
- "Prof. Dr. Ion Chiricuta" Oncology Institute - Nuclear Medicine Department, Cluj-Napoca, Romania.,"Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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