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Song Y, Huang Y, Sun M, Yi W, Yuan X, Zhang Q, Cai H, Liu J. Normalized TSH strategy can improve the initial assessment of thyroid nodules. Scand J Clin Lab Invest 2023; 83:318-322. [PMID: 37382084 DOI: 10.1080/00365513.2023.2225220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 06/01/2023] [Accepted: 06/11/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Serum thyrotropin (TSH) has been recommended for the initial assessment of patients with thyroid nodules to exclude functional thyroid nodules (FTN). However, the sensitivity of TSH is very low. The increased level of thyroid peroxidase antibody (TPOAb) is considered to be one of the reasons. OBJECTIVE To investigate whether normalized TSH (nTSH) can improve diagnostic efficiency by removing TPOAb interference in the first evaluation of thyroid nodules compared with traditional TSH strategy. METHODS Thyroid nodules were retrospectively analysed in 90 patients with FTN and 1038 patients with non-functioning thyroid nodules (non-FTN). The regression coefficient (β) of TPOAb affecting the TSH levels was assessed in patients with thyroid nodules, and then, the nTSH level was calculated based on the following formula: nTSH = TSH-β*TPOAb. We used nTSH levels to initially evaluate the thyroid nodules instead of the traditional TSH values and finally compared the results of the two strategies. RESULTS The sensitivity, specificity, accuracy, positive prediction rate (PPV) and negative prediction rate (NPV) of nTSH for accessing FTN were 50.00%, 87.70%, 84.67%, 26.01% and 95.29%, respectively, which were better than the values of 48.90%, 78.70%, 76.33%, 16.60% and 94.67% associated with TSH, respectively (p < 0.001). CONCLUSION Serum TPOAb testing is recommended for the first assessment of thyroid nodules. Normalized TSH levels can improve assessment efficiency compared to traditional TSH assessment, increase the specificity and reduce an unnecessary 99mTc-TS test.
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Affiliation(s)
- Yingchun Song
- Department of Nuclear Medicine, Tongji University School of Medicine, Shanghai Tenth People's Hospital, Shanghai, China
| | - Yanmin Huang
- Yi Xing Hospital of Integrated Traditional Chinese and Western Medicine, Yixing, China
| | - Ming Sun
- Department of Nuclear Medicine, Tongji University School of Medicine, Shanghai Tenth People's Hospital, Shanghai, China
| | - Wanwan Yi
- Department of Nuclear Medicine, Tongji University School of Medicine, Shanghai Tenth People's Hospital, Shanghai, China
| | - Xueyu Yuan
- Department of Nuclear Medicine, Tongji University School of Medicine, Shanghai Tenth People's Hospital, Shanghai, China
| | - Qian Zhang
- Department of Nuclear Medicine, Tongji University School of Medicine, Shanghai Tenth People's Hospital, Shanghai, China
| | - Haidong Cai
- Department of Nuclear Medicine, Tongji University School of Medicine, Shanghai Tenth People's Hospital, Shanghai, China
| | - Jin Liu
- Department of Nuclear Medicine, Tongji University School of Medicine, Shanghai Tenth People's Hospital, Shanghai, China
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Schanaider A, Barboza T, Vasconcellos M, Gutfilen-Schlesinger G, de Souza SAL. Rat thyroid graft transplantation after cryopreservation with scintigraphic standardization for an experimental study. Clinics (Sao Paulo) 2022; 77:100065. [PMID: 35767899 PMCID: PMC9253157 DOI: 10.1016/j.clinsp.2022.100065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/04/2022] [Accepted: 06/02/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Budget cuts among other factors undermine the use of state-of-the-art equipment by many research groups. This doesn't mean that their scientific data are not reliable or top-notch. Resort to adaptations is a recurrent need in their reality. The aim of this study was to assess whether scintigraphy with 99mTcO4 is effective in evaluating the functionality of thyroid grafts after cryopreservation in rats. MATERIAL AND METHODS 24 rats were randomly distributed into 3 groups: Control Group (CG), without surgical procedure, Hypothyroidism Group (HTG), submitted to total thyroidectomy, and Transplanted Group (TG), with total thyroidectomy and cryopreservation of the thyroid gland for 7 days followed by grafting of a thyroid lobe. A protocol using a gamma camera imaging was conducted fourteen weeks after transplantation, and the whole body 99mTc, focusing on the topic of heterotopic thyroid uptake was evaluated. RESULTS The images acquired had good quality with no noise and artifacts that could jeopardize its analysis. On the 14th day, HTG displayed no thyroid uptake, and the TG had a clear uptake of the thyroid graft in the topography of the biceps femoris muscle. Presented data also showed that both equipment spatial resolution and alignment (4.375 mm) did not interfere with the physiological uptake of 99mTc by the thyroid graft. CONCLUSION The viability and functionality of cryopreserved thyroid autotransplantation in rats who underwent total thyroidectomy were successfully accessed by the scintigraphy protocol developed.
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Affiliation(s)
- Alberto Schanaider
- Programa de Pós-Graduação em Ciências Cirúrgicas, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Thiago Barboza
- Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brazil
| | - Marcel Vasconcellos
- Programa de Pós-Graduação em Ciências Cirúrgicas, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gabriel Gutfilen-Schlesinger
- Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brazil
| | - Sergio Augusto Lopes de Souza
- Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brazil.
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Almohammed HI, Mansour S, Alhulwah AH, Mayhoub FH, Arafah AM. Scintigraphy has the potential to replace thyroid stimulating hormone and ultrasonography in hyperthyroidism diagnosis. Saudi J Biol Sci 2020; 27:1722-1725. [PMID: 32565688 PMCID: PMC7296473 DOI: 10.1016/j.sjbs.2020.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 11/29/2022] Open
Abstract
The value of thyroid scintigraphy in hyperthyroidism diagnosis has long been the subject of debate. Unresolved issue is whether scintigraphy should be performed routinely, selectively, or for all hyperthyroidism patients. So, this study is concerned with the evaluation of thyroid scintigraphy for identifying hyperthyroidism in comparison with thyroid stimulating hormone (TSH) and ultrasound. This is cross sectional study including convenient patients sample (n = 50, 15 males and 35 females) aged (20-50 years) with primary hyperthyroidism and were attending endocrine clinics at King Faisal Specialist Hospital and Research Centre. All patients performed clinical investigations (TSH, ultrasound and thyroid scintigraphy). Among these patients, 96%, 48/50, had positive findings for hyperthyroidism with thyroid SC (95% CI; 96.0-99.5%); 84%, 42/50, had positive findings for hyperthyroidism by US (95% CI; 70.9-92.8%); and 56%, 28/50, had positive findings for hyperthyroidism by TSH measurement (95% CI; 41.3.0-70.0%). There was very good agreement between scintigraphy diagnosis and ultrasonography (kappa score = 0.812 (P < 0.0001), 95% CI (0.77-0.85). In many cases, scintigraphy provides considerably more functioning and anatomic details than ultrasound. In conclusion, these findings bring forth practical aspects of thyroid scintigraphy utilization for hyperthyroidism. By combining functional and anatomical information in one step, scintigraphy provides non-invasive, simple, fast and cost effective hyperthyroidism diagnostic method and has the potential to replace TSH and ultrasonography in hyperthyroidism investigation.
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Affiliation(s)
- Huda I Almohammed
- Radiological Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sahar Mansour
- Radiological Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Arwa H Alhulwah
- Radiological Sciences Department, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fareed H Mayhoub
- Biomedical Physics Department, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ahnaf M Arafah
- Nuclear Medicine Section, Department of Radiology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
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Baser H, Topaloglu O, Bilginer MC, Ulusoy S, Kılıcarslan A, Ozdemir E, Ersoy R, Cakir B. Are cytologic and histopathologic features of hot thyroid nodules different from cold thyroid nodules? Diagn Cytopathol 2019; 47:898-903. [DOI: 10.1002/dc.24251] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/05/2019] [Accepted: 05/28/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Husniye Baser
- Department of Endocrinology and Metabolism; Yildirim Beyazit University Faculty of Medicine; Ankara Turkey
| | - Oya Topaloglu
- Department of Endocrinology and Metabolism; Yildirim Beyazit University Faculty of Medicine; Ankara Turkey
| | - Muhammet C. Bilginer
- Department of Endocrinology and Metabolism; Yildirim Beyazit University Faculty of Medicine; Ankara Turkey
| | - Serap Ulusoy
- Department of General Surgery; Yildirim Beyazit University Faculty of Medicine; Ankara Turkey
| | - Aydan Kılıcarslan
- Department of Pathology; Yildirim Beyazit University Faculty of Medicine; Ankara Turkey
| | - Elif Ozdemir
- Department of Nuclear Medicine; Yildirim Beyazit University Faculty of Medicine; Ankara Turkey
| | - Reyhan Ersoy
- Department of Endocrinology and Metabolism; Yildirim Beyazit University Faculty of Medicine; Ankara Turkey
| | - Bekir Cakir
- Department of Endocrinology and Metabolism; Yildirim Beyazit University Faculty of Medicine; Ankara Turkey
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Małkowski B, Serafin Z, Glonek R, Suwała S, Łopatto R, Junik R. The Role of 18F-FDG PET/CT in the Management of the Autoimmune Thyroid Diseases. Front Endocrinol (Lausanne) 2019; 10:208. [PMID: 31024448 PMCID: PMC6460940 DOI: 10.3389/fendo.2019.00208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/14/2019] [Indexed: 01/14/2023] Open
Abstract
Objective: It is a well-known fact that positron emission tomography (PET) is an effective tool in the assessment of thyroid focal lesions, however only few studies so far have investigated its role in monitoring of autoimmune thyroid diseases (AITDs). The aim of this study is to assess if PET scan may be useful for the assessment of the thyroid gland in patients with an AITD-Hashimoto's thyroiditis. Methods: We evaluated twenty subjects with diagnosed Hashimoto's thyroiditis (proven by presence of elevated thyroid antibodies level and by thyroid imaging). The maximum standardized uptake value (SUV-max) of the thyroid parenchyma was measured using 18F-FDG-PET/CT. Control group consisted of patients who have been in carcinoma remission for other reasons than thyroid cancer and who had been investigated by PET scan to exclude carcinoma recurrence. All control group subjects had their thyroid glands intact, none of them had a medical history of thyroid disease including thyroid nodules. AITDs had been excluded in all control group subjects. STATISTICA 13.1 software was used for statistical analysis. Results: Results: The SUV-max was significantly higher in patients with an AITD than in healthy subjects (median SUV-max 3.94 vs. 1.95; p = 0.005). Conclusions: 18F-FDG-PET/CT scan may differentiate normal thyroid parenchyma from the diffused inflammatory changes of the thyroid gland in patients with AITDs. However, the researchers must be continued.
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Affiliation(s)
- Bogdan Małkowski
- Department of Nuclear Medicine, Oncology Centre, prof. Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, University of Nicolaus Copernicus in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Rafał Glonek
- Department of Endocrinology and Diabetology, University of Nicolaus Copernicus in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
- *Correspondence: Rafał Glonek
| | - Szymon Suwała
- Department of Endocrinology and Diabetology, University of Nicolaus Copernicus in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Rita Łopatto
- Department of Nuclear Medicine, Oncology Centre, prof. Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
| | - Roman Junik
- Department of Endocrinology and Diabetology, University of Nicolaus Copernicus in Torun, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
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Schenke S, Seifert P, Zimny M, Winkens T, Binse I, Görges R. Risk Stratification of Thyroid Nodules Using the Thyroid Imaging Reporting and Data System (TIRADS): The Omission of Thyroid Scintigraphy Increases the Rate of Falsely Suspected Lesions. J Nucl Med 2018; 60:342-347. [DOI: 10.2967/jnumed.118.211912] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 07/20/2018] [Indexed: 02/07/2023] Open
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Ardakani AA, Mohammadzadeh A, Yaghoubi N, Ghaemmaghami Z, Reiazi R, Jafari AH, Hekmat S, Shiran MB, Bitarafan-Rajabi A. Predictive quantitative sonographic features on classification of hot and cold thyroid nodules. Eur J Radiol 2018; 101:170-177. [PMID: 29571793 DOI: 10.1016/j.ejrad.2018.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/04/2018] [Accepted: 02/09/2018] [Indexed: 02/01/2023]
Abstract
PURPOSE This study investigated the potentiality of ultrasound imaging to classify hot and cold thyroid nodules on the basis of textural and morphological analysis. METHODS In this research, 42 hypo (hot) and 42 hyper-function (cold) thyroid nodules were evaluated through the proposed method of computer aided diagnosis (CAD) system. To discover the difference between hot and cold nodules, 49 sonographic features (9 morphological, 40 textural) were extracted. A support vector machine classifier was utilized for the classification of LNs based on their extracted features. RESULTS In the training set data, a combination of morphological and textural features represented the best performance with area under the receiver operating characteristic curve (AUC) of 0.992. Upon testing the data set, the proposed model could classify the hot and cold thyroid nodules with an AUC of 0.948. CONCLUSIONS CAD method based on textural and morphological features is capable of distinguishing between hot from cold nodules via 2-Dimensional sonography. Therefore, it can be used as a supplementary technique in daily clinical practices to improve the radiologists' understanding of conventional ultrasound imaging for nodules characterization.
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Affiliation(s)
- Ali Abbasian Ardakani
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mohammadzadeh
- Department of Radiology, Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Yaghoubi
- Department of Nuclear Medicine, Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghaemmaghami
- Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Reiazi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Medical Image and Signal Processing Research Core, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Homayoun Jafari
- Department of Medical Physics & Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Hekmat
- Department of Nuclear Medicine, School of Medicine, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Bagher Shiran
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Ahmad Bitarafan-Rajabi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Department of Nuclear Medicine, Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Abstract
BACKGROUND In addition to its established role in oncologic imaging, F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) is useful for the assessment of inflammatory activity. However, subacute thyroiditis (SAT) in thyrotoxicosis is rarely detected during these scans. CASE A 66-year-old man with SAT in thyrotoxicosis demonstrated symptoms of transient fatigue, headache, and fever, without typical neck pain. Using F-FDG PET/CT, we found increased F-FDG uptake in the thyroid gland, predominantly in the right side due to SAT. We also observed a coexisting decrease in F-FDG uptake in the liver and increased F-FDG uptake in skeletal muscle due to thyrotoxicosis. CONCLUSION Using F-FDG PET/CT, the combined observations of increased F-FDG uptake in the thyroid and skeletal muscle, and decreased F-FDG uptake in the liver, even when the typical symptom of neck pain is subtle or absent, may be helpful for the differential diagnosis of SAT in thyrotoxicosis.
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Affiliation(s)
| | - Hidetaka Yokoh
- Department of Clinical Cell Biology and Medicine, Graduate School of Medicine, Chiba University, Chiba
| | - Akira Toriihara
- Department of Diagnostic Radiology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo
| | - Hayahiko Fujii
- Department of Radiology, Asahi General Hospital, Chiba, Japan
| | - Naoki Harata
- Department of Radiology, Asahi General Hospital, Chiba, Japan
| | - Jun Isogai
- Department of Radiology, Asahi General Hospital, Chiba, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo
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