Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules
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Abstract:
Fine needle aspiration biopsy is a crucial method for preoperative diagnosis of thyroid nodules. However, thyroid nodules classified as Bethesda categories III-V cannot obtain definite cytological results. Our aim was to study the diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III-V thyroid nodules, so as to provide more precise direction for the follow-up treatments. A total of 174 Bethesda categories III-V thyroid nodules performed TIRADS and BRAFV600E mutation analysis were included in the study. We retrospectively analyzed the ultrasound features as well as the results of BRAFV600E mutation of the 174 thyroid nodules. In the multiple regression analysis models, ultrasound features including lobulated or irregular margin, punctate echogenic foci, and shape with taller-than-wide were statistically significant in malignant nodules (p < 0.05). The area under the curve of the combination of TIRADS and BRAFV600E increased to 0.925, which were much higher than TIRADS (0.861) and BRAFV600E (0.804) separately. Combined diagnosis was of the greatest value to identify Bethesda III-V thyroid nodules definitely, especially with higher sensitivity (93%) and accuracy (90%).Keywords:
Thyroid Nodules
Value (mathematics)
Thyroid Nodules
Nodule (geology)
Clinical Practice
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Abstract Background: To compare the necessity between Fine-needle aspiration (FNA) biopsy and ultrasound examination in the diagnosis of different sizes of the thyroid nodules. Does the FNA biopsy have to do it all? Methods: A retrospective analysis was performed to 8352 thyroid patients who underwent thyroid operations between 2011 and 2016 in our hospital. Results: In FNA(+) group, the nodule was more smaller, the increment speed of the amount of operation increased more faster. In no FNA group, the increment speed decreased not obvious in nodules ≥10mm sub-group, but tremendous in both nodules 5mm-10mm sub-group and nodules ≤ 5mm sub-group no matter the nodules were malignant or benign. Over the six years, the total operation number increased, but operation of patients with nodules ≥10mm decreased slightly and operation of patients with nodules <10mm increased markedly especially in nodules ≤ 5mm sub-group. In no FNA group, to compare the malignancy or benign tumor after surgery between nodules 5mm-10mm sub-group and nodules ≥10mm sub-group, χ2=12.000，P=0.001, and between nodules ≤ 5mm sub-group and nodules ≥10mm sub-group, χ2=7.968，P=0.005, but between nodules 5mm-10mm sub-group and nodules ≤ 5mm sub-group, χ2=0.669，P=0.414. Further pairwise comparison showed, in nodules 5mm-10mm sub-group and nodules ≤ 5mm sub-group, the probability of benign tumor was greater than nodules ≥10mm sub-group. Conclusions: In thyroid nodules ≥10mm sub-group, there is no statistical difference between ultrasound diagnosis and biopsy. In nodules <10mm sub-groups, FNA biopsy has the great significance in the diagnosis to add more references for the subsequent treatment.
Thyroid Nodules
Nodule (geology)
Group B
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Most benign thyroid nodules are treated conservatively. This report reviews transition of benign thyroid nodules in major axis by ultrasonography. We examined 79 patients (109 nodules) diagnosed as those having benign thyroid nodules using fine needle aspiration biopsy (FNAB) and ultrasonography in 1998. None of these patients received any medical and surgical treatments. Nodules that were unchanged or decreased in size accounted for more than 70% of benign nodules. More than 60% of solid nodules did not change or decrease in size. The nodules that were initially smaller, increased in size, while most large nodules were unchanged or decreased. Benign nodules that are unchanged or decrease in size do not have to be treated positively, but nodules that increase in size should undergo repeat FNAB.
Thyroid Nodules
Nodule (geology)
Aspiration biopsy
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Introduction. The widespread use of diagnostic imaging favored the increasing incidence of thyroid nodules. Although most of nodules are benign, their clinical importance lies in the need to exclude malignancy. In assessing and managing thyroid nodules may occur the phenomenon of overdiagnosis and overtreatment on one hand and the risk of missing an aggressive thyroid cancer on the other hand. The equilibrium that has to be reached by health care providers. Materials and methods. We conducted a PubMed, MEDLINE, ISI Web of Science, Cochrane databases search for the relevant and recent guidelines, meta-analysis, randomized controlled trial, reviews articles related to „thyroid nodules assessment”, „thyroid nodules management”, „thyroid nodules guidelines”, „thyroid nodules surgery”. Results. The initial assessment of thyroid nodules includes an evaluation of clinical, laboratory and sonographic risk factors. Due to the sonographic features and size, the nodules are selected for biopsy. Cytologically benign nodules are usually followedup, minimally invasive techniques may be required in certain cases. In suspected or confirmed malignancy, the treatment options of thyroid nodules include surgery or active surveillance. The main controversies appear in management of nodules with inconclusive cytology, low-risk cancers, multinodular goiters, hyperfunctioning nodules, and thyroid incidentalomas. Conclusions. Thyroid nodules due to the high incidence and heterogeneity of background diseases cannot be evaluated and managed in one standardized approach. In the existing literature, there are discussed multiple options for diagnosis and treatment of thyroid nodules. We have reviewed the guidelines recommendations, novel published data, and controversial questions for health care professionals, to understand and provide efficient, personalized, and cost-effective management of patients with thyroid nodules in order to avoid automatic intensive testing and intervention and balancing each case from the patient expectations and demands.
Thyroid Nodules
Overdiagnosis
Nodule (geology)
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Objective
To identify the risk factors that can predict the pathological diagnosis of thyroid nodules before operation, and to reduce the operation of benign nodules in all surgical nodules.
Methods
All consecutive patients with thyroid nodules who underwent surgery and had pathological diagnosis in 2011 were identified. Univariate and logistic multivariate analysis were carried out to exam the risk of malignant thyroid nodules.
Results
The proportion of pathologically malignant nodules in all nodules was 22%. Univariate and logistic multivariate analysis revealed that singles, shape, calcification, echo texture, margin and vascularity were associated with malignancy.
Conclusions
The proportion of pathologically malignant nodules in surgical nodules is relatively low, some ultrasound characteristics of thyroid nodules, called risk factors, were significant in predicting pathological diagnosis. Rational use of these risk factors can predict pathological diagnosis more accurately and reduce the proportion of benign nodules in all surgical nodules.
Key words:
B-type ultrasound examination; Thyroid nodules; Prediction
Thyroid Nodules
Vascularity
Nodule (geology)
Univariate analysis
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Objective T o investigate the value of ultrasound-guided fine-needle aspiration biopsy( U S-FNAB)for the diagnosis of thyroid nodules smaller than 10 mm in diameter. Methods T he clinical data of 105patients( 115 thyroid nodules) with thyroid nodules smaller than 10 mm were retrospectively analyzed. T he cytologic results of U S-FNAB were evaluated and compared to the surgical pathological results and clinical follow-up results. Results Among 115 small thyroid nodules diagnosed by the cytology, 24 nodules were malignant;9 nodules were suspicious for malignancy; 68 nodules were benign; 4 nodules were uncertain; and 10 nodules were inadequate. Actually there were 26 malignant nodules and 89 benign nodules confirmed by clinical follow-ups and pathological results. T he sensitivity, specificity, and accuracy of U S-FNAB for the diagnosis of thyroid nodules smaller than 10 mm were 88. 9%( 24 /27), 90. 0%( 79 /88), and 90. 0%( 103 /115), respectively.Conclusion U S-FNAB is accurate for the diagnosis of thyroid nodules smaller than 10 mm and valuable for practical application.
Thyroid Nodules
Nodule (geology)
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Thyroid Nodules
Indeterminate
Thyroglobulin
Follicular thyroid cancer
Nodule (geology)
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Thyroid Nodules
Thyroid tumors
Nodule (geology)
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