Neuroradiology/Head and Neck Imaging Original Research
|
|
- Arnold Taylor
- 6 years ago
- Views:
Transcription
1 Neuroradiology/Head and Neck Imaging Original Research Hobbs et al. FNA of Thyroid Nodules Neuroradiology/Head and Neck Imaging Original Research Hasan A. Hobbs 1 Manisha Bahl 1 Rendon C. Nelson 1,2 James D. Eastwood 1 Ramon M. Esclamado 2,3 Jenny K. Hoang 1,4 Hobbs HA, Bahl M, Nelson RC, Eastwood JD, Esclamado RM, Hoang JK Keywords: Society of Radiologists in Ultrasound, thyroid, thyroid nodule DOI: /AJR Received May 11, 2013; accepted after revision June 15, Department of Radiology, Division of Neuroradiology, Duke University Medical Center, DUMC Box 3808, Durham, NC Address correspondence to J. K. Hoang (jennykh@gmail.com). 2 Department of Radiology, Division of Abdominal Imaging, Duke University Medical Center, Durham, NC. 3 Department of Surgery, Division of Otolaryngology- Head and Neck Surgery, Duke University Medical Center, Durham, NC. 4 Department of Radiation Oncology, Duke University Medical Center, Durham, NC. This article is available for credit. AJR 2014; 202: X/14/ American Roentgen Ray Society Applying the Society of Radiologists in Ultrasound Recommendations for Fine-Needle Aspiration of Thyroid Nodules: Effect on Workup and Malignancy Detection OBJECTIVE. The Society of Radiologists in Ultrasound (SRU) recommendations on thyroid nodules are intended to diagnose thyroid cancers that have reached clinical significance, while avoiding unnecessary tests and surgery in patients with benign nodules. The aim of our study was to determine the proportion of thyroid nodules undergoing ultrasoundguided fine-needle aspiration (FNA) that do not meet SRU recommendations. MATERIALS AND METHODS. This study is a retrospective study of 400 consecutive ultrasound-guided thyroid FNA encounters from July 2010 through June An encounter was defined as presentation to the department of radiology on a given date for FNA of one or more thyroid nodules. The criteria for performing biopsy of a nodule were determined by the referring clinicians. Nodules were categorized on the basis of sonographic findings as meeting SRU recommendations for biopsy, which we refer to as SRU-positive, or not, which we refer to as SRU-negative. Patients without a definitive pathology diagnosis of Bethesda class benign or malignant nodules were excluded. The characteristics of malignancies were compared for SRU-positive and SRU-negative encounters. RESULTS. The final study group consisted of 360 biopsy encounters for 350 patients and 29 malignancies (8%). Of the 360 biopsy encounters, 86 (24%) were SRU-negative encounters. Malignancy rates in SRU-positive and SRU-negative encounters were 9% (24/274) and 6% (5/86), respectively, and were not significantly different (p = 0.5). Eighteen malignancies (75%) in the SRU-positive group were localized, whereas the others had nodal metastases (4/24) or distant metastases (2/24). SRU-positive encounters included medullary carcinoma, anaplastic carcinoma, and melanoma metastasis in addition to papillary carcinoma. All SRUnegative malignancies were localized papillary carcinomas. CONCLUSION. One in four thyroid biopsy encounters at our institution did not meet SRU recommendations for biopsy. The application of SRU recommendations reduces the number of benign nodules that undergo workup. Potentially missed malignancies in SRUnegative nodules are less aggressive by histologic type and stage compared with SRU-positive malignancies. T he Society of Radiologists in Ultrasound (SRU) provided sonographic criteria for the management of thyroid nodules in an article published in 2005 [1]. The SRU is an American society, and the criteria were developed by a panel of experts from several medical disciplines, including radiology, endocrinology, cytopathology, and surgery. These guidelines attempted to define recommendations for nodules that should and should not undergo ultrasound-guided fineneedle aspiration (FNA). The SRU recommendations assert that FNA is appropriate for nodules that are 10 mm or larger and have microcalcifications, nodules that are 15 mm or larger and are solid or have coarse calcifications, nodules that are 20 mm or larger and are mixed solid and cystic, and nodules with substantial growth since the prior ultrasound study. Despite the guidelines, the number of thyroid nodules undergoing ultrasound-guided FNA has continued to increase because more thyroid nodules undergo biopsy as a result of fear of missing a malignancy [2]. Many thyroid nodules undergoing sonographic workup are small incidental thyroid nodules detected on imaging. Although early diagnosis may be favorable in some malignancies, this may not be the case for thyroid cancer because the majority of the malignancies detected are small papillary carcinomas [3]. 602 AJR:202, March 2014
2 FNA of Thyroid Nodules TABLE 1: Study Subjects and Nodules Many experts believe that these small thyroid cancers represent pseudodisease and that most patients die with thyroid cancer rather than of thyroid cancer [1, 3]. Thus, an ideal approach to selecting which incidental thyroid nodules should undergo workup would not be to diagnose all cancers but, rather, to diagnose cancers that have reached clinical significance, while avoiding unnecessary tests and surgery in patients with benign nodules [1]. This statement is emphasized by the SRU recommendations. Although the specific intent of the SRU recommendations was to reduce the unnecessary workup of thyroid nodules, there were concerns that the recommendations could in fact lead to an increase in the number of thyroid FNAs and subsequent thyroid surgeries [1]. To date, the effect of the guidelines on thyroid FNA volume and malignancy rate and the acceptance of the guidelines in practice have not been evaluated. The aim of this study was to determine the proportion and type of thyroid nodules undergoing ultrasound-guided FNA at our institution that do not meet the SRU recommendations, which we refer to as SRU-negative. Our hypothesis was that many thyroid nodules undergoing FNA do not meet SRU recommendations and that SRU-negative malignancies are uncommon and are less aggressive. Materials and Methods Subjects and Pathologic Categorization This study was approved by our institutional review board and was compliant with the HIPAA. We retrospectively reviewed the records of 400 consecutive ultrasound-guided thyroid FNA encounters through the department of radiology during a 12-month period from July 2010 through June An encounter was defined as presentation to the department of radiology on a given date for FNA of one or more thyroid nodules. The criteria for selecting which nodule or nodules to biopsy were determined by the referring endocrinologists and endocrine surgeons, not the radiologist. In our institution the most common practice for diagnostic ultrasound is to report thyroid nodules 10 mm or larger in the impression section of the ultrasound report without adding a statement to recommend biopsy of the nodule unless there are highly suspicious features such as microcalcifications or hypoechogenicity. The medical records of all included patients were reviewed for the age and sex of the patient, pathologic diagnosis, and management. The pathologic diagnosis was defined by a surgical pathologic result if available (n = 87 patients) and an FNA cytopathologic result (n = 263 patients) if the patient did not undergo surgery. At our institution, FNA cytopathology results are characterized by the Bethesda System for Reporting Thyroid Cytopathology [4]. The Bethesda class categories include the following: class I, nondiagnostic or unsatisfactory; II, benign; III, atypia of undetermined significance or a follicular lesion of undetermined significance; IV, a follicular neoplasm or suspicious for a follicular neoplasm; V, suspicious for malignancy; and VI, malignant. Nodules with FNA cytopathologic results revealing Bethesda class I, III, IV, or V are not regarded as definitive results, and the Bethesda System [4] recommends repeat biopsy for classes I and III and diagnostic surgery for classes IV, V, and VI. A class II result is considered benign, and patients with a class II result do not undergo further biopsy or surgery. In this study, patients with a Bethesda class I, III, IV, or V result who did not undergo repeat Total Benign Malignant Characteristic No. % No. % No. % No. of encounters No. of patients Sex Male Female Age (y) Mean (SD) 55 (14) 55 (15) 54 (14) No. (%) of encounters by patient age 0 19 y y y y y Size of largest nodule for encounter (mm) Mean (SD) 26 (14) 26 (14) 28 (16) No. (%) of encounters by size of largest nodule 5 9 mm mm mm mm Note An encounter was defined as presentation to the department of radiology on a given date for fine-needle aspiration of one or more thyroid nodules. AJR:202, March
3 Hobbs et al. Thyroid FNAs performed during study period (n = 400) Benign (n = 250) SRU-positive (n = 274) FNAs included: Bethesda class II or VI cytopathologic result or final surgical pathology (n = 360) Malignant (n = 24) FNA or surgery were excluded from the study group. All malignancies (Bethesda class VI) were further followed for the stage of disease, treatment response, and overall survival. Benign (n = 81) SRU-negative (n = 86) Malignant (n = 5) Application of SRU Recommendations Diagnostic ultrasound (iu22 unit, Philips Healthcare) images of the thyroid nodules were obtained before the biopsy using a 12- MHz transducer. Thyroid nodules were measured on the ultrasound unit by the technologist or radiologist at the time of imaging and were documented in the examination report. These sizes were used, and the nodule was not measured retrospectively. A board-certified radiologist (7 years of experience) reviewed the ultrasound images on a PACS workstation for findings according to the SRU recommendations. SRU recommendations were met if the biopsied nodule had any of the following characteristics: size of 10 mm or larger with microcalcifications, size of 15 mm or larger with solid composition or coarse calcifications, size of 20 mm or larger with mixed solid-cystic composition, or substantial growth since the prior ultrasound. Because the SRU consensus statement does not explicitly define the requirements for substantial growth, a nodule was considered to show substantial growth if interval growth was the reason for the FNA and the nodule possessed no other criteria meeting SRU recommendations. Past ultrasound studies preceding the last diagnostic thyroid ultrasound were not reviewed specifically for substantial change. Biopsy encounters were categorized on the basis of the sonographic findings as meeting the SRU recommendations for biopsy, which we refer to as SRU-positive, or not. We measured potential reduction of workup by the number of patient encounters rather than individual nodules because the greatest cost saving is in preventing any FNA rather than preventing FNA of a second or third thyroid nodule. In patients who had more than one nodule biopsied during an encounter (n = 120), the encounter was categorized as SRUpositive if any nodule met the SRU recommendations or as SRU-negative if none of the nodules met the recommendations. SRU-negative encounters comprise the subgroup of patients for whom workup with FNA could have been avoided if the SRU recommendations had been applied at the time of biopsy. FNAs excluded: Bethesda class I, III, IV, or V cytopathologic result without repeat FNA or surgery (n = 40) SRU-positive (n = 30) 12 Bethesda class I 15 Bethesda class III 2 Bethesda class IV 1 Bethesda class V SRU-negative (n = 10) 7 Bethesda class I 3 Bethesda class III Fig. 1 Flowchart shows study cohort. Fine-needle aspiration (FNA) biopsy encounters were categorized on basis of sonographic findings as having met Society for Radiologists in Ultrasound (SRU) recommendations for biopsy, which we refer to as SRU-positive, or as not, which we refer to as SRU-negative. FNA cytopathologic results are characterized by Bethesda System for Reporting Thyroid Cytopathology [4]. Bethesda class categories include class I, nondiagnostic or unsatisfactory; II, benign; III, atypia of undetermined significance or follicular lesion of undetermined significance; IV, follicular neoplasm or suspicious for follicular neoplasm; V, suspicious for malignancy; and VI, malignant. Statistical Analysis Nodules biopsied in the SRU-positive and SRU-negative encounters were compared for size, malignancy rate, and characteristics of the malignancies (size, histologic diagnosis, and stage). The proportion of nodules not meeting the SRU recommendations was calculated as follows: (SRU-negative nodules / total nodules) 100. The malignancy rates in the SRU-positive and SRU-negative groups were compared with the Fisher exact test. The sensitivity and specificity of the SRU recommendations for thyroid malignancy were also calculated. Results Subjects and Pathology Four hundred biopsy encounters were performed for 390 patients during the study period. Forty patients were excluded because FNA cytopathologic results revealed Bethesda class I, III, IV, or V without repeat FNA or surgery for definitive pathology results. The final study group consisted of 360 biopsy encounters in 350 patients (290 female, 60 male; mean age, 604 AJR:202, March 2014
4 FNA of Thyroid Nodules TABLE 2: Characterization of Biopsy Encounters According to Whether Society of Radiologists in Ultrasound (SRU) Recommendations for Biopsy Were Met ( SRU-Positive ) or Not ( SRU-Negative ) Biopsy Encounters No. (%) of Encounters by SRU Criteria SRU Criteria No. % 10 mm With Microcalcifications 15 mm Solid Composition or With Coarse Calcifications 20 mm Mixed Solid and Cystic Substantial Growth Since Last Ultrasound SRU-positive 274 Benign (89) 174 (91) 40 (95) 2 (100) Malignant (11) 18 (9) 2 (5) SRU-negative 86 Benign Malignant 5 6 Note An encounter was defined as presentation to the department of radiology on a given date for fine-needle aspiration of one or more thyroid nodules. 55 years; age range, 7 91 years) (Table 1 and Fig. 1). In all patients, diagnostic ultrasound images of the thyroid nodule or nodules were obtained during the procedure. Almost all patients had undergone diagnostic ultrasound at a date before the ultrasound-guided FNA procedure. Sixty patients had incidental nodules seen initially on CT, MRI, or PET/CT. One hundred twenty patients (34%) underwent biopsy of more than one nodule, and a total of 507 nodules were biopsied. The mean nodule size was 26 ± 14 (SD) mm, and only 13 of 507 (2.5%) nodules were less than 10 mm in diameter. There were 29 malignancies in 360 encounters (8% malignancy prevalence), all of which were confirmed on final surgical pathology. The patients with malignancy had a mean age of 54 years (age range, years), and 20 of 29 (69%) were female. SRU Recommendations and Malignancy There were 397 SRU-positive and 110 SRU-negative nodules. In the 360 biopsy encounters, 274 had at least one SRU-positive nodule and 86 were SRU-negative (Table 2). If SRU recommendations had been applied before biopsy, 86 of 360 (24%) encounters would not have resulted in biopsy and 110 of 507 (22%) nodules would have not undergone a biopsy. In the SRU-positive group, 250 (91%) had a benign pathologic result and 24 (9%) had a malignant pathologic result. In the SRU-negative group, 81 (94%) had a benign pathologic result and five (6%) had a malignant pathologic result. There was no significant difference in the malignancy rates of the two groups (p = 0.50). The SRU-positive thyroid malignancies included 17 localized papillary carcinomas, four papillary carcinomas with nodal metastases, one localized medullary carcinoma, one anaplastic carcinoma with distant metastases, and one melanoma metastasis (Table 3). There was one tumor-related death during the study period: The diagnosis in that case was anaplastic thyroid carcinoma with metastases. All SRU-negative malignancies were localized papillary carcinomas that were 14 mm or smaller (Table 3). If the SRU recommendations had been applied before the biopsy, these five localized papillary thyroid carcinomas would not have been biopsied. Thus, applying the SRU recommendations would have resulted in a false-negative rate of 17% (5 missed malignancies / 29 total malignancies). The sensitivity and specificity of the SRU recommendations for thyroid malignancy in our cohort were 83% and 25%, respectively. Of the 40 biopsy encounters that were excluded because of no definitive pathologic diagnosis, 30 were SRU-positive encounters and were in the following Bethesda class: 12, class I; 15, class III; two, class IV; and one, class V. Ten encounters were SRU-negative: seven were class I and three were class III. Discussion The SRU recommendations were developed by an expert group of radiologists to assist physicians in deciding which nodules seen on ultrasound should undergo FNA. One of the concerns of the SRU was the unknown effect of the guidelines on the workup rate of thyroid nodules and the possibility that they could increase, rather than decrease, FNA and subsequent surgery. This study shows that using the SRU criteria for ordering ultrasound-guided FNA at our institution could have eliminated one in four biopsy encounters compared with current practice at our institution. The malignancies diagnosed in nodules that did not meet SRU criteria had a less aggressive histologic diagnosis than the SRU-positive malignancies. The SRU recommendations have been studied by Ahn et al. [5], who applied the criteria to nodules undergoing ultrasound-guided biopsy in their institution in South Korea. In their study, nodules smaller than 10 mm were also biopsied, which is not standard practice for nodules in low-risk patients in the United States without other suspicious sonographic findings [1, 6]. In our study, only 13 nodules were smaller than 10 mm. In their study [5], Ahn et al. performed an analysis of a subset of nodules 10 mm or larger and found that 40% of nodules did not meet SRU recommendations (396 SRU-negative nodules / 996 total nodules). This proportion of SRU-negative encounters is much greater than in our study (24%) and likely reflects the differences in biopsy selection between our institutions. The performance of the SRU recommendations reported as sensitivity and specificity for malignancy also differed between our studies: Ahn et al. found sensitivity and specificity to be 72% and 42%, respectively, whereas we found a higher sensitivity of 83% but a lower specificity of 25%. Sensitivity and specificity are dependent on the prevalence of disease; the prevalence of malignancy in our study group was 8%, compared with 16% in the study by Ahn and colleagues. The malignancy rate in our study is more consistent with those of other studies, and a recent meta-analysis of more than 25,000 FNA biopsies reported 5.4% of nodules were classified as malignant (Bethesda class VI) and 8.1% were classified as suspicious for malignancy (Bethesda class V) or malignant (Bethesda class VI) [7]. Multiple guidelines exist for the evaluation and workup of thyroid nodules based on sonographic criteria. In addition to the SRU guidelines, other major guidelines are from the National Comprehensive Cancer Network (NCCN), American Association of Clinical Endocrinologists (AACE), and American Thyroid Association (ATA) [6, 8, 9]. These guidelines may be the guidelines that some of our endocrinologists and surgeons use in recommending biopsy. The NCCN guidelines are most similar to the SRU guidelines in that the size cutoff for solid nodules without suspicious features is 15 AJR:202, March
5 Hobbs et al. TABLE 3: Categorization of Biopsies, Pathologic Results, and Treatments for Encounters That Met Society of Radiologists in Ultrasound (SRU) Recommendations for Biopsy ( SRU-Positive ) and Encounters That Did Not ( SRU-Negative ) Characteristic SRU-Positive SRU-Negative Total No. of biopsy encounters Size of nodule (mm) Mean (SD) 30 (16) 13 (3) Pathologic result, no. (%) of nodules Benign 250 (91) 81 (94) 331 Malignant 24 (9) 5 (6) 29 Stage of thyroid malignancy, no. (%) of nodules Localized 18 (75) 5 (100) 23 Regional 4 (17) 0 4 Metastatic 1 (4) 0 1 Metastasis to thyroid gland 1 (4) 0 1 Additional procedures in benign nodules, no. (%) of nodules Surgery for benign disease 58 (23) 5 (6) 63 Follow-up imaging 68 (27) 33 (40) 101 Note An encounter was defined as presentation to the department of radiology on a given date for fine-needle aspiration of one or more thyroid nodules. mm. Both the AACE and ATA recommend biopsy for solid nodules larger than 10 mm. In addition, the AACE recommends biopsy of any size nodule with one or more suspicious sonographic findings [8]. Overall, the larger size cutoff of the SRU and NCCN recommendations would result in higher specificity (workup of fewer benign cases) than the AACE and ATA guidelines for our cohort of patients. As seen from our results, the specificity for the SRU recommendations is already very low (25%). The cost of higher specificity for malignancy is a potentially higher false-negative rate and more missed malignancies. The falsenegative rate in our study was 17% for the SRU recommendations, but all the SRU-negative malignancies were smaller than 15 mm and were localized to the thyroid. Cancers of this size, histologic type, and stage have excellent survival of greater than 99%, and several experts believe that many of these patients will die with rather than of thyroid cancer [6, 10]. A contentious question for future research is whether treatment of small localized papillary cancers improves survival [11]. Postmortem studies show that a certain number of small thyroid cancers will remain indolent in a patient s life, with up to 36% of patients having undiagnosed thyroid cancer at death [12]. If the small SRU-negative cancers were undiagnosed, untreated, and progressed to a larger size, the survival could still be excellent. Ito et al. [13] followed 340 papillary microcarcinomas that were selected to not receive treatment: After 10 years, there were new nodal metastases in 3% of cases and no cancer deaths [13]. For these reasons, the SRU recommendations specifically aim to diagnose cancers that have reached clinical significance, while avoiding unnecessary tests and surgery in patients with benign nodules [1]. Our study shows that SRU recommendations achieve this goal by missing only localized papillary carcinomas while reducing workup by one quarter. There are several limitations to this study. First, this study is a retrospective study at one academic center conducted over a limited period of 12 months. Our results may not be generalizable to different practice types and referral patterns. Second, FNAs performed in the department of radiology do not include all thyroid FNAs at our institution. FNAs of thyroid nodules are also performed using ultrasound guidance by surgeons, endocrinologists, and pathologists, and these FNAs were not included. The nodules biopsied by clinicians and pathologists might have a higher proportion of SRU-negative nodules due to more liberal biopsy practices because of convenience of biopsy in a clinic, or the opposite could occur because clinic biopsies may be performed on larger nodules that are less technically challenging to biopsy. Third, ultrasound studies were reviewed by a single reader, and additional readers could yield slightly different results in the performance of SRU recommendations because of interreader variability. We also did not review all past ultrasound studies for the criterion of substantial growth because what constitutes substantial growth has not been specifically defined by the SRU. Finally, we applied the criteria based on the imaging findings and clinical information available. There could be other clinical information that was not available in the medical records that put the patients at higher risk of malignancy to warrant a biopsy. In conclusion, the SRU recommendations achieve the goal of diagnosing cancers that have reached clinical significance, while avoiding unnecessary tests and surgery in patients with benign nodules [1]. Using SRU recommendations can reduce workup of one in four thyroid biopsy encounters compared with current practice without strict guidelines. Potentially missed malignancies in SRU-negative nodules are less aggressive by histologic type, size, and stage compared with SRU-positive malignancies. References 1. Frates MC, Benson CB, Charboneau JW, et al.; Society of Radiologists in Ultrasound. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005; 237: Coorough N, Hudak K, Buehler D, Selvaggi S, Sippel R, Chen H. Fine needle aspiration of the thyroid: a contemporary experience of 3981 cases. J Surg Res 2011; 170: Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, JAMA 2006; 295: AJR:202, March 2014
6 FNA of Thyroid Nodules 4. Cibas ES, Ali SZ; NCI Thyroid FNA State of the Science Conference. The Bethesda System for Reporting Thyroid Cytopathology. Am J Clin Pathol 2009; 132: Ahn SS, Kim EK, Kang DR, Lim SK, Kwak JY, Kim MJ. Biopsy of thyroid nodules: comparison of three sets of guidelines. AJR 2010; 194: American Thyroid Association Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer; Cooper DS, Doherty GM, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009; 19: Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda System for Reporting Thyroid Cytopathology: a meta-analysis. Acta Cytol 2012; 56: Gharib H, Papini E, Paschke R, et al.; AACE/ AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 2010; 16(suppl 1): National Comprehensive Cancer Network website. NCCN guidelines: thyroid carcinoma nodule evaluation, version physician_gls/f_guidelines.asp#thyroid. Accessed May 7, National Cancer Institute website. SEER data: 1983 to seer.cancer.gov/. Accessed December McLeod DS, Sawka AM, Cooper DS. Controversies in primary treatment of low-risk papillary thyroid cancer. Lancet 2013; 381: Harach HR, Franssila KO, Wasenius VM. Occult papillary carcinoma of the thyroid: a normal finding in Finland a systematic autopsy study. Cancer 1985; 56: Ito Y, Miyauchi A, Inoue H, et al. An observational trial for papillary thyroid microcarcinoma in Japanese patients. World J Surg 2010; 34:28 35 FOR YOUR INFORMATION This article is available for CME and Self-Assessment (SA-CME) credit that satisfies Part II requirements for maintenance of certification (MOC). To access the examination for this article, follow the prompts associated with the online version of the article. AJR:202, March
Neuroradiology/Head and Neck Imaging Original Research JOURNAL CLUB:
Neuroradiology/Head and Neck Imaging Original Research Hobbs et al. Ultrasound of Thyroid Nodules Neuroradiology/Head and Neck Imaging Original Research FOCUS ON: Hasan A. Hobbs 1 Manisha Bahl 1 Rendon
More informationIncidental Thyroid Nodules on CT or MRI: Discordance Between What We Report and What Receives Workup
Neuroradiology/Head and Neck Imaging Original Research Tanpitukpongse et al. Reporting and Workup of Incidental Thyroid Nodules Noted on CT or MRI Neuroradiology/Head and Neck Imaging Original Research
More informationRepeat Ultrasound-Guided Fine-Needle Aspiration for Thyroid Nodules 10 mm or Larger Can Be Performed 10.7 Months After Initial Nondiagnostic Results
Neuroradiology/Head and Neck Imaging Original Research Moon et al. Repeat US-Guided FNA of Thyroid Nodules After Nondiagnostic Results Neuroradiology/Head and Neck Imaging Original Research Hee Jung Moon
More informationIncidental thyroid nodules (ITNs) are commonly encountered
ORIGINAL RESEARCH HEAD & NECK Imaging-Detected Incidental Thyroid Nodules that Undergo Surgery: A Single-Center Experience Over 1 Year M. Bahl, J.A. Sosa, R.C. Nelson, and J.K. Hoang ABSTRACT BACKGROUND
More informationIncidental Thyroid Nodules at Non FDG PET Nuclear Medicine Imaging: Evaluation of Prevalence and Malignancy Rate
Nuclear Medicine and Molecular Imaging Original Research Yerubandi et al. Incidental Thyroid Nodules on Non-PET Nuclear Medicine Imaging Nuclear Medicine and Molecular Imaging Original Research Vijay Yerubandi
More informationPractical Approach to Thyroid Nodules:Ultrasound Criteria for Performing FNA Revisited
Practical Approach to Thyroid Nodules:Ultrasound Criteria for Performing FNA Revisited Poster No.: C-0100 Congress: ECR 2013 Type: Educational Exhibit Authors: S. Kuzmich, S. Sritharan, S. MUKUNDHAN, M.
More informationDownloaded from by John Hanna on 11/09/15 from IP address Copyright ARRS. For personal use only; all rights reserved
Neuroradiology/Head and Neck Imaging Original Research Zhu et al. Ultrasound Versus Afirma Testing of FNA-Indeterminate Thyroid Nodules Neuroradiology/Head and Neck Imaging Original Research Qing-Li Zhu
More informationContrast-enhanced ultrasound of solitary thyroid nodules - qualitative and quantitative evaluation: initial results
Contrast-enhanced ultrasound of solitary thyroid nodules - qualitative and quantitative evaluation: initial results Poster No.: C-2436 Congress: ECR 2015 Type: Authors: Keywords: DOI: Scientific Exhibit
More informationVolume 2 Issue ISSN
Volume 2 Issue 3 2012 ISSN 2250-0359 Correlation of fine needle aspiration and final histopathology in thyroid disease: a series of 702 patients managed in an endocrine surgical unit *Chandrasekaran Maharajan
More informationImproving the Long Term Management of Benign Thyroid Nodules
25 th Annual Scientific AACE Clinical Congress Improving the Long Term Management of Benign Thyroid Nodules Stephanie L. Lee, MD, PhD Director, Thyroid Health Center Section of Endocrinology, Diabetes
More informationRepeat Thyroid Nodule Fine-Needle Aspiration in Patients With Initial Benign Cytologic Results
Anatomic Pathology / REPEAT THYROID FINE-NEEDLE ASPIRATION Repeat Thyroid Nodule Fine-Needle Aspiration in Patients With Initial Benign Cytologic Results Melina B. Flanagan, MD, MSPH, 1 N. Paul Ohori,
More informationRisk of Thyroid Cancer Based on Thyroid Ultrasound Imaging Characteristics
Risk of Thyroid Cancer Based on Thyroid Ultrasound Imaging Characteristics Diabetes Update and Advances in Endocrinology & Metabolism Vickie A Feldstein MD Rebecca Smith- Bindman MD Department of Radiology
More informationIncidental thyroid nodules (ITNs) are a common radiologic finding,
Published August 21, 2014 as 10.3174/ajnr.A4089 ORIGINAL RESEARCH HEAD & NECK Radiology Reports for Incidental Thyroid Nodules on CT and MRI: High Variability across Subspecialties A.T. Grady, J.A. Sosa,
More informationThyroid Cytopathology: Weighing In The Bethesda System
Thyroid Cytopathology: Weighing In The Bethesda System V8 Conflicts No financial consideration Bias Work in the Canadian environment where litigation is less Thyroid cytology is often referred in by small
More informationTHYROID NODULES: THE ROLE OF ULTRASOUND
THYROID NODULES: THE ROLE OF ULTRASOUND NOVEMBER 2017 DR. DEAN DURANT DEFINITION Thyroid nodule: Focal area within the thyroid gland with echogenicity different from surrounding parenchyma. THYROID NODULES
More informationThyroid Cancer: When to Treat? MEGAN R. HAYMART, MD
Thyroid Cancer: When to Treat? MEGAN R. HAYMART, MD ASSOCIATE PROFESSOR OF MEDICINE UNIVERSITY OF MICHIGAN MICHIGAN AACE 2018 ANNUAL MEETING Thyroid Cancer: When Not to Treat? FOCUS WILL BE ON LOW-RISK
More informationsystem and the Bethesda system applied for reporting thyroid cytopathology
Original Research Article A comparative study between conventional system and the Bethesda system applied for reporting thyroid cytopathology M. Mamatha 1*, S. Chandra Sekhar 2, H. Sandhya Rani 3, S. Sandhya
More informationNCI Thyroid FNA State of the Science Conference. The Bethesda System For Reporting Thyroid Cytopathology
The Bethesda System For Reporting Thyroid Cytopathology Towards a Uniform Terminology With Management Guidelines NCI Thyroid FNA State of the Science Conference Bethesda, MD October 22-23, 2007 154 registrants
More informationThyroid nodules are a common clinical presentation, with
Original Research Endocrine Surgery Thyroid Ultrasound-Guided Fine-Needle Aspiration Cytology Results: Observed Increase in Indeterminate Rate over the Past Decade Otolaryngology Head and Neck Surgery
More informationRates of thyroid malignancy by FNA diagnostic category
Williams et al. Journal of Otolaryngology - Head and Neck Surgery 2013, 42:61 ORIGINAL RESEARCH ARTICLE Open Access Rates of thyroid malignancy by diagnostic category Blair A Williams 1*, Martin J Bullock
More informationThyroid Nodules. No conflicts. Overview 5/16/2017. UCSF Internal Medicine Updates May 22, 2017 Elizabeth Murphy, MD, DPhil
Thyroid Nodules UCSF Internal Medicine Updates May 22, 2017 Elizabeth Murphy, MD, DPhil No conflicts Overview Thyroid nodule and cancer review Ultrasound FNA cytology Nodule follow up Putting it all together
More informationEuropean Journal of Radiology
European Journal of Radiology 82 (2013) 321 326 Contents lists available at SciVerse ScienceDirect European Journal of Radiology jo ur n al hom epage: www.elsevier.com/locate/ejrad Ultrasonographic criteria
More informationClinical Outcome for Atypia of Undetermined Significance in Thyroid Fine-Needle Aspirations Should Repeated FNA Be the Preferred Initial Approach?
Anatomic Pathology / Clinical Outcome for AUS Thyroid FNA Clinical Outcome for Atypia of Undetermined Significance in Thyroid Fine-Needle Aspirations Should Repeated FNA Be the Preferred Initial Approach?
More informationCLINICAL MEDICAL POLICY
Policy Name: Policy Number: Responsible Department(s): CLINICAL MEDICAL POLICY Molecular Markers for Fine Needle Aspirates of Thyroid Nodules MP-065-MD-DE Medical Management Provider Notice Date: 10/15/2018;
More informationQuality Initiative Project assessing the impact of TIRADS on net number of thyroid biopsies and adherence of TIRADS-reporting by radiologists
Quality Initiative Project assessing the impact of TIRADS on net number of thyroid biopsies and adherence of TIRADS-reporting by radiologists Tetyana Maniuk BSc, Ania Kielar MD, FRCPC Joseph O Sullivan
More informationCLINICAL GUIDELINES. Introductory notes:
CLINICAL GUIDELINES Thyroid Ultrasound Reporting Guideline Recommendations Thomas Gilbert, M.D., M.P.P., Robert Kanterman, M.D., Erik Rockswold, MHA Updated June, 2017 Introductory notes: Thyroid nodules
More informationHow good are we at finding nodules? Thyroid Nodules Thyroid Cancer Epidemiology Initial management Long-term follow up Disease-free status
New Perspectives in Thyroid Cancer Jennifer Sipos, MD Assistant Professor of Medicine Division of Endocrinology The Ohio State University Outline Thyroid Nodules Thyroid Cancer Epidemiology Initial management
More informationWork Up & Evaluation of Thyroid Nodules In 2013: State of The Art
Work Up & Evaluation of Thyroid Nodules In 2013: State of The Art BC Surgical Oncology Network, Fall Update Todd McMullen MD PhD FRCSC FACS Endocrine Surgeon Divisions of General Surgery and Oncology Director,
More informationUS-FNA is an easy-to-use and accurate tool for evaluating
Published September 15, 2011 as 10.3174/ajnr.A2686 ORIGINAL RESEARCH D.W. Kim E.J. Lee S.J. Jung J.H. Ryu Y.M. Kim Role of Sonographic Diagnosis in Managing Bethesda Class III Nodules BACKGROUND AND PURPOSE:
More informationClinical performance and utility of Afirma GEC in a community hospital practice
Clinical performance and utility of Afirma GEC in a community hospital practice Michael Traynor, Jacob Torrison, Faculty: Hallanger-Johnson JE, Newman DW, and Beal JR PURPOSE: To assess the performance
More informationResearch Article Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules?
International Endocrinology Volume 2016, Article ID 3803647, 6 pages http://dx.doi.org/10.1155/2016/3803647 Research Article Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle
More informationULTRASOUND GUIDED FINE NEEDLE THYROID BIOPSIES: UNSATISFACTORY FOR PATHOLOGICAL ASSESSMENT RATE
ULTRASOUND GUIDED FINE NEEDLE THYROID BIOPSIES: UNSATISFACTORY FOR PATHOLOGICAL ASSESSMENT RATE Stéphane Doucette-Preville (PGY-2) Marnie Turnbull (US technologist) Dr. Edward Wiebe (Staff radiologist)
More information2015 American Thyroid Association Thyroid Nodule and Cancer Guidelines
2015 American Thyroid Association Thyroid Nodule and Cancer Guidelines Angela M. Leung, MD, MSc, ECNU November 5, 2016 Outline Workup of nontoxic thyroid nodule(s) Ultrasound FNAB Management of FNAB results
More informationDong Wook Kim, MD 1 Auh Whan Park, MD 1 Eun Joo Lee, MD 1 Hye Jung Choo, MD 1 Sang Hyo Kim, MD 2 Sang Hyub Lee, MD 2 Jae Wook Eom, MD 3
Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules Smaller Than 5 mm in the Maximum Diameter: Assessment of Efficacy and Pathological Findings Dong Wook Kim, MD 1 Auh Whan Park, MD 1 Eun
More informationPredictors of Malignancy in Thyroid Fine-Needle Aspirates Cyst Fluid Only Cases
Predictors of Malignancy in Thyroid Fine-Needle Aspirates Cyst Fluid Only Cases Can Potential Clues of Malignancy Be Identified? Mohammad Jaragh, MD 1 ; V. Bessie Carydis, MMedSci (Cytol) 1 ; Christina
More informationThyroid nodules - medical and surgical management. Endocrinology and Endocrine Surgery Manchester Royal Infirmary
Thyroid nodules - medical and surgical management JRE Davis NR Parrott Endocrinology and Endocrine Surgery Manchester Royal Infirmary Thyroid nodules - prevalence Thyroid nodules common, increase with
More informationHigh thyroglobulin (Tg) in a lymph node indicates metastatic
ORIGINAL RESEARCH HEAD & NECK Optimized Cutoff Value and Indication for Washout Thyroglobulin Level According to Ultrasound Findings in Patients with Well-Differentiated Thyroid Cancer J.Y. Jung, J.H.
More informationJournal of Diagnostic Pathology 2011 (6); 1: Leading Article
Leading Article Beyond the horizon of current thyroid cytology reporting in Sri Lanka... Lokuhetty MDS Thyroid enlargement is a commonly encountered clinical problem among Sri Lankan patients, be it diffuse
More informationLet s Make Sense of Present & Predict Future. In Light of Past 1/12/2016
The New Diagnostic Paradigms in Thyroid Surgical Pathology and Affects on Reporting of Thyroid Fine Needle Aspiration Specimens Deliberations, Criticisms & Discussions Zubair W. Baloch, MD, PhD. Professor
More informationSurgical Treatment for Papillary Thyroid Carcinoma in Japan: Differences from Other Countries
REVIEW ARTICLE J Korean Thyroid Assoc Vol. 4, No. 2, November 2011 Surgical Treatment for Papillary Thyroid Carcinoma in Japan: Differences from Other Countries Yasuhiro Ito, MD and Akira Miyauchi, MD
More informationWarinthorn Phuttharak*, Charoonsak Somboonporn, Gatenapa Hongdomnern
Colour Doppler Ultrasonography in the Diagnosis of Malignancy in Thyroid Nodules RESEARCH COMMUNICATION Diagnostic Performance of Gray-scale versus Combined Grayscale with Colour Doppler Ultrasonography
More informationSonographic Features of Benign Thyroid Nodules
Article Sonographic Features of Benign Thyroid Nodules Interobserver Reliability and Overlap With Malignancy Jeffrey R. Wienke, MD, Wui K. Chong, MD, Julia R. Fielding, MD, Kelly H. Zou, PhD, Carol A.
More information4/22/2010. Hakan Korkmaz, MD Assoc. Prof. of Otolaryngology Ankara Dıșkapı Training Hospital-Turkey.
Management of Differentiated Thyroid Cancer: Head Neck Surgeon Perspective Hakan Korkmaz, MD Assoc. Prof. of Otolaryngology Ankara Dıșkapı Training Hospital-Turkey Thyroid gland Small endocrine gland:
More informationHEAD AND NECK ENDOCRINE SURGERY
HEAD AND NECK ENDOCRINE SURGERY OCTOBER 22-23, 2010 THE MARK HOPKINS SAN FRANCISCO, CA THYROID FNA AND CYTOPATHOLOGY THEODORE R. MILLER, MD THE THYROID NODULE Prevalence of palpable nodule: Female ~ 6%
More informationMalignant-looking thyroid nodules with size reduction: core needle biopsy results
Malignant-looking thyroid nodules with size reduction: core needle biopsy results Ha Young Lee 1,2, Jung Hwan Baek 1, Eun Ju Ha 1,3, Jee Won Park 1,4, Jeong Hyun Lee 1, Dong Eun Song 5, Young Kee Shong
More informationTHYROID CYTOLOGY THYROID CYTOLOGY FINE-NEEDLE-ASPIRATION ANCILLARY TESTS IN THYROID FNA
ANCILLARY TESTS IN THYROID FNA Prof. Fernando Schmitt Department of Pathology and Oncology, Medical Faculty of Porto University Head of Molecular Pathology Unit, IPATIMUP General-Secretary of the International
More informationRisk of Malignancy in Thyroid Nodules 4 cm or Larger
Original Article Endocrinol Metab 2017;32:77-82 https://doi.org/10.3803/enm.2017.32.1.77 pissn 2093-596X eissn 2093-5978 Risk of Malignancy in Thyroid Nodules 4 cm or Larger Uchechukwu C. Megwalu 1,2,3
More information5/3/2017. Ahn et al N Engl J Med 2014; 371
Alan Failor, M.D. Clinical Professor of Medicine Division of Metabolism, Endocrinology and Nutrition University of Washington April 20, 2017 No disclosures to report 1. Appropriately evaluate s in adult
More informationThyroid Nodules. Family Medicine Refresher Course Geeta Lal MD, FACS April 2, No financial disclosures
Thyroid Nodules Family Medicine Refresher Course Geeta Lal MD, FACS April 2, 2014 No financial disclosures Objectives Review epidemiology Work up of Thyroid nodules Indications for FNAB Evolving role of
More informationThe incidence of thyroid cancer is increasing in the United. An Exponential Growth in Incidence of Thyroid Cancer: Trends and Impact of CT Imaging
Published October 10, 2013 as 10.3174/ajnr.A3743 ORIGINAL RESEARCH HEAD & NECK An Exponential Growth in Incidence of Thyroid Cancer: Trends and Impact of CT Imaging J.K. Hoang, K. Roy Choudhury, J.D. Eastwood,
More informationTaller-Than-Wide Sign of Thyroid Malignancy: Comparison Between Ultrasound and CT
Neuroradiology/Head and Neck Imaging Original Research Yoon et al. Taller-Than-Wide Sign of Thyroid Malignancy Neuroradiology/Head and Neck Imaging Original Research Soo Jeong Yoon 1 Dae Young Yoon 1,2
More informationTHI-RADS. US differentiation of thyroid lesions.
THI-RADS. US differentiation of thyroid lesions. Poster No.: C-0864 Congress: ECR 2015 Type: Scientific Exhibit Authors: A. N. Sencha, Y. Patrunov, M. S. Mogutov, E. Penyaeva, A. 1 1 1 2 1 1 1 2 Gruzdev,
More informationTHI-RADS. US differentiation of thyroid lesions.
THI-RADS. US differentiation of thyroid lesions. Poster No.: C-0864 Congress: ECR 2015 Type: Scientific Exhibit Authors: A. N. Sencha, Y. Patrunov, M. S. Mogutov, E. Penyaeva, A. 1 1 1 2 1 1 1 2 Gruzdev,
More informationDifferentiated Thyroid Carcinoma
Differentiated Thyroid Carcinoma The GOOD cancer? Jennifer Sipos, MD Associate Professor of Medicine Director, Benign Thyroid Program Division of Endocrinology, Diabetes and Metabolism The Ohio State University
More informationCorrespondence should be addressed to David N. Bimston; Received 23 January 2017; Accepted 20 March 2017; Published 13 April 2017
Hindawi International Surgical Oncology Volume 2017, Article ID 4689465, 6 pages https://doi.org/10.1155/2017/4689465 Research Article Noninvasive Encapsulated Follicular Variant of Papillary Thyroid Cancer:
More informationACCME/Disclosures. Questions to Myself? 4/11/2016
The New Diagnostic Paradigms in Thyroid Surgical Pathology and Affects on Reporting of Thyroid Fine-Needle Aspiration Specimens Deliberations, Criticisms & Discussions Zubair W. Baloch, MD, PhD. Professor
More informationIntroduction. Materials and methods Y-N XU 1,2, J-D WANG 1,2
1 di 5 11/04/2016 17:54 G Chir Vol. 31 - n. 5 - pp. 205-209 Maggio 2010 Y-N XU 1,2, J-D WANG 1,2 Introduction The World Health Organization (WHO) defined papillary thyroid microcarcinomas (PTMC) as tumors
More informationImaging-cytology correlation of thyroid nodules with initially benign cytology
Imaging-cytology correlation of thyroid nodules with initially benign cytology Poster No.: C-1815 Congress: ECR 2013 Type: Scientific Exhibit Authors: S. H. Hwang, E.-K. Kim, J. Y. Kwak; Seoul/KR Keywords:
More informationClinical Guidance in Thyroid Cancers. Stephen Robinson Imperial at St Mary s On behalf of BTA
Clinical Guidance in Thyroid Cancers Stephen Robinson Imperial at St Mary s On behalf of BTA Background to thyroid cancer Incidence probably increasing slowly 1971-95; 2.3 women 0.9 men /100,000 2001;
More informationCan Color Doppler Sonography Aid in the Prediction of Malignancy of Thyroid Nodules?
Article Can Color Doppler Sonography Aid in the Prediction of Malignancy of Thyroid Nodules? Mary C. Frates, MD, Carol B. Benson, MD, Peter M. Doubilet, MD, PhD, Edmund S. Cibas, MD, Ellen Marqusee, MD
More informationRole of fine needle aspiration cytology and cytohistopathological co-relation in thyroid lesions: experience at a tertiary care centre of North India
International Journal of Research in Medical Sciences Chandra S et al. Int J Res Med Sci. 2016 Oct;4(10):4552-4556 www.msjonline.org pissn 2320-6071 eissn 2320-6012 Research Article DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20163328
More informationDIAGNOSIS AND REPORTING OF FOLLICULAR-PATTERNED THYROID LESIONS BY FINE NEEDLE ASPIRATION
Follicular-patterned thyroid lesions, WC Faquin 1 DIAGNOSIS AND REPORTING OF FOLLICULAR-PATTERNED THYROID LESIONS BY FINE NEEDLE ASPIRATION William C. Faquin, M.D., Ph.D Department of Pathology, Massachusetts
More informationThyroid Nodule Management
Thyroid Nodule Management Shane O. LeBeau, MD Clinical Associate Professor of Medicine Clinical Lead, Endocrine Thyroid Unit Division of Endocrinology, Diabetes and Metabolism University of Pittsburgh
More informationPrincipal Site Investigator ENHANCE (Evaluation of Thyroid FNA Genomic Signature) study: An IRB approved study with funding to Rochester Regional
October 20 th 2018 Principal Site Investigator ENHANCE (Evaluation of Thyroid FNA Genomic Signature) study: An IRB approved study with funding to Rochester Regional Health from Veracyte Review ultrasound
More informationUpdate on Thyroid FNA The Bethesda System. Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center
Update on Thyroid FNA The Bethesda System Shikha Bose M.D. Associate Professor Cedars Sinai Medical Center Thyroid Nodules Frequent occurrence Palpable: 4-7% of adults Ultrasound: 10-31% Majority benign
More informationThyroid Nodules. Hossein Gharib, MD, MACP, MACE
Thyroid Nodules Hossein Gharib, MD, MACP, MACE Professor of Medicine Mayo Clinic College of Medicine President Elect, American College of Endocrinology University Course January 2008 CP1294362-1 Thyroid
More informationThyroid Nodule. Disclosure. Learning Objectives P A P A P A 3/18/2014. Nothing to disclose.
Thyroid Nodule Evaluating the patient with a thyroid nodule and some management options. Miguel V. Valdez PA C Disclosure Nothing to disclose. Learning Objectives Examination of thyroid gland Options for
More informationAtypical Ductal Hyperplasia and Papillomas: A Comparison of Ultrasound Guided Breast Biopsy and Stereotactic Guided Breast Biopsy
Atypical Ductal Hyperplasia and Papillomas: A Comparison of Ultrasound Guided Breast Biopsy and Stereotactic Guided Breast Biopsy Breast Cancer is the most common cancer diagnosed in women in the United
More informationBuilding On The Best A Review and Update on Bethesda Thyroid 2017
Building On The Best A Review and Update on Bethesda Thyroid 2017 Syed Z. Ali, MD, FRCPath, FIAC Professor of Pathology and Radiology The Johns Hopkins Hospital, Baltimore, Maryland USA TBSRTC Diagnostic
More informationReview of Literatures
Review of Literatures Fine needle biopsy was popular in the Scandinavian countries some four decades ago. Though FNAC for any palpable tumor was first introduced in America in the 1920s by Martin, Ellis
More informationSonographic Differentiation of Thyroid Nodules With Eggshell Calcifications
Article Sonographic Differentiation of Thyroid Nodules With Eggshell Calcifications Byung Moon Kim, MD, Min Jung Kim, MD, Eun-Kyung Kim, MD, Jin Young Kwak, MD, Soon Won Hong, MD, Eun Ju Son, MD, Ki Hwang
More informationThyroid nodules with minimal cystic changes have a low risk of malignancy
Thyroid nodules with minimal cystic changes have a low risk of malignancy Dong Gyu Na 1, Ji-hoon Kim 2, Dae Sik Kim 1,3, Soo Jin Kim 1,4 1 Department of Radiology, Human Medical Imaging and Intervention
More informationSonographic Patterns of Benign Thyroid Nodules: Verification at Our Institution
Neuroradiology/Head and Neck Imaging Original Research Virmani and Hammond Sonographic Patterns of enign Thyroid Nodules Neuroradiology/Head and Neck Imaging Original Research Vivek Virmani 1 Ian Hammond
More informationAdina Alazraki, MD, FAAP Assistant Professor Radiology and Pediatrics Emory University and Children s Healthcare of Atlanta
Adina Alazraki, MD, FAAP Assistant Professor Radiology and Pediatrics Emory University and Children s Healthcare of Atlanta Review recently published pediatric guidelines for management of thyroid nodules
More informationAn online questionnaire survey on preferred timing for the diagnosis and management of thyroid carcinoma in general population in Korea
ORIGINAL ARTICLE pissn 2288-6575 eissn 2288-6796 http://dx.doi.org/1.4174/astr.216.9.6.297 Annals of Surgical Treatment and Research An online questionnaire survey on preferred timing for the diagnosis
More informationUltrasound-Guided Fine-Needle Aspiration of Thyroid Nodules: New events
Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules: New events Sandrine Rorive, M.D., PhD. Erasme Hospital - Université Libre de Bruxelles (ULB) INTRODUCTION The assessment of thyroid nodules
More informationThe Frozen Section: Diagnostic Challenges and Pitfalls
The Frozen Section: Diagnostic Challenges and Pitfalls William C. Faquin, M.D., Ph.D. Director, Head and Neck Pathology Massachusetts General Hospital & Massachusetts Eye and Ear Infirmary Harvard Medical
More informationCOMPARISON OF ULTRASOUND FINDINGS WITH CYTOLOGIC RESULTS IN THYROID NODULES
COMPARISON OF ULTRASOUND FINDINGS WITH CYTOLOGIC RESULTS IN THYROID NODULES E. Razmpa 1, H. Ghanaati 2, B. Naghibzadeh 3, P. Mazloom 1 and A. Kashfi 1 1) Department of Otolaryngology, School of Medicine,
More informationIndex terms: Thyroid Ultrasonography Pathology Cancer. DOI: /kjr
Histopathologic Findings Related to the Indeterminate or Inadequate Results of Fine-Needle Aspiration Biopsy and Correlation with Ultrasonographic Findings in Papillary Thyroid Carcinomas So Lyung Jung,
More informationMolecular Markers in Fine Needle Aspirates of the Thyroid
Molecular Markers in Fine Needle Aspirates of the Thyroid Policy Number: 2.04.78 Last Review: 3/2014 Origination: 3/2013 Next Review: 3/2015 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will
More informationPAPILLARY THYROID CANCER IS A
ORIGINAL ARTICLE Thyroid Cancer Survival in the United States Observational Data From 1973 to 2005 Louise Davies, MD, MS; H. Gilbert Welch, MD, MPH Objective: To compare the survival rate of people with
More information"Atypical": Criteria and
"Atypical": Criteria and Controversies Esther Rossi MD PhD MIAC Division of Anatomic Pathology and Cytology Catholic University of Sacred Heart Rome, Italy CASE HISTORY In 2015, 45 y/o woman underwent
More informationResearch Article Imaging-Cytology Correlation of Thyroid Nodules with Initially Benign Cytology
International Endocrinology, Article ID 491508, 8 pages http://dx.doi.org/10.1155/2014/491508 Research Article Imaging-Cytology Correlation of Thyroid Nodules with Initially Benign Cytology Shin Hye Hwang,
More information10/7/2016. Learning Objectives. Thyroid Gland
To cut or not to cut? Evaluating surgical criteria for benign and non-diagnostic thyroid nodules ASHLYN SMITH, MMS PA-C ENDOCRINOLOGY ASSOCIATES SCOTTSDALE, AZ CHIEF DELEGATE, AMERICAN SOCIETY OF ENDOCRINE
More informationRole of core needle biopsy as a first-line diagnostic tool for thyroid nodules: a retrospective cohort study
Role of core needle biopsy as a first-line diagnostic tool for thyroid nodules: a retrospective cohort study Min Ji Hong 1, Dong Gyu Na 2,3, Soo Jin Kim 3,4, Dae Sik Kim 3,5 1 Department of Radiology,
More informationUsefulness of Diagnostic Qualifiers for Thyroid Fine-Needle Aspirations With Atypia of Undetermined Significance
Anatomic Pathology / AUS Qualifiers in Thyroid FNAs Usefulness of Diagnostic Qualifiers for Thyroid Fine-Needle Aspirations With Atypia of Undetermined Significance Paul A. VanderLaan, MD, PhD, 1 Ellen
More informationSonographic Features of Thyroid Nodules & Guidelines for Management
Sonographic Features of Thyroid Nodules & Guidelines for Management Mark A. Lupo, MD, FACE, ECNU Thyroid & Endocrine Center of Florida Assistant Clinical Professor of Medicine Florida State University,
More informationThyroid fine-needle aspiration and The Bethesda Classification System
Dan Med J 65/3 March 2018 DANISH MEDICAL JOURNAL 1 Thyroid fine-needle aspiration and The Bethesda Classification System Louise Vølund Larsen 1, Alice Viktoria Egset 1, Camilla Holm 1, Stine Rosenkilde
More informationThe Comparison of Scintigraphic and Ultrasonographic Evaluation Criteria of Thyroid Nodules with Histopathologic Findings
Research Article The Comparison of Scintigraphic and Ultrasonographic Evaluation Criteria of Thyroid Nodules with Histopathologic Findings Seracettin Eğin * Department of General Surgery, University of
More informationRecent Advances in Core Needle Biopsy for Thyroid Nodules
Review Article Endocrinol Metab 2017;32:407-412 https://doi.org/10.3803/enm.2017.32.4.407 pissn 2093-596X eissn 2093-5978 Recent Advances in Core Needle Biopsy for Thyroid Nodules Chan Kwon Jung 1, Jung
More informationWell Differen*ated Thyroid Microcarcinoma. Robert A. Levine, MD, FACE, ECNU Thyroid Center of New Hampshire Geisel School of Medicine at Dartmouth
Well Differen*ated Thyroid Microcarcinoma Robert A. Levine, MD, FACE, ECNU Thyroid Center of New Hampshire Geisel School of Medicine at Dartmouth Objec*ves (1) Review epidemiology of thyroid microcarcinoma.
More informationHow to Interpret Thyroid Fine-Needle Aspiration Biopsy Reports: A Guide for the Busy Radiologist in the Era of the Bethesda Classification System
Neuroradiology/Head and Neck Imaging Review Dhyani et al. How to Interpret FNAB Results of Thyroid Nodules Neuroradiology/Head and Neck Imaging Review Manish Dhyani 1 William Faquin 2 Carrie C. Lubitz
More informationBiopsy of Thyroid Nodules: Comparison of Three Sets of Guidelines
Neuroradiology/Head and Neck Imaging Original Research Ahn et al. Biopsy of Thyroid Nodules Neuroradiology/Head and Neck Imaging Original Research FOCUS ON: Sung Soo Ahn 1 Eun-Kyung Kim 1 Dae Ryong Kang
More informationCytological Evaluation of Thyroid Lesions Based on the Bethesda System.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-086.Volume 5, Issue 2 Ver. VII (December. 206), PP 2-7 www.iosrjournals.org Cytological Evaluation of Thyroid Lesions
More informationThyroid Neoplasm. ORL-Head and neck Surgery 2014
In The Name of God Thyroid Neoplasm ORL-Head and neck Surgery 2014 Malignant Neoplasm By age 90, virtually everyone has nodules Estimates of cancer prevalence at autopsy 4% to 36% Why these lesions are
More informationKeywords: papillary carcinoma, Hurthle, FNAC, follicular pattern.
bü z ÇtÄ TÜà väx Efficacy of Fine Needle Aspiration Cytology in the Diagnosis of Thyroid Swellings in Red Sea State, Sudan 1 Abstract Background: Fine needle aspiration cytology (FNAC) is a safe, easy
More informationComparison of Thyroid Fine-Needle Aspiration and Core Needle Biopsy
Anatomic Pathology / THYROID FNA AND CORE NEEDLE BIOPSY Comparison of Thyroid Fine-Needle Aspiration and Core Needle Biopsy Andrew A. Renshaw, MD, 1 and Nat Pinnar, MD 2 Key Words: Thyroid; Neoplasia;
More informationMEDICAL POLICY No R0 THYROID-RELATED PROCEDURES
THYROID-RELATED PROCEDURES Effective Date: October 1, 2018 Review Dates: 05/18 Date Of Origin: May 9, 2018 Status: New This medical policy addresses the following thyroid-related procedures: Screening
More informationPEDIATRIC Ariel Katz MD
PEDIATRIC Ariel Katz MD Dept. Otolaryngology Head &Neck Surgery Wolfson Medical Center Holon, Israel OBJECTIVES Overview/Background Epidemiology/Etiology Intro to Guidelines Workup Treatment Follow-Up
More information