Summary Objective: The purpose of the study was the characterization of adverse events (AEs) after fine-needle aspiration biopsies (FNABs) of thyroid nodules, as well as possible predisposing factors. Methods: A total of 205 patients, each of whom had undergone an FNAB of a thyroid nodule, were included in the study (15 of whom were taking anticoagulant medication). The thyroid nodules were classified according to the ultrasound criteria of the American Thyroid Association (ATA). The FNABs were carried out by four trained nuclear medicine specialists from two institutions. To detect AEs, all patients were asked to fill out a standardized self-assessment questionnaire. Results: Out of 205 patients, 189 (92 %) reported no AEs. Fourteen patients (6.8 %) had mild or moderate AEs, such as short-term pain at the puncture site. In two patients (1 %), the AEs were classified as significant, and required medical followup, which revealed an intrathyroid hematoma in one patient and dysphonia in the other. All AEs were reversible. None of the patients taking anticoagulants experienced any AEs. The parameters of age, sex, nodule volume, ATA nodule type, needle size, and physician performing the biopsy were not predisposing factors for side effects (p = 0.54, p = 0.73, p = 0.75, p = 0.94, p = 0.35, and p = 0.24, respectively). Conclusions: The vast majority of patients tolerated the FNAB very well. AEs were seldom observed. A small number of patients experienced AEs that required no intervention or could be self-managed by the patient. Considering the almost negligible risk of the procedure, FNAB should be increasingly used for the classification of thyroid nodules.
BackgroundThyroid nodules are frequently detected by cervical ultrasound examinations. In follow-up studies, malignant as well as benign nodules may exhibit an increase in size.The objective of our investigation was to test whether histologically determined malignant and benign thyroid nodules show differences in growth rates above a defined significance level.MethodsA retrospective ultrasound cohort follow-up study from 4 to 132 months included 26 patients with differentiated carcinomas and 26 patients with adenomas of the thyroid gland. Significance levels were determined by intra- and interobserver variations of volumetric measurements in 25 individuals.ResultsIntra- and interobserver volumetric measurements were highly correlated (r = 0.99 and r = 0.98, respectively), with variations of 28 and 40%, respectively. The growth rates of malignant and benign nodules did not show differences with respect to two sonographic measurements (d = − 0.04, 95%CI(P): 0.41–0.85, P = 0.83). Using shorter increments and multiple measurements, growth rates of malignant nodules revealed significantly higher values (d = 0.16, 95%CI(P): 0.02–0.04, P = 0.039).ConclusionsThe growth rates of benign and malignant thyroid nodules do not appear to differ using two sonographic volumetric measurements. However, due to temporal changes in cellular proliferation and arrest, malignant nodules may exhibit higher growth rates with multiple assessments and shorter increments.
Background: Epidemiologic data revealed an increasing incidence of papillary carcinomas (PTCs) in the German population. There is some evidence that the size of resected PTCs has decreased during the last few years. Purpose:The aim of the present study was to test the hypothesis that the sonographic characteristics of PTCs vary with size.Material/Methods: Consecutive PTCs were histologically confirmed in 41 patients. Ultrasound examinations of these 50 PTCs were reevaluated retrospectively and classified according to five sonographic criteria.Results: It could be shown that the sonographic shape (p < 0.001), the contour (p = 0.024), the structure (p = 0.04), the echogenicity (p < 0.001) and calcifications (p = 0.008) varied with the size of the neoplasms. By factoranalysis a factor F PTC with an eigenvalue of 1.89 could be extracted from the data on which the sonographic structure, the ontour and the presence of calcifications had the strongest impact with factorloadings of 0.74, 0.68 and 0.61, respectively. Conclusion:The knowledge of the variation of the ultrasound characteristics should be of assistance for the sonographic classification of PTCs. In this context microcarcinomas usually do not display cystic components. However, they may show microcalcifications. Cystic components, hyperechogenicity and the taller-than-wide sign are predominantly seen in larger PTCs.
in selected patients with higher operative risks and cytological diagnosis of follicular neoplasm ultrasound parameters may be helpful to assume a benign nature of the neoplasm and thus avoid the necessity of a histological work-up.
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