Clinical applications of Doppler ultrasonography for thyroid disease: consensus statement by the Korean Society of Thyroid Radiology

Chung, Jin; Lee, Yoo Jin; Choi, Young Jun; Ha, Eun Ju; Suh, Chong Hyun; Choi, Miyoung; Baek, Jung Hwan; Na, Dong Gyu

doi:10.14366/usg.20072

Cited by 31 publications

(22 citation statements)

References 108 publications

(319 reference statements)

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“…Different enhancement modes are related to the corresponding pathologic mechanisms (40). Numerous studies (11,32,(41)(42)(43)(44) have demonstrated hypo-enhancement and heterogeneous enhancement are major features of malignancy thyroid nodules. Possible explanations were necrosis, calcification, fibrosis, and embolus formation within the tumor (43).…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound in the Differential Diagnosis and Risk Stratification of ACR TI-RADS Category 4 and 5 Thyroid Nodules With Non-Hypovascular

et al. 2021

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ObjectiveThis study aims to investigate the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis and risk stratification of ACR TI-RADS category 4 and 5 thyroid nodules with non-hypovascular.MethodsFrom January 2016 to December 2019 in our hospital, 217 ACR TI-RADS category 4 and 5 nodules with non-hypovascular in 210 consecutive patients were included for a derivation cohort. With surgery and/or fine-needle aspiration (FNA) as a reference, conventional ultrasound (US) features and CEUS features were analyzed. Multivariate logistic regression analysis was used to screen the independent risk factors and establish a risk predictive model. Between January 2020 and March 2021, a second cohort of 100 consecutive patients with 101 nodules were included for an external validation cohort. The model was converted into a simplified risk score and was validated in the validation cohort. The area under the receiver operating characteristic curves (AUC) were used to assess the models’ diagnostic performance.ResultsMicro-calcification, irregular margin, earlier wash-out, centripetal enhancement, and absence of ring enhancement were independent risk factors and strongly discriminated malignancy in the derivation cohort (AUC = 0.921, 95% CI 0.876–0.953) and the validation cohort (0.900, 0.824–0.951). There was no significant difference (P = 0.3282) between the conventional US and CEUS in differentiating malignant non-hypovascular thyroid nodules, but a combination of them (the predictive model) had better performance than the single method (all P <0.05), with a sensitivity of 87.0%, specificity of 86.2%, and accuracy of 86.6% in the derivation cohort. The risk score based on the independent risk factors divided non-hypovascular thyroid nodules into low-suspicious (0–3 points; malignancy risk <50%) and high-suspicious (4–7 points; malignancy risk ≥ 50%), the latter with nodule ≥10mm was recommended for FNA. The risk score showed a good ability of risk stratification in the validation cohort. Comparing ACR TI-RADS in screening suitable non-hypovascular nodules for FNA, the risk score could avoid 30.8% benign nodules for FNA.ConclusionsCEUS is helpful in combination with conventional US in differentiating ACR TI-RADS category 4 and 5 nodules with non-hypovascular. The risk score in this study has the potential to improve the diagnosis and risk stratification of non-hypovascular thyroid nodules.

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Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound in the Differential Diagnosis and Risk Stratification of ACR TI-RADS Category 4 and 5 Thyroid Nodules With Non-Hypovascular

et al. 2021

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“…Intranodular vascularity was observed in 16.7%–91.7% of malignant nodules and 30.7%–65.3% of benign nodules [ 13 64 97 98 99 100 101 ]. Although intranodular vascularity may predict malignancy risk, no consistent associations have been reported for vascularity patterns with malignancy risk [ 101 102 103 ]. Several studies have reported that intranodular vascularity did not predict malignancy risk and was not superior to gray-scale US alone for the prediction of malignancy risk in all thyroid nodules [ 35 101 ].…”

Section: Us Lexicon For Thyroid Nodulesmentioning

confidence: 99%

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

et al. 2021

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Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1–2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

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“…Two separate biopsies were taken from BTN for control purposes and cytological sampling was performed. The biopsies taken were reported cytopathological using the Bethesda classification (2). Volumetric measurements of the nodules were made with US examination.…”

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confidence: 99%

“…However, surgery may have undesirable effects such as nerve paralysis, long hospital stay, difficulty in reoperation, scarring, and permanent hypothyroidism/ hypoparathyroidism. [2][3][4][5] Medical suppression treatments of thyroid nodules are often unsuccessful and do not contribute to the disappearance of complaints such as a feeling of pressure on the neck and cosmetic problems. Moreover, undesirable effects such as atrial fibrillation and decreased bone density may occur.…”

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confidence: 99%

Clinical and functional results of radiofrequency ablation and microwave ablation in patients with benign thyroid nodules

Javadov¹,

Karatay²,

Uğurlu³

2021

SMJ

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Objectives: To determine how well ultrasoundguidance percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) performed for benign symptomatic thyroid nodules in terms of clinical and functional outcomes. Methods:Patients who had a thyroid nodulelinked symptoms acting as dysphagia, cosmetic issues, pain, a foreign body sense, hyperthyroidism secondary to autonomous nodules, or concern of malignancy were involved in the study. The primary was the comparison in symptom scores obtained Original Article at 1, 3, and 6 months after RFA and MWA. The volume alterations in nodules and alterations in thyroid gland functions were secondary objectives.Results: This prospective study carried out from November 2014 and January 2017 at the General Surgery Department, Marmara University, Faculty of Medicine, Istanbul, Turkey included a total of 100 nodules (50% MWA, 50% RFA). There were statistically significance in pain scores, dysphagia scores, and foreign body sensation scores at 1, 3, and 6 months after therapy in both ablation groups (p=0.0006, p=00004, p=0.0005). At the same time, there were statistically significant reductions in size and volume of the nodules for RFA and MWA (p=0.0004, p=0.0003). There was no significant difference between the RFA and MWA groups' cosmetic scoring and volume changes (p=0.68, p=0.43). Conclusion:Alternative therapies for benign symptomatic thyroid nodules include RFA and MWA. The findings of this research revealed that both approaches are safe and effective.

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Clinical applications of Doppler ultrasonography for thyroid disease: consensus statement by the Korean Society of Thyroid Radiology

Cited by 31 publications

References 108 publications

Contrast-Enhanced Ultrasound in the Differential Diagnosis and Risk Stratification of ACR TI-RADS Category 4 and 5 Thyroid Nodules With Non-Hypovascular

Contrast-Enhanced Ultrasound in the Differential Diagnosis and Risk Stratification of ACR TI-RADS Category 4 and 5 Thyroid Nodules With Non-Hypovascular

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

Clinical and functional results of radiofrequency ablation and microwave ablation in patients with benign thyroid nodules

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