Diagnostic Value of Contrast-Enhanced Ultrasound Evaluation of Malignant and Benign Solitary Thyroid Nodules

Thyroid nodules are frequent in general population, found in 3.7-7% of people by palpation and 42-67% by ultrasonography (US). The differential diagnosis ranges from papillary (PC), follicular (FC) and medullary (MC) carcinomas to follicular adenoma (FA) and colloid goitre. Cancer risk in thyroid nodules varies: 5% in masses found by palpation, 1.6-15% by US, 3.9-11.3% by computed tomography (CT), 5-6% by magnetic resonance imaging (MRI) and 30-50% by positron emission tomography (PET). The final diagnosis depends on fine needle aspiration (FNA) findings and histopathology. The recent WHO classification (2017) is based on classic morphology, including assessment of invasion and nuclei. New entities are defined to designate tumours with doubtful invasion or controversial nuclear features. By immunohistochemistry, PC expresses HBME-1, TROP-2, CITED1 and CK19. Notably, PC can stain for CD20. MC is recognised by neuroendocrine differentiation. To distinguish FA vs. FC, evaluation of HBME-1, p27 and galectin has been suggested. Regarding miRNAs, miR-146b, miR-222, miR-221 and miR-181b are upregulated, while miR-145, miR-451, miR-613 and miR-137 are downregulated in PC. FC features downregulated miR-199a-5p and upregulated miR-197 and miR-346. In MC, miR-21 and miR-129-5p are downregulated. In addition, increased systemic inflammatory reaction can be poor prognostic factor in thyroid cancer. The aim of this chapter is to review classic and innovative histopathology of thyroid nodules for diagnostic pathology practice and research in multidisciplinary thyroid teams.

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“…The innovations in ultrasonography include contrast-enhanced ultrasonography, elastography and superb microvascular imaging [1,38,39].…”

Section: Radiological Evaluation Of a Thyroid Nodulementioning

confidence: 99%

Thyroid Nodules in Diagnostic Pathology: From Classic Concepts to Innovations

Fridrihsone¹,

Štrumfa²,

Strumfs³

et al. 2018

Histopathology - An Update

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“…In a follow up study, Agha et al showed that CEUS had a sensitivity of 95.9% for the detection of pathological parathyroid glands in comparison to 60.8% for (99m) Technetium-sestamibi scintigraphy. Sensitivity of CEUS in patients with negative scintigraphy was 96.3% [100,101].…”

Section: Color Doppler Imagingmentioning

confidence: 99%

Thyroid Ultrasound: State of the Art. Part 2 – Focal Thyroid Lesions

et al. 2017

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Accurate differentiation of focal thyroid nodules (FTL) and thyroid abnormalities is pivotal for proper diagnostic and therapeutic work-up. In these two part articles, the role of ultrasound techniques in the characterization of FTL and evaluation of diffuse thyroid diseases is described to expand on the recently published World Federation in Ultrasound and Medicine (WFUMB) thyroid elastography guidelines and review how this guideline fits into a complete thyroid ultrasound exam.

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Thyroid and Parathyroid Glands

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2022

Contrast-Enhanced Ultrasound

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Diagnostic Value of Contrast-Enhanced Ultrasound Evaluation of Malignant and Benign Solitary Thyroid Nodules

Abstract: # Corresponding author Contributed by Jânis GardovskisThe aim of the study was to investigate the diagnostic value of contrast-enhanced ultrasound (CEUS)

Cited by 3 publications

References 20 publications

Thyroid Nodules in Diagnostic Pathology: From Classic Concepts to Innovations

Thyroid Nodules in Diagnostic Pathology: From Classic Concepts to Innovations

Thyroid Ultrasound: State of the Art. Part 2 – Focal Thyroid Lesions

Thyroid and Parathyroid Glands

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