EANM practice guideline/SNMMI procedure standard for RAIU and thyroid scintigraphy

Giovanella, Luca; Avram, Anca M.; Iakovou, Ioannis; Kwak, Jennifer; Lawson, Susan; Lulaj, Elizabeth; Luster, Markus; Piccardo, Arnoldo; Schmidt, Matthias; Tülchinsky, Mark; Verburg, F. A.; Wolin, Ely A.

doi:10.1007/s00259-019-04472-8

Cited by 136 publications

(144 citation statements)

References 38 publications

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“…Nevertheless, the limited number of malignancies reported from 1990 to 2017 indirectly supports current knowledge that the prevalence of malignancy among AFTNs is low 4,5,12 . Indeed, clinical guidelines recommend refraining from FNA if one hyperfunctioning nodule is found that corresponds to the nodule detected on US 4,5,15 . The correlation between US presentation and cytological diagnosis is reported in the literature 29 and all the main systems for thyroid cytology reporting have been found to appropriately stratify the risk of malignancy 30‐34 .…”

Section: Resultsmentioning

confidence: 99%

“…Nevertheless, no cancers were found by Schenke et al 17 in surgically treated patients, and a very low rate of malignancy has traditionally been reported in the literature 25,28,39 . In addition, refraining from invasive diagnostic procedures in scintigraphically demonstrated AFTNs is recommended in the current clinical guidelines, as stated 4,5,15 . Lastly, two authors involved in the present study (LG, PT) performed patients' examinations during their clinical practice, which could introduce a bias; however, the main observers of the study (MC, CV) were completely blind to patients' diagnoses and outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…The relationship between thyroid autonomy and TSH levels, however, is largely influenced by iodine intake, and normal TSH levels are detected in 50% of patients with AFTNs 14 . Consequently, variable indications are reported in the different clinical guidelines regarding the scintigraphic evaluation of thyroid nodules in the light of TSH 4,15 . It must also be considered that the sonographic features of AFTNs are heterogeneous 16,17 .…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound systems for risk stratification of thyroid nodules prompt inappropriate biopsy in autonomously functioning thyroid nodules

Castellana

Virili

Paone

et al. 2020

Clinical Endocrinology

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Objective Ultrasound (US) risk stratification systems (RSSs) have been developed to reduce the number of unnecessary fine‐needle aspiration (FNA) biopsies in patients with thyroid nodules. Autonomously functioning thyroid nodules (AFTN) account for 5%‐10% of palpable lesions and are very rarely malignant. The present study was undertaken to investigate how RSSs classify AFTNs and whether RSSs are able to avoid unnecessary FNA biopsies in such cases. Methods Patients with AFTN who had undergone US, scintigraphy and thyroid function evaluation from December 2016 to December 2017 were selected. US images were retrospectively reviewed and AFTN reclassified according to AACE/ACE/AME, ACR‐TIRADS, ATA, BTA, EU‐TIRADS, K‐TIRADS and TIRADS. Risk class and indication for FNA were assessed. Results A number of 87 AFTNs from 85 consecutive patients were enrolled. A median diameter of 22 mm (range 10‐59) was found, with an ovoid isoechoic nodule being the most frequent US presentation. When AFTNs were reclassified according to US RSSs, the most common categories were low and intermediate risk. AFTNs were assessed as being at high risk/high suspicion/malignant in 1%‐9%, with good agreement among AACE/ACE/AME, ATA, EU‐TIRADS, K‐TIRADS and TIRADS. Remarkably, FNA was indicated in 27%‐90% of AFTNs. A statistically significant difference among the systems was found; 8% of cases were nonclassifiable by one or more US RSS. Conclusions Ultrasound RSSs prompt inappropriate FNA in a significant number of patients with AFTN.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ultrasound systems for risk stratification of thyroid nodules prompt inappropriate biopsy in autonomously functioning thyroid nodules

Castellana

Virili

Paone

et al. 2020

Clinical Endocrinology

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“…Die Untersuchungsprotokolle sind weitgehend standardisiert; diesbezüglich kann auf die S1-Leitlinie zur Schilddrüsenszintigrafie (Version 4) der Deutschen Gesellschaft für Nuklearmedizin [11] sowie auf die methodischen Ausführungen hierzu in diesem Journal [6,7] verwiesen werden. Eine aktuelle Zusammenstellung des Indikationsspektrums für eine Schilddrüsenszintigrafie aus nuklearmedizinischer Sicht findet sich in den im vergangenen Jahr publizierten, gemeinsamen Leitlinien der European Association of Nuclear Medicine (EANM) und der Society of Nuclear Medicine and Molecular Imaging (SNMMI) [12].…”

Section: Introductionunclassified

Die „Standard“-Schilddrüsenszintigrafie – ist sie noch zeitgemäß?

Görges

Bockisch

Seifert

2020

Der Nuklearmediziner

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ZusammenfassungAus fachfremder Sicht wird der Stellenwert der „konventionellen“ Schilddrüsenszintigrafie zur Klärung diverser thyreologischer Fragestellungen international mittlerweile weit niedriger eingeschätzt, als dies dem hierzulande tätigen Nuklearmediziner bewusst ist. Dieser Aufsatz gibt einen Überblick über häufig geäußerte Kritikpunkte an der Schilddrüsenszintigrafie und möchte einiges hierzu klarstellen sowie in berechtigten Fällen fundierte Gegenargumente liefern. In diesem Rahmen wird ein Überblick über die weiterhin bestehenden Indikationen gegeben, es werden aber auch Aspekte angeschnitten, bei denen Verbesserungsbedarf besteht. Abschließend erfolgt eine Aussicht auf zukünftige Perspektiven und Weiterentwicklungen der funktionellen Charakterisierung von thyreoidalem Gewebe.

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“…Despite blood biochemical detection and ultrasonography are widely used, it is still not enough to obtain a precise diagnosis in several situations. Thyroid scintigraphy with 99m Tc-pertechnetate is a valid avenue to identify the causes of thyrotoxicosis, especially for distinguishing Graves' disease (GD) and toxic multinodular goiter (TMG) when both thyrotropin receptor antibody was negative or differentiating GD from thyroiditis (8). However, thyroid scintigraphy images are mostly simple planar with limited resolution, which makes the interpretation is a time-consuming, experience-dependent, and subjective work with signi cant variation among inter-observer measurement (9).…”

Section: Introductionmentioning

confidence: 99%

Deep Convolution Neural Network Based Artificial Intelligence Improves Diagnosis of Thyroid Scintigraphy for Thyrotoxicosis: a Dual Center Study

Yang¹,

Pi²,

He³

et al. 2020

Preprint

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Background: 99mTc-pertechnetate thyroid scintigraphy is a valid avenue for distinguishing causes of thyrotoxicosis in the clinic, but the interpretation of thyroid scintigraphic images is subjected with significant variation among different inter-observers. We aim to develop an artificial intelligence (AI) system to improve the diagnosis of thyrotoxicosis.Materials and methods: We constructed an AI model based on a deep neural network with 2468 thyroid scintigraphic images collected from West China Hospital, and evaluated the diagnostic accuracy for classifying four patterns of thyrotoxicosis: ‘diffusely increased,’ ‘diffusely decreased,’ ‘focal increased,’ and ‘heterogeneous uptake.’ Then, we compared the diagnostic performance of the AI model and five physicians with 200 testing cohorts from two centers.Results: We constructed the AI model, which has the best performance in internal database validation based on four kinds of standout pre-trained networks. This AI model achieves satisfactory performance in classifying four patterns of thyrotoxicosis with an overall accuracy of 91.92% for internal and 86.75% for external data validation. In the following contrastive study, the AI model represented improved diagnostic accuracy and consistency than 5 physicians for interpreting data from West China Hospital (88% vs. 66~73%) and Panzhihua Central Hospital (83% vs. 53%~79%), respectively.Conclusion: Deep convolution neural network based AI model represented considerable performance in classifying four patterns of thyroid scintigraphic images; this may help physicians diagnose causes of thyrotoxicosis and reduced the physicians’ error rate.

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EANM practice guideline/SNMMI procedure standard for RAIU and thyroid scintigraphy

Cited by 136 publications

References 38 publications

Ultrasound systems for risk stratification of thyroid nodules prompt inappropriate biopsy in autonomously functioning thyroid nodules

Ultrasound systems for risk stratification of thyroid nodules prompt inappropriate biopsy in autonomously functioning thyroid nodules

Die „Standard“-Schilddrüsenszintigrafie – ist sie noch zeitgemäß?

Deep Convolution Neural Network Based Artificial Intelligence Improves Diagnosis of Thyroid Scintigraphy for Thyrotoxicosis: a Dual Center Study

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