Fusion iENA Scholar Study: Sensor-Navigated I-124-PET/US Fusion Imaging versus Conventional Diagnostics for Retrospective Functional Assessment of Thyroid Nodules by Medical Students

Freesmeyer, Martin; Winkens, Thomas; Weissenrieder, Luis; Kühnel, Christian; Gühne, Falk; Schenke, Simone; Drescher, Robert; Seifert, Philipp

doi:10.3390/s20123409

Cited by 9 publications

(10 citation statements)

References 45 publications

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“…If conventional diagnostics (anamnesis, laboratory parameters, ultrasound, and Tc-99m-scintigraphy) revealed ambiguous findings, e.g., uncertain functional assessment of thyroid nodules, additional I-124-PET/CT, and US fusion imaging investigations were performed within the scope of several clinical study protocols (not part of the present study). The results were published [ 26 , 27 , 28 ]. A part of this patient cohort was consecutively enrolled for further US examinations performed by a MTA between July 2015 and February 2016 (data of the present study).…”

Section: Methodsmentioning

confidence: 99%

Ultrasound Cine Loop Standard Operating Procedure for Benign Thyroid Diseases—Evaluation of Non-Physician Application

et al. 2021

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Conventional ultrasound (US) is time-consuming, and results are subjected to high interobserver variability. In this study, the reliability of a novel thyroid US cine loop standard operating procedure (SOP) applied by non-physicians (Medical Technical Assistant, MTA) is investigated. Thirty-three consecutive patients (22 females, 11 males) were enrolled. Patients underwent conventional thyroid US performed by a nuclear medicine physician and additional MTA US cine loop according to a local SOP that includes transversal and sagittal cine loops covering the entire thyroid. The video sequences were transferred to the Picture Archiving and Communication System (PACS) for second reading purposes. MTA US data were not considered for medical reports but for blinded second reading review of the PACS images. The results of conventional physician US reports and reviewed MTA US cine loops were compared regarding size determinations of the thyroid and its nodules, as well as Thyroid Imaging Reporting and Data Systems (TIRADS) classification of all identified lesions. The results revealed very high concordance between conventional physician US and MTA US cine loop review for both size measurements and TIRADS classifications (r(s) = 0.84–0.99, p < 0.0001 each). Minor technical impairments were identified. The evaluated thyroid US cine loop SOP enables reliable second reading results and can be applied by non-physicians.

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Section: Methodsmentioning

confidence: 99%

Ultrasound Cine Loop Standard Operating Procedure for Benign Thyroid Diseases—Evaluation of Non-Physician Application

et al. 2021

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“…For this purpose, 123 I-SPECT/US fusion imaging was performed and allowed definite correlation of the hyperfunctional area with the Kwak-TIRADS 5 thyroid nodule, suggesting hyperfunctional thyroid carcinoma (B2). 4,6 Concordantly, thyroglobulin levels were found to be highly elevated (2846.0 ng/mL). We expended diagnostics by 123 I whole-body scintigraphy (C).…”

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confidence: 87%

“…Its detection was achieved by 123 I-SPECT/US fusion imaging that has not been introduced so far. The technique of US fusion itself is well-described as a problem-solving tool 6,10–13 . However, by using 123 I-SPECT/US, higher image quality can be achieved compared with 99m Tc-SPECT/US.…”

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confidence: 99%

Excellent Response to Multimodal Therapy Approach in Hyperfunctioning Metastatic Follicular Thyroid Carcinoma Diagnosed on 123I-SPECT/Ultrasound Fusion Imaging

et al. 2022

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An 83-year-old woman presented with new-onset hyperthyroidism and suspicious thyroid nodules on ultrasound (US). Conventional 99mTcO4 thyroid scintigraphy showed hyperfunctioning areas that could not be clearly assigned to the US findings. With the aid of 123I-SPECT/US fusion imaging, suspicious nodules were unambiguously identified as autonomously hyperfunctioning lesions. Additional 123I whole-body scan revealed iodine-avid lymphonodular and pulmonal metastases. Clinical diagnosis of hormone-active thyroid carcinoma was made and histologically confirmed. Because of significant hyperthyroidism as well as multiple partially iodine-negative metastases, a multimodal treatment regime consisting of 131I radioiodine therapy, surgery, and radiation therapy was conducted, leading to almost complete remission.

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“…For small hyperfunctioning TNs, the use of thyroid suppression scintigraphy can help to unmask nodules that appear isofunctioning under normal conditions [13]. The combi- nation of functional and morphological imaging has been investigated by a group from Jena in several studies [16,17,18,19]. Seifert et al stated that with conventional TS, the rate of hypofunctioning and small hyperfunctioning TNs may be underestimated.…”

Section: Distribution Of the Functional Status Of Thyroid Nodulesmentioning

confidence: 99%

“…not available nation of functional and morphological imaging has been investigated by a group from Jena in several studies [16,17,18,19]. Seifert et al stated that with conventional TS, the rate of hypofunctioning and small hyperfunctioning TNs may be underestimated.…”

Section: Distribution Of the Functional Status Of Thyroid Nodulesmentioning

confidence: 99%

Distribution of Functional Status of Thyroid Nodules and Malignancy Rates of Hyperfunctioning and Hypofunctioning Thyroid Nodules in Germany

et al. 2022

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Aim Thyroid scintigraphy enables the depiction of the functional status of thyroid nodules (TNs) with both, 99mTc-pertechnetate and 123Iodine. The functional status is relevant for diagnostic procedures for the differentiation of benign and malignant TNs. The aim of this study was to examine the current frequencies of hyper-, hypo- and isofunctioning TNs in Germany and to estimate the risk of malignancy with regard to functional status. Methods In 11 study centers, a minimum of 100 nodules per center were consecutively enrolled between July 2019 and April 2020. Inclusion criteria were: newly diagnosed nodule, nodule’ size of 10 mm or more, thyroid scintigraphy. Exclusion criteria were: completely cystic TNs, patients with prior radioiodine therapy or thyroid surgery. The risk of malignancy was estimated for hyper- and hypofunctioning TNs. Results Overall, 849 patients (72 % women) with 1262 TNs were included. Patients’ age ranged from 18 to 90 years. Most TNs were hypofunctioning (n=535, 42%) followed by isofunctioning TNs (n=488, 39%) and hyperfunctioning TNs (n=239, 19%). When only TNs with a maximum size of 2 cm or more were considered the rate of hyperfunctioning and hypofunctioning TNs increased (to 27% and 49%) while isofunctioning TNs decreased. Only one of all hyperfunctioning TNs was malignant. In hypofunctioning nodules, the malignancy rate was estimated at 10%. Conclusion In Germany, the proportion of hyperfunctioning TNs is approximately 20% and increases in larger TNs to up to 27%. Due to the low risk of malignancy in hyperfunctioning TNs, no further procedures to rule out malignancy are necessary. The risk of malignancy of hypofunctioning TNs is significantly higher. Thus, a thyroid scintigraphy is a useful diagnostic tool in Germany.

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Fusion iENA Scholar Study: Sensor-Navigated I-124-PET/US Fusion Imaging versus Conventional Diagnostics for Retrospective Functional Assessment of Thyroid Nodules by Medical Students

Cited by 9 publications

References 45 publications

Ultrasound Cine Loop Standard Operating Procedure for Benign Thyroid Diseases—Evaluation of Non-Physician Application

Ultrasound Cine Loop Standard Operating Procedure for Benign Thyroid Diseases—Evaluation of Non-Physician Application

Excellent Response to Multimodal Therapy Approach in Hyperfunctioning Metastatic Follicular Thyroid Carcinoma Diagnosed on 123I-SPECT/Ultrasound Fusion Imaging

Distribution of Functional Status of Thyroid Nodules and Malignancy Rates of Hyperfunctioning and Hypofunctioning Thyroid Nodules in Germany

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