&lt;p&gt;Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules &amp;lt;10 mm in the maximum diameter: does size matter?&lt;/p&gt;

Lyu, Yi-Jun; Shen, Fang; Yan, Yun; Situ, Ming-zhu; Wu, Weizhu; Jiang, Guoqiang; Chen, Ya-ya

doi:10.2147/cmar.s189358

Cited by 15 publications

(13 citation statements)

References 42 publications

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“…The US‐guided FNA has proved an efficient medical procedure even for nodules 1 cm or less 14 . However, the largest study looking for a correlation between nodule size and thyroid cancer did not analyse nodules 1 cm or less 15 …”

Section: Discussionmentioning

confidence: 99%

Thyroid nodules 1 cm or less are related to Bethesda System nondiagnostic and suspicious for malignancy categories

2020

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There were 576 000 new cases of thyroid cancer worldwide in 2018. 1 In Brazil, it was estimated that in 2020 there will be 13 780 new cases of malignant thyroid neoplasia. 2 The increasing worldwide incidence is likely due to the evolution of screening methods and early diagnosis. 3 Frequently related factors are age, gender, exposure to radiation, and lack of iodine intake. 4,5 According to the American Thyroid Association, fine needle aspiration (FNA) is recommended for nodules 1 cm or greater with high or intermediate suspicion on ultrasound (US), for nodules 1.5 cm or greater with a low suspicious pattern on US, and even for nodules 2 cm or greater with a very low suspicious pattern on US. Sub-centimetre nodules generally do not require FNA evaluation and cytological investigation. 6 The European Thyroid Association recommends active surveillance for sub-centimetre nodules with at least one feature of high suspicion and the absence of abnormal lymph nodes. They also recommend FNA for nodules greater than 1 cm with high-risk features; however, there is no specific information for nodules measuring exactly 1 cm. 7 According to the Brazilian consensus, FNA is not indicated

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Section: Discussionmentioning

confidence: 99%

Thyroid nodules 1 cm or less are related to Bethesda System nondiagnostic and suspicious for malignancy categories

2020

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“…Although FNA prior to RFA is mandatory in all patients, it does not exclude an underlying malignancy with 100% certainty. About 2–3% of US-guided FNA are known to be false-negative ( 30 , 31 ). In our series, we encountered this limitation in 3 out of 103 patients.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation for symptomatic, non-functioning, thyroid nodules: a single-center learning curve

Bom

Joosten

Borren

et al. 2022

Endocrine Connections

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Objective: Radiofrequency ablation (RFA) is increasingly considered the prime option for treating symptomatic, benign, non-functioning thyroid nodules (NFTN). However, little is known about the degree of operator experience required to achieve optimal results. This study describes the RFA learning curve of a single-centre team. Methods: Retrospective cohort study of the first 103 patients receiving RFA treatment for a single, symptomatic, and benign NFTN, with a follow-up of at least one year. Primary outcome measure was technique efficacy, defined as the percentage of patients with a 6-month nodal volume reduction ratio (VRR) > 50% after single-session RFA. Optimal treatment efficacy was defined as a 6-month VRR > 50% achieved in at least 75% of patients. Secondary outcomes were complications of RFA and indications of secondary interventions. Results: Median nodal volume at baseline was 12.0 ml (range 2.0–58.0 ml). A 6-month VRR > 50% was achieved in 45% of the first 20 patients, 75% of the next 20, and 79% of the following 63 patients. Complications included minor bleeding (N = 4), transient hyperthyroidism (N = 4), and transient loss of voice (N = 1). Poor volume reduction or nodular regrowth led to diagnostic lobectomy in 11 patients and a second RFA in five. Lobectomy revealed a follicular carcinoma (T2N0M0) in two patients. In one patient, nodule regrowth was caused by an intranodular solitary B-cell lymphoma. Conclusion: About 40 procedures are required to achieve a 6-month VRR > 50% in the majority of patients. Appropriate follow-up with re-evaluation is recommended for all patients with a VRR < 50% and in those with regrowth to exclude underlying malignancy.

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“…Leenhardt et al [22] reported that diagnostic efficiency for lesions with a maximum diameter ≤10.0 mm was lower than for lesions with a maximum diameter >10.0 mm. However, Lyu et al [23] reported that nodule size did not affect the diagnostic efficiency of US-FNAC. Our study has proved that there is a significant correlation between the size of thyroid nodules and diagnosis using FNAC ( p < 0.01), puncture feeling ( p < 0.001), and FNAC combined with puncture ( p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

The Value of Ultrasound-Guided Fine-Needle Aspiration Cytology Combined with Puncture Feeling in the Diagnosis of Thyroid Nodules

Chen

et al. 2021

Acta Cytologica

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Introduction: There are few studies on the role of puncture feeling in thyroid nodules during ultrasound-guided fine-needle aspiration cytology (US-FNAC), although it is expected to become a new predictive technique. We aimed to analyze the importance of puncture feeling in combination with US-FNAC and investigate whether it can be used as an indicator to predict the nature of thyroid nodules. Materials and Methods: From January 1, 2018, to October 31, 2020, a total of 623 thyroid nodules were included. Puncture feeling was classified as “soft,” “hard,” or “hard with grittiness.” The correlation between puncture feeling and postoperative pathology and the diagnostic value of FNAC combined with puncture feeling were analyzed, and the influence of thyroid nodule size on puncture feeling, FNAC, and FNAC combined with puncture feeling was studied. We further explored the correlation between puncture feeling and histopathology in Bethesda III and IV thyroid nodules. Results: There was a significant correlation between puncture feeling and postoperative pathology (p < 0.001). The sensitivity, negative predictive value, and total coincidence rate of US-FNAC combined with puncture feeling for the diagnosis of thyroid nodules were higher than those of US-FNAC alone (96.1, 83.6, and 94.7% vs. 89.0, 65.5, and 89.7%, respectively). Thyroid nodule size was the influencing factor for puncture feeling, FNAC, and FNAC combined with puncture feeling (p < 0.05 for all). The area under the curve for puncture feeling, FNAC, and FNAC combined with puncture feeling for thyroid nodules of size ≤1 cm was greater than for modules of size >1 cm. Puncture feeling was of great value in diagnosing Bethesda III thyroid nodules (p < 0.001), and all Bethesda IV thyroid nodules had puncture feeling of soft. Conclusion: Puncture feeling is of great value during US-FNAC. “Hard” and “hard with grittiness” were indicators for malignancy, while “soft” indicated that the thyroid nodule was likely to be benign. The diagnostic value of US-FNAC combined with puncture feeling for thyroid nodules is higher than US-FNAC alone, especially when nodule size is ≤1 cm. Puncture feeling is of great value in predicting the nature of Bethesda III thyroid nodules.

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<p>Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules <10 mm in the maximum diameter: does size matter?</p>

Cited by 15 publications

References 42 publications

Thyroid nodules 1 cm or less are related to Bethesda System nondiagnostic and suspicious for malignancy categories

Thyroid nodules 1 cm or less are related to Bethesda System nondiagnostic and suspicious for malignancy categories

Radiofrequency ablation for symptomatic, non-functioning, thyroid nodules: a single-center learning curve

The Value of Ultrasound-Guided Fine-Needle Aspiration Cytology Combined with Puncture Feeling in the Diagnosis of Thyroid Nodules

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