Patterns of Sonographically Detectable Echogenic Foci in Pediatric Thyroid Carcinoma with Corresponding Histopathology: An Observational Study

Toslak, İclal Erdem; Martin, Brendan; Barkan, Güliz A.; Kılıç, Ayşe; Lim-Dunham, Jennifer E.

doi:10.3174/ajnr.a5419

Cited by 11 publications

(14 citation statements)

References 15 publications

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“…Intracystic CTA is strongly correlated with inspissated colloid content [ 16 ]. However, many cases of punctate NEF may correspond to dystrophic calcifications and colloid, as well as psammomatous calcifications [ 11 , 14 , 23 ] and it remains unclear whether the histopathologic feature of intrasolid punctate NEF with CTA is colloid or microcalcification [ 21 , 22 , 24 ]. Although the histopathologic features of large NEFs remain to be elucidated, they might have a relationship with those of intrasolid punctate NEFs without CTA based on the high rate of their concurrence.…”

Section: Discussionmentioning

confidence: 99%

“…The US lexicon of microcalcifications primarily defines them as punctate (≤1 mm) echogenic foci with focal hyperechogenicity relative to the thyroid tissue within the solid component of a nodule [ 5 , 6 ]. Although the US feature of microcalcification is strongly associated with malignancy, some reports [ 7 , 11 ] have indicated that the term "microcalcification" is a misnomer because many punctate echogenic foci are found in benign nodules [ 12 ] and are not well correlated with psammomatous microcalcifications on histopathologic examinations [ 11 , 13 , 14 ]. Recent studies [ 12 , 15 ] have suggested that some types of NEF with a comet tail artifact (CTA) may be associated with malignancy, but this possibility remains controversial.…”

Section: Introductionmentioning

confidence: 99%

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Malignancy risk of thyroid nodules with nonshadowing echogenic foci

Sohn

Paik

et al. 2021

Ultrasonography

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This study was conducted to determine the malignancy risk and diagnostic value of various types of nonshadowing echogenic foci (NEF) in the risk stratification of thyroid nodules. Methods: A total of 1,018 consecutive thyroid nodules (≥1 cm) with final diagnoses were included. The presence of NEF was determined and types of NEF were classified according to the presence of a comet tail artifact (CTA), location, and size through a prospective evaluation. The associations with malignancy, malignancy risk, and diagnostic value of various types of NEF were assessed. Results: Intrasolid punctate NEF without CTA was the only type of NEF that was an independent predictor of malignancy (P<0.001). The malignancy risk of intrasolid punctate NEF without CTA was substantially higher in solid hypoechoic nodules than in isoechoic or nonsolid nodules (71.3% vs. 9.2%, P<0.001). In solid hypoechoic nodules, slightly increased sensitivity (70.8% vs. 67.9%) for malignancy and a similar malignancy risk (71.4% vs. 71.3%) were observed for intrasolid punctate NEF (with or without CTA) and intrasolid punctate NEF without CTA, respectively. NEF with CTA at the margin of the cystic component was not associated with malignancy or benignity in nonsolid nodules (P≥0.236). Conclusion: Intrasolid punctate NEF without CTA was the only independent predictor of malignancy. However, solid hypoechoic nodules with intrasolid punctate NEF should be classified as high-suspicion nodules regardless of coexisting CTA. Other types of NEF had no added value for detecting malignancy compared to intrasolid punctate NEF without CTA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Malignancy risk of thyroid nodules with nonshadowing echogenic foci

Sohn

Paik

et al. 2021

Ultrasonography

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“…Finally, US features were compared with the findings at pathologic examination to investigate the US‐pathologic correlate of PEF. The Authors found that histopathological detected psammoma bodies were strongly correlated to the presence of PEF ( P < 0.001), data that disagree with previous studies 8,11 . In this view, the Authors argued for this discordance reflecting on their higher prevalence of psammoma bodies (74.6%) in the pathologically proven PTCs, compared to the rates previously reported (30.8%–40%) 8,11 .…”

mentioning

confidence: 70%

“…The Authors found that histopathological detected psammoma bodies were strongly correlated to the presence of PEF ( P < 0.001), data that disagree with previous studies 8,11 . In this view, the Authors argued for this discordance reflecting on their higher prevalence of psammoma bodies (74.6%) in the pathologically proven PTCs, compared to the rates previously reported (30.8%–40%) 8,11 . Among PTCs with PEF, 94.4% cases showed any type of calcified deposits or inspissated colloids.…”

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confidence: 72%

Untangling the ultrasound conundrum of microcalcifications in papillary thyroid cancer

Verde

Ponsiglione

2022

J of Clinical Ultrasound

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The Thyroid Imaging Reporting and Data System (TI-RADS) is a comprehensive system aiming to standardize interpretation and reporting of thyroid nodules on ultrasound (US) proposed by the American College of Radiology (ACR). 1 In a recent meta-analysis, Li and colleagues found that ACR TI-RADS showed moderate to high sensitivity and moderate specificity in risk stratification of thyroid nodules, avoiding a large number of unnecessary biopsies. 2This scoring system relies on the evaluation of five categories of US thyroid nodule features (composition, echogenicity, shape, margins, and echogenic foci) with an incremental score that is correlated to the likelihood of malignancy. 1,3 Regarding the US standardized classification of echogenic foci, the ACR TI-RADS suggests adopting a precise terminology including the following different patterns: large comet-tail artifacts, macrocalcifications, peripheral calcifications, and punctate echogenic foci (PEF). 4,5 Specifically, ACR TI-RADS defines PEF as "dot-like" foci which may be associated with small comet-tail artifacts but without posterior acoustic shadowing. 4,6 Accordingly, the use of the term

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“…Based on the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS), 3 types of echogenic foci are potentially linked to malignancy [ 6 , 7 ]: macrocalcifications, punctate echogenic foci, and peripheral rim calcifications (or eggshell calcifications). Macrocalcifications have been reported to carry a mild risk of malignancy, while punctate echogenic foci, which are mostly accompanied by psammomatous calcifications in papillary thyroid cancer, have been regarded with a high possibility of malignancy [ 8 , 9 ]. Nevertheless, the literature on the malignancy probability of rim calcifications has remained controversial [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Different sonographic features of peripheral thyroid nodule calcification and risk of malignancy: a prospective observational study

Nabahati¹,

Ghaemian²,

Moazezi³

et al. 2021

Pol J Radiol

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IntroductionTo investigate the association of peripheral calcification, as well as its sonographic features, with thyroid nodule malignancy.Material and methodsThis study was prospectively conducted during 2015-2020 on patients diagnosed with thyroid nodule undergoing ultrasound-guided fine-needle aspiration in Shahid Beheshti teaching hospital or private offices in Babol, northern Iran. The ultrasonographic characteristics of the nodules, as well as the cytological findings, were recorded. Regression analysis was used to assess the relationship between sonographic results and malignancy. We also used receiver operator characteristics (ROC) analysis to estimate the ability of ultrasound to predict the characteristic features of malignancy, as estimated by the area under the curve (AUC).ResultsA total of 1857 thyroid nodules were finally included, of which 84 were peripherally calcified nodules. There was a significant positive association between the nodule malignancy and peripheral calcification (OR = 2.23, 95% CI: 1.13-4.35). In the nodules with peripheral calcification, significant positive associations were seen between malignancy and lobulated margin (OR = 3.85, 95% CI: 1.02-14.54) and solid composition (OR = 4.05, 95% CI: 0.99-16.53). The ROC analysis indicated that AUC for lobulated margin and solid composition was 63.8% and 66.5%, respectively, in predicting malignant thyroid nodules.ConclusionsThe findings showed that peripheral calcification on sonography can be a potential indicator of malignant thyroid nodules. Also, the presence of lobulated margin and/or solid composition, besides peripheral calcification, can be helpful in better distinguishing malignant from benign nodules.

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Patterns of Sonographically Detectable Echogenic Foci in Pediatric Thyroid Carcinoma with Corresponding Histopathology: An Observational Study

Cited by 11 publications

References 15 publications

Malignancy risk of thyroid nodules with nonshadowing echogenic foci

Malignancy risk of thyroid nodules with nonshadowing echogenic foci

Untangling the ultrasound conundrum of microcalcifications in papillary thyroid cancer

Different sonographic features of peripheral thyroid nodule calcification and risk of malignancy: a prospective observational study

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