The effect of routine radiological reporting of thyroid incidentalomas on rates of thyroid needle biopsy, thyroid surgery and detection of thyroid malignancy

Sinnott, Joseph Dalby; Mortimer, Rebecca; Smith, Joel; Skelton, Emily; Drinkwater, K.; Lipscomb, David; Howlett, David

doi:10.1111/cen.13424

Cited by 7 publications

(9 citation statements)

References 26 publications

(30 reference statements)

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“…Although sonography is the primary imaging test for a palpable thyroid nodule or known thyroid malignancy, thyroid abnormalities are oftentimes firstly detected by CT [ 1 ]. A thyroid nodule may be incidentally found by CT when it is used to evaluate an unknown bump at the neck area [ 2 ]. Sonography is known to suffer some limitations, such as the dependency on operators' skills and lack of advantages in determining the lymphatic metastasis in central groups [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Value of CT Features in the Diagnosis of Papillary Thyroid Tumors in Incidental Thyroid Nodules

Zhang

Qiao

Zhang

2020

International Journal of Endocrinology

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The present work has investigated the value of computed tomography (CT) features in the diagnosis of papillary thyroid tumors in the incidental thyroid nodules (ITNs). In the 82 enrolled patients, 101 thyroid nodules were incidentally found by the neck CT scanning, among which 49 were histologically confirmed to be papillary thyroid carcinoma (PTC) while the other 52 were nodular goiter (NG). The tumor location, size, shape, tiny calcification, cystic change, and signs of an irregular ring, marginal defects, and enhanced blurring were all depicted by CT features. Both univariate and multivariate analyses were employed to identify independent predictors of PTC. The univariate analysis of PTC and NG showed that four CT features were statistically significant, including tiny calcification and signs of an irregular ring, marginal defects, and enhanced blurring. Furthermore, the multivariate logistic regression model indicated that signs of an irregular ring, marginal defects, and enhanced blurring were strongly correlated with PTC, of which the odds ratio (OR) was 27.374 (95% CI: 5.871∼127.636), 28.587 (95% CI: 4.139∼197.460), and 4.315 (95% CI: 0.858∼21.694), respectively. In the predictive model of PTC, the value of sensitivity, specificity, accuracy, and Youden index was 87.8%, 94.2%, 91.1%, and 0.82 with a likelihood ratio of 15.1. Therefore, the signs of an irregular ring, marginal defects, and enhanced blurring may be helpful in the diagnosis of PTC in incidentally found thyroid nodules.

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Section: Introductionmentioning

confidence: 99%

Value of CT Features in the Diagnosis of Papillary Thyroid Tumors in Incidental Thyroid Nodules

Zhang

Qiao

Zhang

2020

International Journal of Endocrinology

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“…The patient eligibility criteria as reported in the individual studies were presented in Table S3. Eight were single centre studies 20–27 and one study 28 involved two centres. Six studies 20,22,23,25,26,28 were carried out in the United States whilst the rest were from the United Kingdom, 21 Australia 24 and Israel 27 .…”

Section: Resultsmentioning

confidence: 99%

“…Eight were single centre studies 20–27 and one study 28 involved two centres. Six studies 20,22,23,25,26,28 were carried out in the United States whilst the rest were from the United Kingdom, 21 Australia 24 and Israel 27 . Eight studies 20–22,24–28 were carried in the adult population and one 23 in individuals under the age of 18.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies 20,22,23,25,26,28 were carried out in the United States whilst the rest were from the United Kingdom, 21 Australia 24 and Israel 27 . Eight studies 20–22,24–28 were carried in the adult population and one 23 in individuals under the age of 18. The definitions of modes of detection (incidental and nonincidental) as reported in the individual studies are summarized in Table S4.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 738 malignant thyroid nodules and 2508 benign thyroid nodules were included in the six case‐control studies 20–24,26,28 . The odds of incidental detection in the cancer and benign groups ranged from 0.16 to 0.5 and 0.06 to 0.38, respectively (odds ratio = 0.64–2.86; statistical significance testing was not performed; shown in Table 1).…”

Section: Resultsmentioning

confidence: 99%

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The influence of incidental detection of thyroid nodule on thyroid cancer risk and prognosis—A systematic review

Chooi

Ravindiran

Balasubramanian

2021

Clinical Endocrinology

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Background Clinically inapparent thyroid nodules discovered serendipitously on imaging for nonthyroid indications are termed as thyroid incidentalomas. It is unclear whether these incidentalomas have a lower prevalence of malignancy or slower tumour progression compared to symptomatic nodules. The aims of this systematic review were to determine the impact of incidental detection of thyroid nodules on both the risk of malignancy and on prognosis in patients with thyroid cancer. Method PubMed and MEDLINE® on Web of Science databases were searched from inception to March 2020 for English language articles reporting on human studies of thyroid cancer risk and/or prognosis in incidental and nonincidental nodules. Results Eighteen observational studies published between 1998 and 2020 were eligible for analysis; four studies reported on risk, nine on prognosis and five studies reported on both risk and prognosis. When comparing the incidental and nonincidental groups in the risk study, the odds of incidental detection in the cancer and benign groups ranged from 0.16 to 0.5 and 0.06 to 0.38, respectively (odds ratio [OR] = 0.64–2.86) in case‐control studies (n = 6); the risk of malignancy for thyroid nodules ranged from 4% to 23.5% in the incidental and 3.8% to 28.7% in the nonincidental groups (relative risk = 0.13–6.27) in the cohort studies (n = 3). A meta‐analysis of the eligible case‐control studies (n = 3) showed a nonsignificant summated OR of 1.04 (95% confidence interval = 0.63–1.70; p = .88). In the prognosis study, five direct and thirteen indirect markers of prognosis were compared between the incidental and nonincidental groups. A meta‐analysis was not possible but incidentally detected thyroid cancer had better progression‐free and overall survival. Conclusion Current evidence suggests that investigation and management of thyroid nodules should not be influenced by the mode of detection.

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Incidental Findings in Multislice CT of the Body

Hellström

2018

Multislice CT

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The effect of routine radiological reporting of thyroid incidentalomas on rates of thyroid needle biopsy, thyroid surgery and detection of thyroid malignancy

Abstract: This study posits that routine radiological reporting of thyroid incidentalomas, with further investigation when clinically appropriate, is warranted. The results suggest that lesion size and CT characteristics are not reliable criteria to triage patients for investigation/biopsy.

Cited by 7 publications

References 26 publications

Value of CT Features in the Diagnosis of Papillary Thyroid Tumors in Incidental Thyroid Nodules

Value of CT Features in the Diagnosis of Papillary Thyroid Tumors in Incidental Thyroid Nodules

The influence of incidental detection of thyroid nodule on thyroid cancer risk and prognosis—A systematic review

Incidental Findings in Multislice CT of the Body

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