The Future of Thyroid Nodule Risk Stratification

Burgos, Nydia; Ospina, Naykky Singh; Sipos, Jennifer A.

doi:10.1016/j.ecl.2021.12.002

Cited by 10 publications

(6 citation statements)

References 80 publications

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“…Blood type and thyroid nodule are not known to have a direct relationship (16). Thyroid nodules are growths that develop within the thyroid gland, and while they are often benign, they can also be cancerous (2).…”

Section: Discussionmentioning

confidence: 99%

Distribution of ABO blood groups and Rh factor in benign and malign thyroid nodules

DENİZ>

2023

Journal of Health Sciences and Medicine

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Aim: Many factors affect the diagnostic value of the fine-needle aspiration biopsy applied for these thyroid nodules. I aimed to investigate whether one of these factors would be ABO blood groups and Rh factor and examine the relationship of these factors with the Bethesda categorization. Additionally, I aimed to evaluate ABO blood groups and Rh factors in patients with thyroid cancer. Material and Method: This study was planned in a cross-sectional retrospective design. The data of the patients were obtained from the hospital data bank. In the analysis of 801 patients following the acceptance criteria, 412 patient data were obtained. Patients were divided into 4 (O, A, B, and AB groups) according to their blood groups and analyzed for nodules (solitary/ multinodular). Nodules were divided into malignant and benign, according to histopathological diagnosis, and all were analyzed. Results: There was no difference in analyzing the demographic data according to the blood groups. The rates of the FNAB history were 51 (32.3%), 39 (24.2%), 14 (26.4%), and 13 (32.5%) in the same order of blood groups (p=0.393). In the analysis of the nodule type, multinodular did not differ from solitary nodules among the blood groups [O: 141 (89.2%); A:140(87%), B: 46(86.8%), and AB: 35(87.5%)]. Thyroid function status (euthyroid, hypothyroid, or hyperthyroid) was similar for all the blood groups (p=0.815). The O-group had 1 (0.6%) patient with Bethesda score-6, and the A-group had 2 (1.2%) patients with Bethesda score-6. For Bethesda score-5, per blood group had 2 patients. The histopathological distribution of malign nodules (p=0.782) is as follows: O-groups: 6 (33.3%) (Rh+:27%; Rh-:5,5%), A groups: 7(63,6%) (Rh+:54,5%; Rh-:0,9%), B groups: 2(20%)(Rh+:20%; Rh-:0%) and AB groups: 1(33%) (Rh+:33%) Rh-:0%). Conclusion: Malign nodule rate was highest in the A-group and lowest in the B groups, although it did not differ in the overall analysis. No relationship was found between the Bethesda categorization of nodules, their sizes, type of nodules, type of thyroid cancer, and ABO blood groups.

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Section: Discussionmentioning

confidence: 99%

Distribution of ABO blood groups and Rh factor in benign and malign thyroid nodules

DENİZ>

2023

Journal of Health Sciences and Medicine

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“…Future studies using artificial intelligence should focus on improving patient outcomes and use rigorous scientific methods. [13] Other Cross-sectional Imaging Methods…”

Section: Examination Of Lymph Nodementioning

confidence: 99%

Management of Thyroid Nodules

Uludag

2023

Sisli Etfal

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Thyroid nodules are common and the prevalence varies between 4 and 7% by palpation and 19–68% by high-resolution USG. Most thyroid nodules are benign, and the malignancy rate varies between 7 and 15% of patients. Thyroid nodules are detected incidentally during clinical examination or, more often, during imaging studies performed for another reason. All detected thyroid nodules should be evaluated clinically. The main test in evaluating thyroid function is thyroid stimulating hormone (TSH). If the serum TSH level is below the normal reference range, a radionuclide thyroid scan should be performed to determine whether the nodule is hyperfunctioning. If the serum TSH level is normal or high, ultrasonography (US) should be performed to evaluate the nodule. US is the most sensitive imaging method in the evaluation of thyroid nodules. Computed tomography (CT) and magnetic resonance imaging are not routinely used in the initial evaluation of thyroid nodules. There are many risk classification systems according to the USG characteristics of thyroid nodules, and the most widely used in clinical practice are the American Thyroid Association guideline and the American College of Radiology Thyroid Imaging Reporting and Data System. Fine needle aspiration biopsy (FNAB) is the gold standard method in the evaluation of nodules with indication according to USG risk class. In the cytological evaluation of FNAB, the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is the most frequently applied cytological classification. TBSRTC is a simplified, 6-category reporting system and was updated in 2023. The application of molecular tests to FNAB specimens, especially those diagnosed with Bethesda III and IV, is increasing to reduce the need for diagnostic surgery. Especially in Bethesda III and IV nodules, different methods are applied in the treatment of nodules according to the malignancy risk of each category, these are follow-up, surgical treatment, radioactive iodine treatment, and non-surgical ablation methods.

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“…21 Some potential barriers to risk stratification use included lack of a universal lexicon, the need for additional training to support efficacy in thyroid ultrasound assessment, and time constraints. 19,21,22 Moreover, although clinical evidence from highly trained and experienced evaluators support acceptable measures of concordance on thyroid nodule risks assessment, measurements of reproducibility including more diverse groups of evaluators identify low concordance as an important concern in routine practice. [23][24][25] To facilitate adoption of high quality thyroid nodule risk stratification, it is important to identify implementation strategies that can support this process.…”

Section: Introductionmentioning

confidence: 99%

“…For example, the results of an international survey (including radiologists, endocrinologists, surgeons and other relevant specialists) showed that although most respondents were familiar with thyroid nodule risk stratification, up to one‐third had not implemented risk stratification in practice 21 . Some potential barriers to risk stratification use included lack of a universal lexicon, the need for additional training to support efficacy in thyroid ultrasound assessment, and time constraints 19,21,22 . Moreover, although clinical evidence from highly trained and experienced evaluators support acceptable measures of concordance on thyroid nodule risks assessment, measurements of reproducibility including more diverse groups of evaluators identify low concordance as an important concern in routine practice 23–25 …”

Section: Introductionmentioning

confidence: 99%

Implementation strategies to support ultrasound thyroid nodule risk stratification: A systematic review

Edwards

Brito

Salloum

et al. 2023

Clinical Endocrinology

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BackgroundUltrasound risk stratification can improve the care of patients with thyroid nodules by providing a structured and systematic approach for the evaluation of thyroid nodule features and thyroid cancer risk. The optimal strategies to support implementation of high quality thyroid nodule risk stratification are unknown. This study seeks to summarise strategies used to support implementation of thyroid nodule ultrasound risk stratification in practice and their effects on implementation and service outcomes.MethodsThis is a systematic review of studies evaluating implementation strategies published between January 2000 and June 2022 that were identified on Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane, Scopus, or Web of Science. Screening of eligible studies, data collection and assessment for risk of bias was completed independently and in duplicate. Implementation strategies and their effects on implementation and service outcomes were evaluated and summarised.ResultsWe identified 2666 potentially eligible studies of which 8 were included. Most implementation strategies were directed towards radiologists. Common strategies to support the implementation of thyroid nodule risk stratification included: tools to standardise thyroid ultrasound reports, education on thyroid nodule risk stratification and use of templates/forms for reporting, and reminders at the point of care. System based strategies, local consensus or audit were less commonly described. Overall, the use of these strategies supported the implementation process of thyroid nodule risk stratification with variable effects on service outcomes.ConclusionsImplementation of thyroid nodule risk stratification can be supported by development of standardised reporting templates, education of users on risk stratification and reminders of use at the point of care. Additional studies evaluating the value of implementation strategies in different contexts are urgently needed.

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The Future of Thyroid Nodule Risk Stratification

Cited by 10 publications

References 80 publications

Distribution of ABO blood groups and Rh factor in benign and malign thyroid nodules

Distribution of ABO blood groups and Rh factor in benign and malign thyroid nodules

Management of Thyroid Nodules

Implementation strategies to support ultrasound thyroid nodule risk stratification: A systematic review

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