The Prevalence and Significance of Incidental Thyroid Nodules Identified on Computed Tomography

Yoon, Dae Young; Chang, Suk Ki; Choi, Choongik; Yun, Eun Joo; Seo, Young Lan; Nam, Eun Suk; Cho, Sung Jin; Rho, Young‐Soo; Ahn, Hwoe Young

doi:10.1097/rct.0b013e318157fd38

Cited by 142 publications

(121 citation statements)

References 21 publications

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“…An ITN is a common finding seen in 1 in 6 contrast-enhanced neck CT scans and also frequently seen on cervical spine CT and chest CT scans. 1 ITNs pose a difficult problem for radiologists and clinicians because despite favorable features of the low malignancy rate in ITN of 0.5%-9% 2,3 and excellent survival for most thyroid cancers, many radiologists feel compelled to recommend work-up of ITNs seen on CT for fear of missing a malignancy. The decision to further evaluate such incidental nodules can start a cascade of sonographic imaging, biopsy, and even surgery for nodules that are commonly discovered to be benign.…”

mentioning

confidence: 99%

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Incidental Thyroid Nodules on CT: Evaluation of 2 Risk-Categorization Methods for Work-Up of Nodules

Nguyen

Choudhury

Eastwood

et al. 2013

AJNR Am J Neuroradiol

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mentioning

confidence: 99%

“…4,6 If Ն10 mm is the only criterion for selection, then Յ78% of ITNs on CT could require sonography. 3 Thus, there is a need for a more effective method of managing CT-detected ITNs.…”

mentioning

confidence: 99%

Incidental Thyroid Nodules on CT: Evaluation of 2 Risk-Categorization Methods for Work-Up of Nodules

Nguyen

Choudhury

Eastwood

et al. 2013

AJNR Am J Neuroradiol

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“…Only 146 studies documented such a finding (<1%). This reporting rate is much lower than published prevalence rates of 16% for incidental thyroid nodules on CT and MRI studies (12,13), even considering the large numbers of films that were chest x-rays, which raised the concern that radiologist reporting of thyroid nodules was incomplete.…”

Section: Resultsmentioning

confidence: 58%

Developing a Registry for Thyroid Incidentalomas: Lessons Learned and the Path Forward

Davies

Pichiotino

Black

2016

Thyroid

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Background: Incidentalomas are findings on an imaging test done for other reasons, for which there are no matching symptoms in the patient. They are common in the adrenal gland, pancreas, liver, and thyroid, among other sites. Incidentalomas are a problem because we have a limited understanding of their natural history: it is difficult to know how much of a threat they pose to individual patients. An observational registry that would allow a systematic study of thyroid incidentalomas could reveal their natural history and the effect of detection on patients' lives, as well as document the cost to the healthcare system. A registry would help to determine which incidentalomas could be monitored and which require action. Study design: A cohort study was conducted, with case identification via radiology imaging reports with follow-up through a minimum of one year post-identification. Results: In one year, >109,000 imaging studies were performed that might reveal an incidental thyroid finding (computed tomography scans of the neck or chest, magnetic resonance imaging of the neck, plain x-ray of the chest, non-thyroid directed ultrasound of the neck, positron emission tomography scan, or myocardial perfusion scan). A total of 125 patients were identified as having a thyroid nodule, with a <1% reporting rate among eligible imaging studies, much lower than other published estimates of incidental thyroid nodule prevalence on imaging. Of the 125 nodules, 46 had been previously identified (were not ''new''). Of the 79 patients with new nodules, more than half (44; 53%) were not notified of the finding. The approved study design allowed contact only with those who had been clearly notified of their thyroid nodule. Among those who could be reached, many did not recall the finding (6/15; 40%). Of those who did recall the finding, none self-identified it as an incidentaloma. Conclusions: There are serious logistical and ethical hurdles to developing observational registries of incidentalomas, as well as threats to data validity because incidentalomas are incompletely identified, reported, and acted upon. Solutions commonly used to optimize data quality for registries would increase reporting, but could potentially overwhelm the healthcare system and harm patients. A novel interventional design that is proposed here for future work may facilitate both study and amelioration of the problem.

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“…Incidental findings include masses (often called 'incidentalomas') or anatomic malformations. Incidental thyroid nodular lesions are common and were first identified on CT (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Incidental finding of papillary thyroid carcinoma on CT examination of mandibular lesion: Case report

et al. 2017

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Abstract. The number of significant incidental findings identified on radiographic examinations has increased. In total, 169 patients, 87 males and 82 females, with a mean age of 67.3 years (range, 17-92 years), as well as 65 patients (38.5%), 43 (66.2%) female and 22 (33.8%) male had abnormal findings in the thyroid for one year in our institution. Thyroid nodules are the most common incidental findings on oral and maxillofacial evaluations. Computed tomography (CT) and magnetic resonance imaging (MRI) examination are frequently used to detect thyroid abnormality. The present study reported a case of papillary thyroid carcinoma (PTC) detected following CT and MRI examination of a mandibular lesion. The CT examination of the oral and maxillofacial region included the thyroid, which must be examined carefully to detect various diseases, including PTC. Collaboration between radiologists and clinicians is important to manage these incidental findings.

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The Prevalence and Significance of Incidental Thyroid Nodules Identified on Computed Tomography

Abstract: We found at least a 9.4% (15/160) prevalence of malignancy among ITN detected on CT. The further evaluation with US or biopsy should be performed, if an ITN shows CT features suggesting malignancy (calcification; AP/T ratio, >1.0; or mean attenuation value, >130 HU).

Cited by 142 publications

References 21 publications

Incidental Thyroid Nodules on CT: Evaluation of 2 Risk-Categorization Methods for Work-Up of Nodules

Incidental Thyroid Nodules on CT: Evaluation of 2 Risk-Categorization Methods for Work-Up of Nodules

Developing a Registry for Thyroid Incidentalomas: Lessons Learned and the Path Forward

Incidental finding of papillary thyroid carcinoma on CT examination of mandibular lesion: Case report

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