The relationship between ultrasound microcalcifications and psammoma bodies in thyroid tumours: a single-institution retrospective study

O'Connor, Eoghan; Mullins, M.; O'Connor, Diarmuid; Phelan, Sine; Bruzzi, John F.

doi:10.1016/j.crad.2021.09.014

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…A taller-than-wide shape, irregular margins and the presence of microcalcifications are well-known indicators for malignancy in thyroid nodules that have been reported in various previous studies (5,13,16,17). A retrospective analysis showed that US microcalcifications in thyroid nodules had a high specificity of 93%, PPV of 75%, and NPV of 76.7% but a low sensitivity of 42.8% for malignancy (1). In another study, microcalcifications had a high specificity (90.8%) and a low sensitivity (44.2%) for predicting malignancy (17).…”

Section: Discussionmentioning

confidence: 77%

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Clinical utility of histogram analysis of grayscale sonograms in assessing sonographic suspicious malignant thyroid nodules

Zhang¹,

Wang²,

Sun³

et al. 2022

Transl Cancer Res TCR

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Background: When sonographic suspicious malignant thyroid nodules initially proven to be inconsistent by aspiration, repeat fine-needle aspiration cytology (FNAC) is commonly recommended. Although FNAC is simple and reliable, it is also an invasive operation with inevitable false negative results. To determine which sonographic features and histogram parameters based on gray-scale ultrasonic images need repeat aspiration.Methods: All of the nodules were suspicious for malignancy by preoperative ultrasound (US), and their initial FNAC findings indicated Bethesda category II, or III. Histogram analyses were performed for grayscale ultrasonic images. Mean, variance, skewness, kurtosis, percentiles (1st, 10th, 50th, 90th, 99th), and sonographic features were compared between pathological benign nodules and malignant ones. Thereafter, receiver operator characteristic (ROC) curves were analyzed for the valuable indicators.Results: One hundred and nineteen consecutive patients with 123 histopathologically diagnosed focal thyroid nodules were included in the cohort. The factors associated with malignancy were taller-thanwide shape [odds ratio (OR) =15.165; 95% confidence interval (CI): 3.157-72.854], irregular margins (OR =11.492; 95% CI: 1.747-75.573), microcalcifications (OR =5.107; 95% CI: 1.455-17.927) and skewness (OR =25.800; 95% CI: 1.034-76.422). The skewness of malignant thyroid nodules is higher than that of benign thyroid nodules and has an area under the curve (AUC) of 0.776 in the diagnosis.Conclusions: For thyroid nodules suspicious on US but not on cytology, skewness, together with tallerthan-wide shape, irregular margins and microcalcifications might be a promising marker for clinicians to perform repetitive FNACs.

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Section: Discussionmentioning

confidence: 77%

“…Since the application of thyroid ultrasound (US), the incidence of thyroid malignant tumors has increased significantly (1). In total, 586,000 cases of thyroid cancer were reported worldwide in 2020 (2).…”

Section: Introductionmentioning

confidence: 99%

Clinical utility of histogram analysis of grayscale sonograms in assessing sonographic suspicious malignant thyroid nodules

Zhang¹,

Wang²,

Sun³

et al. 2022

Transl Cancer Res TCR

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“…This is consistent with the preserved ultrasonographic features in most studies. [23][24][25] Additionally, other ultrasound features such as tumor size, multiplicity, and blood ow signal were included in the model.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of clinical predictive models for differentiated thyroid carcinoma and cervical lymph node metastasis: A retrospective cohort study

Chen,

Wang,

et al. 2023

Preprint

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Background: For differentiated thyroid carcinoma (DTC), the main negative prognostic factor is cervical lymph node metastasis (CLNM). Two clinical prediction models were established based on the preoperative characteristics of thyroid nodules to provide a more individualized guidance for predicting DTC and CLNM. Methods: Altogether, 679 hospitalized patients with DTC and 294 patients with benign thyroid nodules were retrospectively included, and patients with DTC were further distinguished as having CLNM. Two multiple logistic regression models were established in this retrospective cohort. The considered predictors mainly included ultrasound features of thyroid nodules and lymph nodes, as well as clinical characteristics, including body mass index, age, sex, and thyroid-related laboratory parameters. All cases were used as a training set and internally validated using bootstrap resampling. Results: The receiver operating curve (ROC) of the model for diagnosing benign and malignant thyroid nodules corresponded to an area under the curve (AUC) of 0.873 in the training set and a Brier score of 0.116 for calibration. After bootstrap internal validation, the adjusted AUC was 0.858, and the Brier score was 0.122. The model had better performance than the only ultrasound grading for diagnosing DTC. The ROC of the model for predicting CLNM had an AUC value of 0.745 in the training set, and the Bbrier score was 0.203. After bootstrap internal validation, the adjusted AUC value was 0.720, and the Brier score was 0.214. Conclusion: The two clinical prediction models have good predictive efficacy for diagnosing DTC and assessing its metastasis, providing new diagnostic tools.

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Psammoma bodies in thyroid: are they always indicative of malignancy? A multi-institutional study

Rossi,

Agarwal,

Erkilic

et al. 2024

Virchows Arch

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Traditionally, psammoma bodies (PB) have been considered as tale-tell evidence of papillary thyroid carcinoma (PTC) and are frequently encountered in classic and other subtypes of PTCs. However, the presence of PBs in the thyroid gland does not always indicate malignancy. The leading hypothesis on their origin suggests that PB are remnants of papillary structures that have undergone thrombosis, necrosis, and subsequent calcification. From January 2010 to May 2024, 26 patients with psammoma bodies associated with benign thyroid lesions, mainly thyroid follicular nodular disease (TFND), Hashimoto thyroiditis (HT), Graves’ disease, and follicular adenomas, were found. The case cohort included 16 females and 10 males with a median age of 49.3 years. The series included 12 TFND, two HT, and 12 follicular adenomas (11 out of 12 were oncocytic adenomas). Twenty-four out of 26 underwent total thyroidectomy. In 24 out of 26 cases, the entire lobes and parenchyma were included and serial cuts at multiple levels were performed in cases with PB but without any evidence of malignancy. Even though the detection of PB is associated with a malignant thyroid lesion, especially PTC and its subtypes, our multi-institutional series showed that in a minority PB can be found in a variety of benign thyroid lesions. Evaluation of the entire thyroid parenchyma at multiple levels is mandatory to exclude sub-centimeter papillary thyroid carcinoma.

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The relationship between ultrasound microcalcifications and psammoma bodies in thyroid tumours: a single-institution retrospective study

Cited by 4 publications

References 9 publications

Clinical utility of histogram analysis of grayscale sonograms in assessing sonographic suspicious malignant thyroid nodules

Clinical utility of histogram analysis of grayscale sonograms in assessing sonographic suspicious malignant thyroid nodules

Development and validation of clinical predictive models for differentiated thyroid carcinoma and cervical lymph node metastasis: A retrospective cohort study

Psammoma bodies in thyroid: are they always indicative of malignancy? A multi-institutional study

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