The ultrasound risk stratification systems for thyroid nodule have been evaluated against papillary carcinoma. A meta-analysis

Trimboli, Pierpaolo; Castellana, Marco; Piccardo, Arnoldo; Romanelli, Francesco; Grani, Giorgio; Giovanella, Luca; Durante, Cosimo

doi:10.1007/s11154-020-09592-3

Cited by 72 publications

(52 citation statements)

References 43 publications

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“…In order to stratify the malignancy risk of thyroid nodule, thyroid imaging reporting and data systems (TIRADS) are used by ultrasound examination. TIRADS seems to be an accurate tool to diagnose PTC ( 6 , 7 , 8 ) but has lower reliability in detecting non-typical PTC ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth

Naciu

Verri

Crescenzi

et al. 2021

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary We present the case of a 47-year-old Caucasian previously healthy woman with a voluminous thyroid nodule occupying almost the entire anterior neck region. The lesion had progressively increased in size during the previous 3 months and the patient presented intermittent symptoms of dysphagia and odynophagia with a slight change in voice. Fine needle aspiration showed papillary carcinoma. Based on imaging and cytological findings, the patient underwent total thyroidectomy. The surgical sample revealed a totally enlarged thyroid gland (weight: 208 g) with the presence of a poly-lobulated lesion centrally located and involving the isthmus and both lobes. Hobnail features were present in more than 30% of the neoplastic cells in agreement with the criteria for this subtype. Psammoma bodies and focal necrosis were also present. The extra-thyroidal extension included strap muscles and peri-esophageal glands. Immunohistochemistry using VE1 antibody for detecting BRAF-V600E mutation resulted positive. The final diagnosis was papillary thyroid carcinoma (PTC) hobnail variant (HVPTC)-pT4a. The HVPTC is a rare entity and, in most cases, appears like a unifocal lesion with a maximum tumor size of 8 cm reported so far. To our knowledge, this represents the largest tumor ever described (14 cm), showing rapid growth and with multinodular goiter-like aspect. Learning points HVPTC is an aggressive variant of PTC, usually associated with radioactive iodine refractoriness, and a higher mortality rate compared to classic PTC. However, there is a marked individual variability in this association. HVPTC usually appears as small unifocal lesion but a multinodular goiter presentation may occur. The present case highlights that despite of the histology, our patient achieved a high ablation success rate after radioactive iodine therapy.

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Section: Discussionmentioning

confidence: 99%

Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth

Naciu

Verri

Crescenzi

et al. 2021

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…Ultrasound assessment is known to be suboptimal for detection of follicular and oncocytic thyroid carcinomas as compared to papillary thyroid carcinoma; yet some thyroid cancers with poor prognosis, e.g., some follicular and oncocytic carcinomas, are typically classified as BETHESDA III or IV [38,39]. Moreover, 18 F-FDG avid thyroid cancer is a tumor that is generally more biologically aggressive [40][41][42].…”

Section: Discussionmentioning

confidence: 99%

The dilemma of 18F-FDG PET/CT thyroid incidentaloma: what we should expect from FNA. A systematic review and meta-analysis

et al. 2021

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Purpose 18F-FDG thyroid incidentaloma (TI) occurs in ~2% of PET/CT examinations with a cancer prevalence of up to 35–40%. Guidelines recommend fine-needle aspiration cytology (FNA) if a focal 18F-FDG TI corresponds to a sonographic nodule >1 cm. The aim of this systematic review and meta-analysis was to provide evidence-based data on the diagnostic distribution of 18F-FDG TIs in the six Bethesda systems for reporting thyroid cytopathology (BETHESDA) subcategories. Methods Original studies reporting 18F-FDG TIs and cytologically classified according to BETHESDA were included. Six separate meta-analyses were performed to obtain the pooled prevalence (95% confidence interval, 95% CI) of 18F-FDG TIs in the six BETHESDA subcategories. Results Fifteen studies were finally included. Nine studies were from Asian/Eastern and six from Western countries. FNA data according to BETHESDA was available in 2304 cases. The pooled prevalence of 18F-FDG TIs according to BETHESDA was BETHESDA I 10% (6–14), BETHESDA II 45% (37–53), BETHESDA III 8% (3–13), BETHESDA IV 8% (5–12), BETHESDA V 6% (4–9), BETHESDA VI 19% (13–25). A significantly different prevalence was found in the BETHESDA IV between Asian/Eastern (2%) and Western (19%) studies. Conclusion Two-thirds of focal 18F-FDG TIs undergoing FNA have either malignant (BETHESDA VI) or benign (BETHESDA II) cytology while a minority will have indeterminate (BETHESDA III or IV) FNA results. Significant differences between Asian/Eastern and Western studies are also present in the prevalence of indeterminate FNA results.

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“…The observer’s agreement among multiple centers is poorly satisfactory in assessing these features ( 7 ). Thyroid Imaging Reporting and Data Systems (TI-RADS) are enormously valuable to PTC as risk stratification systems, while relatively less to FTC, MTC, and other malignancies ( 20 ). Interestingly, the AI model appears to be a promising tool to facilitate a better knowledge of TN via quantitative analysis of typical US features and introduction of texture features.…”

Section: Applications Of Ai In the Us Diagnosis Of Tnmentioning

confidence: 99%

Artificial Intelligence for Personalized Medicine in Thyroid Cancer: Current Status and Future Perspectives

Liu

et al. 2021

Front. Oncol.

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Thyroid cancers (TC) have increasingly been detected following advances in diagnostic methods. Risk stratification guided by refined information becomes a crucial step toward the goal of personalized medicine. The diagnosis of TC mainly relies on imaging analysis, but visual examination may not reveal much information and not enable comprehensive analysis. Artificial intelligence (AI) is a technology used to extract and quantify key image information by simulating complex human functions. This latent, precise information contributes to stratify TC on the distinct risk and drives tailored management to transit from the surface (population-based) to a point (individual-based). In this review, we started with several challenges regarding personalized care in TC, for example, inconsistent rating ability of ultrasound physicians, uncertainty in cytopathological diagnosis, difficulty in discriminating follicular neoplasms, and inaccurate prognostication. We then analyzed and summarized the advances of AI to extract and analyze morphological, textural, and molecular features to reveal the ground truth of TC. Consequently, their combination with AI technology will make individual medical strategies possible.

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The ultrasound risk stratification systems for thyroid nodule have been evaluated against papillary carcinoma. A meta-analysis

Cited by 72 publications

References 43 publications

Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth

Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth

The dilemma of 18F-FDG PET/CT thyroid incidentaloma: what we should expect from FNA. A systematic review and meta-analysis

Artificial Intelligence for Personalized Medicine in Thyroid Cancer: Current Status and Future Perspectives

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