Ultrasound-Based Diagnostic Classification for Solid and Partially Cystic Thyroid Nodules

Kim, D.W.; Park, J.S.; In, Hyun Sin; Choo, Hye Jung; Ryu, Ji Hwa; Jung, Soo Jin

doi:10.3174/ajnr.a2923

Cited by 49 publications

(35 citation statements)

References 27 publications

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“…[1][2][3][4][5] Nodule echogenicity was classified according to a comparison with the adjacent parenchyma and strap muscle as follows: isoechogenicity (defined as the same echogenicity, as compared with the adjacent normal thyroid parenchyma), hypoechogenicity (defined as decreased echogenicity, as compared with the adjacent normal thyroid parenchyma, and increased echogenicity, as compared with the strap muscle), marked hypoechogenicity (defined as the same or decreased echogenicity, as compared with the strap muscle), hyperechogenicity (including complete calcification with marked hyperechogenicity and posterior shadowing), and anechoic (ie, thyroid cyst). The PTC margins included smooth, irregular (including spiculated margin), and lobulated types.…”

Section: Image Analysismentioning

confidence: 99%

Computed Tomography Features of Papillary Thyroid Carcinomas

Kim

2014

Journal of Computer Assisted Tomography

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Section: Image Analysismentioning

confidence: 99%

Computed Tomography Features of Papillary Thyroid Carcinomas

Kim

2014

Journal of Computer Assisted Tomography

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“…Quantitatively, predominantly cystic thyroid nodules have a low cellularity compared to solid thyroid nodules; qualitatively, large and predominantly cystic thyroid nodules tend to accompany intranodular changes such as cystic degeneration and/or hemorrhage, which may have poor colloid accumulation [14]. Furthermore, the amount of colloid can be diminished and appear dense, fragmented, and in droplet form during LBC preparations [20].…”

Section: Discussionmentioning

confidence: 99%

“…Specimen adequacy was assessed using the recommendation of the Bethesda system for reporting cytopathology: 6 groups of 10 well-visualized follicular cells in each slide were the minimal criteria [12, 13]. According to the Bethesda system, any specimens that contained abundant colloid or numerous inflammatory cells were considered adequate even if 6 groups of follicular cells were not identified; however, specimens that consisted only of cystic contents were considered inadequate [14]. To evaluate cytological cellularity, the numbers of cell clusters composed of more than 10 well-visualized follicular cells were counted under a single ×100 microscope field in the area of highest cellular density.…”

Section: Methodsmentioning

confidence: 99%

“…1). Cytomorphological features were reviewed and categorized using the Bethesda classification as follows: inadequate (Bethesda category I), benign (Bethesda category II), atypia of undetermined significance or follicular lesion of undetermined significance (Bethesda category III), suspicious for a follicular neoplasm (Bethesda category IV), suspicious for malignancy (Bethesda category V), or malignant (Bethesda category VI) [14]. …”

Section: Methodsmentioning

confidence: 99%

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Factors that Influence Sample Adequacy in Liquid-Based Cytology after Ultrasonography-Guided Fine-Needle Aspiration of Thyroid Nodules: A Single-Center Study

et al. 2018

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Objective: The factors that influence the acquisition of adequate samples during liquid-based cytology (LBC) remain unclear. This study aimed to identify factors that affect cytological adequacy in LBC after ultrasonography (US)-guided fine-needle aspiration (US-FNA) of thyroid nodules. Study Design: From January 2017 to May 2017, a single radiologist performed US-FNA to diagnose 112 thyroid nodules in 112 consecutive patients. Based on US findings after US-FNA, the size, location, position, composition, calcification, and vascularity of each nodule, as well as the US-based diagnosis, were investigated by the same radiologist. Blinded to US information, a single cytopathologist investigated cytological adequacy, cytological cellularity, and Bethesda category. Results: Of the 112 thyroid nodules, cytological adequacy was achieved in 91.1% (102/112). Thyroid nodules with sizes ≥20 mm or those that were predominantly cystic showed a higher rate of cytological inadequacy (p < 0.05). Thyroid nodule location, position, calcification status, and vascularity did not influence cytological adequacy, nor did US-based diagnosis (p > 0.05). Nodule composition or calcification significantly influenced cytological cellularity (p < 0.05), whereas nodule size, location, position, vascularity, and US-based diagnosis did not (p > 0.05). Conclusions: Most investigated factors did not influence cytological adequacy or cellularity.

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“…Data were collected only from physicians who perform USFNA themselves or directly ordered USFNA. For the purpose of this investigation, a solid nodule was defined as a thyroid nodule which is purely solid or predominantly solid with any cystic component accounting for B10 % of the total volume [11].…”

Section: Methodsmentioning

confidence: 99%

Survey of current approaches to non-diagnostic fine-needle aspiration from solid thyroid nodules

et al. 2015

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The exact frequency of non-diagnostic ultrasound-guided fine-needle aspiration (USFNA) is unknown. Clinical guidelines suggest repeating USFNA of these nodules. However, there is no specific recommendation or evidence on how and when this re-aspiration should be done. We aim to describe the approaches considered by endocrinologists to yield the highest likelihood of a satisfactory sample in solid thyroid nodules. A cross-sectional survey of The Endocrine Society (TES) and the American Thyroid Association members was conducted between October and December 2012. A total of 694 surveys were returned, 648 (93.4 %) from TES. The responders were equally divided between private and academic settings and had a high degree of expertise. Thirty-nine percent of respondents estimated the frequency of non-diagnostic USFNA to be above 10 %. For its management, 311 (46 %) recommended repeating USFNA in 1-3 months. For a second non-diagnostic USFNA, 216 (31 %) recommend surgery. The most common approaches to increase the diagnostic yield were (1) use of suction with USFNA, 18 % and (2) changing the targeted area of biopsy within the nodule, 18 %. Few considered the patients' preferences as an important driver for the management of non-diagnostic USFNA. Finally, a molecular test for bypassing non-diagnostic USFNA was regarded as the most needed strategy for future research. Variability exists in the management of non-diagnostic USFNA and strategies to increase the diagnostic yield. Testing the suggested strategies in clinical trials and understanding patient's preferences should be supported by guideline panels and funding agencies.

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Ultrasound-Based Diagnostic Classification for Solid and Partially Cystic Thyroid Nodules

Abstract: BACKGROUND AND PURPOSE:The ability of US to differentiate benign thyroid nodules from malignant ones is still a matter of debate. The aim of this study was to assess the diagnostic efficacy of a US-based classification system for solid and PCTNs through a prospectively designed study.

Cited by 49 publications

References 27 publications

Computed Tomography Features of Papillary Thyroid Carcinomas

Computed Tomography Features of Papillary Thyroid Carcinomas

Factors that Influence Sample Adequacy in Liquid-Based Cytology after Ultrasonography-Guided Fine-Needle Aspiration of Thyroid Nodules: A Single-Center Study

Survey of current approaches to non-diagnostic fine-needle aspiration from solid thyroid nodules

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