Validation of American Thyroid Association Ultrasound Risk-Adapted Approach for Repeating Cytology in Benign Thyroid Nodules

Maino, Fabio; Bufano, Annalisa; Dalmazio, Gilda; Campanile, M; Pilli, Tania; Forleo, Raffaella; Brilli, Lucia; Ciuoli, Cristina; Cantara, Silvia; Capezzone, Marco; Cartocci, Alessandra; Pacini, Furio; Castagna, Maria Grazia

doi:10.1089/thy.2020.0351

Cited by 13 publications

(7 citation statements)

References 23 publications

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“…Although the estimated malignancy rate for FNA-proven benign nodules is low (0%–3%) [ 182 ], the follow-up strategy for these nodules should be determined by US-based risk stratification [ 184 193 194 195 196 ]. A meta-analysis reported that the estimated malignancy rate of nodules with benign cytological results was 3.7% in surgical specimens [ 185 ], and 1%–3.2% determined by repeat FNA or long-term follow-up [ 184 194 196 197 ]. Whether false-negative FNA rates are higher [ 86 198 199 200 ] or similar [ 85 201 202 203 ] for large nodules compared to small nodules is controversial.…”

Section: Us-based Management Of Thyroid Nodules After Fnamentioning

confidence: 99%

“…Whether false-negative FNA rates are higher [ 86 198 199 200 ] or similar [ 85 201 202 203 ] for large nodules compared to small nodules is controversial. However, the false negative rates of FNA are relatively high (3.1%–18.2%) for high suspicion thyroid nodules [ 184 194 195 196 ]. Therefore, we recommend that thyroid nodules with high suspicion US patterns should undergo repeat FNA within 12 months of the initial FNA, unless there is a decrease in nodule size.…”

Section: Us-based Management Of Thyroid Nodules After Fnamentioning

confidence: 99%

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2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

et al. 2021

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Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1–2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

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Section: Us-based Management Of Thyroid Nodules After Fnamentioning

confidence: 99%

Section: Us-based Management Of Thyroid Nodules After Fnamentioning

confidence: 99%

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

et al. 2021

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“…The “dark side of the moon” of FNAC is represented by indeterminate lesions [atypia of undetermined significance/follicular lesion of undetermined significance (Bethesda III) and follicular neoplasm/suspicious for follicular neoplasm (Bethesda IV)] and researchers have contributed molecular markers to be search for in cytological material to improve FNAC diagnosis [ 24 – 27 ]. Together with classical mutations (including at least BRAF, RAS, hTERT point mutations and RET/PTC, NTRK, PAX8/PPARγ rearrangements), other tools have been included in clinical practice, such as Next-Generation Sequencing panels [ 25 , 26 ] and Gene Expression Classifier [ 27 ], and others markers have been only hypothesized such as the use of miRNA [ 28 , 29 ]. In clinical routine, search for genetic mutations is still debating.…”

Section: Resultsmentioning

confidence: 99%

Pregnancy-associated plasma protein A mRNA expression as a marker for differentiated thyroid cancer: results from a “surgical” and a “cytological” series

Marzocchi

Capezzone

Sagnella

et al. 2021

J Endocrinol Invest

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Purpose Pregnancy-associated plasma protein A (PAPPA) is a metalloproteinase initially described for its role during pregnancy. PAPPA regulates IGF ligands 1 (IGF1) bioavailability through the degradation of IGF-binding protein 4 (IGFBP4). After the cleavage of IGFBP4, free IGF1 is able to bind IGF1 receptors (IGF1R) triggering the downstream signaling. Recently, PAPPA expression has been linked with development of several cancers. No data have been published on thyroid cancer, yet. Methods We evaluated PAPPA, insulin-like growth factor (IGF1), IGF1 receptors (IGF1R) and IGF-binding protein 4 (IGFBP4) mRNA expression levels in a “Surgical series” of 94 thyroid nodules (64 cancers, 16 follicular adenomas and 14 hyperplastic nodules) and in a “Cytological series” of 80 nodules from 74 patients underwent to fine-needle aspiration cytology (FNAC). In tissues, PAPPA was also evaluated by western blot. Results We found that PAPPA expression was increased in thyroid cancer specimen at mRNA and protein levels and that, adenomas and hyperplastic nodules had an expression similar to normal tissues. When applied on thyroid cytologies, PAPPA expression was able to discriminate benign from malignant nodules contributing to pre-surgical classification of the nodules. We calculated a cut-off with a good specificity (91%) which reached 100% when combined with molecular biology. Conclusion These results show that PAPPA could represent a promising diagnostic marker for differentiated thyroid cancer.

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“…The most commonly reported complications of FNA are local pain and minor hematomas; serious ones are rare [9] . [6] .…”

Section: Discussionmentioning

confidence: 99%

“…Medical professional societies such as the American Thyroid Association (ATA) and American Association of Clinical Endocrinologists have suggested that the initial cytological diagnosis can be postponed until growth of a nodule or a change in its US features is observed. Repeated FNA of nodules with an initial benign cytological diagnosis leads to a final diagnosis of cancer in approximately 2% of cases [6] . Sampling Method: This study was performed on convenience sample.…”

Section: Introductionmentioning

confidence: 99%

Role of Ultrasonography and Color Doppler Imaging in Identification of Thyroid Nodules Suspicious of Malignancy for Fine Needle Aspiration

Kamel

El-Sabbagh

Ali

2021

Ain Shams Medical Journal

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Validation of American Thyroid Association Ultrasound Risk-Adapted Approach for Repeating Cytology in Benign Thyroid Nodules

Cited by 13 publications

References 23 publications

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations

Pregnancy-associated plasma protein A mRNA expression as a marker for differentiated thyroid cancer: results from a “surgical” and a “cytological” series

Role of Ultrasonography and Color Doppler Imaging in Identification of Thyroid Nodules Suspicious of Malignancy for Fine Needle Aspiration

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