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Dolidze DD, Covantsev S, Chechenin GM, Pichugina NV, Bedina AV, Bumbu A. Core needle biopsy for thyroid nodules assessment-a new horizon? World J Clin Oncol 2024; 15:580-586. [PMID: 38835840 PMCID: PMC11145964 DOI: 10.5306/wjco.v15.i5.580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/29/2024] [Accepted: 04/10/2024] [Indexed: 05/21/2024] Open
Abstract
Ultrasound-guided fine-needle aspiration is the standard for evaluating thyroid nodules with a high safety profile and a relatively low number of non-diagnostic cytological findings. Nevertheless, this diagnostic method traditionally has its weak points. Several diagnostic categories such as Bethesda I, III and IV are not reliable for thyroid carcinoma risk assessment. Recent advancements in a core needle biopsy made it possible to use this tool as a new method for thyroid nodules evaluation. The main feature of this method is the use of thin needles (18-21G) and guns with an automatic trigger mechanism. The histological material collected with the use of a core needle biopsy is usually superior to cytological. Therefore, the core needle biopsy can be used as a complementary technique to a standard fine needle aspiration in difficult and dubious cases of thyroid neoplasia with uncertain malignant potential.
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Affiliation(s)
- David D Dolidze
- Department of Clinical Research and Development, Botkin Hospital, Moscow 125284, Russia
- Department of Surgery, Russian Medical Academy of Continuous Professional Education, Moscow 125445, Russia
| | - Serghei Covantsev
- Department of Clinical Research and Development, Botkin Hospital, Moscow 125284, Russia
- Emergency Surgery №76, Botkin Hospital, Moscow 125284, Russia
| | - Grigorii M Chechenin
- Department of Surgery, Russian Medical Academy of Continuous Professional Education, Moscow 125445, Russia
- Department of Surgery, Botkin Hospital, Moscow 125284, Russia
| | - Natalia V Pichugina
- Department of Medical Ultrasonography, Botkin Hospital, Moscow 125284, Russia
| | - Anastasia V Bedina
- Medicine, Moscow State Medical University I.M. Sechenov, Moscow 119048, Russia
| | - Anna Bumbu
- Department of Oncology, Botkin Hospital, Moscow 125284, Russia
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2
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Su X, Yue C, Yang W, Ma B. A comparative analysis of core needle biopsy and repeat fine needle aspiration in patients with inconclusive initial cytology of thyroid nodules. Front Endocrinol (Lausanne) 2024; 15:1309005. [PMID: 38356956 PMCID: PMC10865505 DOI: 10.3389/fendo.2024.1309005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 01/11/2024] [Indexed: 02/16/2024] Open
Abstract
Purpose To assess and compare the effectiveness of ultrasound-guided core needle biopsy (CNB) in comparison to repeat fine-needle aspiration(rFNA) for thyroid nodules that yield inconclusive results following the initial fine-needle aspiration (FNA). Methods A cohort of 471 patients who received an inconclusive cytological diagnosis following the initial FNA were included in this study. These patients subsequently underwent either CNB (n=242) or rFNA (n=229). The inconclusive FNA results encompassed categories I, III, and IV of The Bethesda System for Reporting Thyroid Cytopathology(TBSRTC), as well as the ultrasound images indicating malignancy despite FNA results falling under TBSRTC category II. This study assessed the sampling satisfaction rate, diagnostic efficacy, and complications associated with CNB compared to rFNA. Additionally, the impact of repeat puncture time and nodule size on diagnostic efficacy was analyzed. Results Following repeat punctures, the satisfaction rate of the CNB sampling was found to be significantly higher than that of rFNA (83.9% vs 66.8%). The diagnostic rate in the CNB group was significantly greater compared to that of the rFNA group (70.7% vs 35.8%). In patients with nodule maximum diameters ranging from 5 mm to 20 mm, the diagnostic accuracy was significantly higher in the CNB group compared to that in the rFNA group. In patients with intervals less than 90 days, between 90 days and one year, the diagnostic rate in the CNB group was found to be higher compared to that in the rFNA group. In CNB, not immediately adjacent to the capsule was a risk factor for nodular puncture bleeding (37.0% vs 22.7%.). Conclusion CNB demonstrated higher rates of satisfaction and diagnosis compared to the rFNA. The diagnostic effectiveness of CNB was not influenced by the time interval or the size of the thyroid nodule. Therefore, in cases where the initial FNA diagnosis of thyroid nodules is inconclusive, CNB should be considered as a viable option for re-puncture.
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Affiliation(s)
| | | | | | - Buyun Ma
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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3
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Pozdeyev N, Dighe M, Barrio M, Raeburn C, Smith H, Fisher M, Chavan S, Rafaels N, Shortt JA, Lin M, Leu MG, Clark T, Marshall C, Haugen BR, Subramanian D, Crooks K, Gignoux C, Cohen T. Thyroid Cancer Polygenic Risk Score Improves Classification of Thyroid Nodules as Benign or Malignant. J Clin Endocrinol Metab 2024; 109:402-412. [PMID: 37683082 DOI: 10.1210/clinem/dgad530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/29/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
CONTEXT Thyroid nodule ultrasound-based risk stratification schemas rely on the presence of high-risk sonographic features. However, some malignant thyroid nodules have benign appearance on thyroid ultrasound. New methods for thyroid nodule risk assessment are needed. OBJECTIVE We investigated polygenic risk score (PRS) accounting for inherited thyroid cancer risk combined with ultrasound-based analysis for improved thyroid nodule risk assessment. METHODS The convolutional neural network classifier was trained on thyroid ultrasound still images and cine clips from 621 thyroid nodules. Phenome-wide association study (PheWAS) and PRS PheWAS were used to optimize PRS for distinguishing benign and malignant nodules. PRS was evaluated in 73 346 participants in the Colorado Center for Personalized Medicine Biobank. RESULTS When the deep learning model output was combined with thyroid cancer PRS and genetic ancestry estimates, the area under the receiver operating characteristic curve (AUROC) of the benign vs malignant thyroid nodule classifier increased from 0.83 to 0.89 (DeLong, P value = .007). The combined deep learning and genetic classifier achieved a clinically relevant sensitivity of 0.95, 95% CI [0.88-0.99], specificity of 0.63 [0.55-0.70], and positive and negative predictive values of 0.47 [0.41-0.58] and 0.97 [0.92-0.99], respectively. AUROC improvement was consistent in European ancestry-stratified analysis (0.83 and 0.87 for deep learning and deep learning combined with PRS classifiers, respectively). Elevated PRS was associated with a greater risk of thyroid cancer structural disease recurrence (ordinal logistic regression, P value = .002). CONCLUSION Augmenting ultrasound-based risk assessment with PRS improves diagnostic accuracy.
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Affiliation(s)
- Nikita Pozdeyev
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Division of Endocrinology Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Manjiri Dighe
- Department of Radiology, University of Washington, Seattle, WA 98195, USA
| | - Martin Barrio
- Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Christopher Raeburn
- Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Harry Smith
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Matthew Fisher
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Sameer Chavan
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Nicholas Rafaels
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Jonathan A Shortt
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Meng Lin
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Michael G Leu
- Information Technology Services, UW Medicine, Seattle, WA 98195, USA
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA 98195, USA
- Department of Pediatrics, University of Washington, Seattle, WA 98105, USA
- Division of Hospital Medicine, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Toshimasa Clark
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Carrie Marshall
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Bryan R Haugen
- Division of Endocrinology Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - Kristy Crooks
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Christopher Gignoux
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Trevor Cohen
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA 98195, USA
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Zufry H, Nazarrudin N, Zulfa PO, Sucipto KW, Kamarlis RK, Ekadamayanti AS, Beočanin A, Firdausa S. Comparative analysis of accuracy between fine-needle aspiration biopsy and postoperative histopathology for detecting large thyroid nodules: A retrospective observational study. NARRA J 2023; 3:e206. [PMID: 38450262 PMCID: PMC10914041 DOI: 10.52225/narra.v3i2.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/10/2023] [Indexed: 03/08/2024]
Abstract
To avoid unnecessary surgeries, ultrasound-guided fine-needle aspiration biopsy (FNAB) is an effective and reliable procedure for the preoperative evaluation of thyroid nodules. However, there have been only a limited number of studies exploring the ability of preoperative FNAB to distinguish malignancy compared to postoperative histopathology in thyroid nodules larger than 4 cm. The aim of this study was to investigate the diagnostic accuracy of FNAB compared to postoperative histopathology in distinguishing malignancy in thyroid nodules larger than 4 cm. A single-center retrospective observational study was conducted at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, between January 2014 and December 2018. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. A total of 83 patients were included in the study. The results showed that preoperative FNAB may have the ability to distinguish malignancy compared to postoperative histopathology. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 42.85%, 98.38%, 90.00%, 83.56%, and 84.33%, respectively. These data suggested that ultrasound-guided preoperative FNAB is a reliable diagnostic tool in the preoperative evaluation of thyroid nodules larger than 4 cm, but it has limited capability in distinguishing malignancies. In conclusion, although FNAB may be useful in reducing unnecessary surgeries, histopathology remains the preferred method for confirming malignancy in thyroid nodules.
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Affiliation(s)
- Hendra Zufry
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
- Innovation and Research Center of Endocrinology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | | | - Putri O. Zulfa
- Innovation and Research Center of Endocrinology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Krishna W. Sucipto
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
| | - Reno K. Kamarlis
- Department of Anatomical Pathology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Anatomical Pathology, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
| | - Agustia S. Ekadamayanti
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
| | | | - Sarah Firdausa
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
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Antonia TD, Maria LI, Ancuta-Augustina GG. Preoperative evaluation of thyroid nodules - Diagnosis and management strategies. Pathol Res Pract 2023; 246:154516. [PMID: 37196471 DOI: 10.1016/j.prp.2023.154516] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/06/2023] [Indexed: 05/19/2023]
Abstract
Thyroid cancer is the most common endocrine malignancy, with increasing incidence over the past few decades. Fine needle aspiration (FNA) biopsy is the gold standard for preoperative diagnosis of thyroid malignancies. Nevertheless, this method renders indeterminate results in up to 30% of the cases. Therefore, these patients are often referred to unnecessary surgery to establish the diagnosis. To improve the accuracy of preoperative diagnosis, several other ways, such as ultrasonography, elastography, immunohistochemical analysis, genetic testing, and core needle biopsy, have been developed and can be used either in association with or as an alternative to FNA. This review aims to evaluate all these diagnostic tools to determine the most appropriate way of managing thyroid nodules and subsequently improve the selection of cases referred to surgery.
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Affiliation(s)
- Tapoi Dana Antonia
- Carol Davila University of Medicine and Pharmacy, Department of Pathology, Bucharest, Romania; University Emergency Hospital, Department of Pathology, Bucharest, Romania
| | - Lambrescu Ioana Maria
- Carol Davila University of Medicine and Pharmacy, Department of Cellular and Molecular Biology and Histology, Bucharest, Romania; Victor Babes National Institute of Pathology, Bucharest, Romania.
| | - Gheorghisan-Galateanu Ancuta-Augustina
- Carol Davila University of Medicine and Pharmacy, Department of Cellular and Molecular Biology and Histology, Bucharest, Romania; CI Parhon National Institute of Endocrinology, Bucharest, Romania
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6
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Li W, Han YT, Hu Z, Zhang Y, Zhao X, Guo X, Cai W, Zhang M. Comparison of fine-needle aspiration and core-needle biopsy in the pathological evaluation on thyroid lesions: A single-center experience on 407 Chinese patients. Diagn Cytopathol 2023; 51:315-320. [PMID: 36779298 DOI: 10.1002/dc.25107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/02/2022] [Accepted: 01/13/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND The object of this study was to compare the diagnosis performance of US-guided fine-needle aspiration (FNA) and core-needle biopsy (CNB) for patients with thyroid nodules, in aspects of sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV). MATERIALS AND METHODS Four hundred seven Chinese patients from July 2019 to June 2022 were retrospectively recruited in this study. Cytological diagnoses were categorized into six categories based on the 2017 Bethesda System for Reporting Thyroid Cytopathology (BSRTC), and histological specimens were drawn a diagnosis by means of an analogy with the Bethesda system. RESULTS All patients incorporated were proceed with surgical excision (SE) and received final surgical diagnoses. The rate of malignancy (ROM) was comparable between two methods, with the exception that the test-negative category of the FNA group was significantly higher than that of the CNB group (39.25% vs. 23.86%, p = .022). Sensitivity and accuracy were higher in CNB group (82.50% and 87.83%, respectively) than that in FNA group (72.00% and 79.36%, respectively), as well as NPV (76.14% in CNB vs. 60.75% in FNA), but not in terms of the specificity and PPV (95.59% and 97.30% in FNA vs. 97.10% and 98.02% in CNB). CONCLUSION CNB displayed a higher sensitivity and accuracy than FNA in malignant lesions of thyroid. Both FNA and CNB exhibit excellent performance with the understanding that both need to be applied under the most appropriate conditions to maximize their benefits.
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Affiliation(s)
- Wei Li
- Department of Pathology, Tianjin First Central Hospital, Tianjin, China
| | - Ya-Ting Han
- Department of Cell Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Zhandong Hu
- Department of Pathology, Tianjin First Central Hospital, Tianjin, China
| | - Yujie Zhang
- Department of Pathology, Tianjin First Central Hospital, Tianjin, China
| | - Xin Zhao
- Department of Thyroid and Breast Surgery, Tianjin First Central Hospital, Tianjin, China
| | - Xuexi Guo
- Department of Pathology, Tianjin First Central Hospital, Tianjin, China
| | - Wenjuan Cai
- Department of Pathology, Tianjin First Central Hospital, Tianjin, China
| | - Mingfang Zhang
- Department of Pathology, Tianjin First Central Hospital, Tianjin, China
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7
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Kim S, Shin JH, Ihn YK. Biopsy strategies for intermediate and high suspicion thyroid nodules with macrocalcifications. Curr Med Res Opin 2023; 39:179-186. [PMID: 36369696 DOI: 10.1080/03007995.2022.2146404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES (1) To find strategies to improve diagnostic performance of ultrasound-guided biopsy of intermediate and high suspicion thyroid nodules with macrocalcifications. (2) To find malignancy rates of nodules with macrocalcification. MATERIALS AND METHODS From 2018 to 2022, fine-needle aspiration biopsy (FNAB) and core needle biopsy (CNB) were retrospectively evaluated. Macrocalcifications were categorized into three types: intra-nodular, rim and entirely calcified. Diagnostic performance was compared between biopsy modes (FNAB vs. CNB) and FNAB techniques (to-and-fro vs. whirling). Multivariate logistic regression was performed to determine features associated with performance of FNAB. Malignancy rates were calculated according to macrocalcification types. RESULTS A total of 114 procedures (87 FNAB and 27 CNB) in 89 nodules per 86 patients (mean age, 64 years; 76 women) were performed. Overall, CNB performed better than FNAB (unsatisfactory rate: 3.7% vs. 33.3%, p = .005). For macrocalcification thicker than 2 mm, whirling FNAB technique demonstrated a comparable unsatisfactory rate with statistical trends toward significance (to-and-fro: 69.2% vs. whirling: 27.8%, p = .055). The entirely calcified nodule was associated with poor performance of FNAB (adjusted odds ratio 4.46 [95% CI: 1.19-16.67], p = .027). Overall malignancy was 22.5%, higher in intra-nodular macrocalcification than rim and entirely calcified types (68.4% vs. 21.1% vs. 10.5%, p = .025). CONCLUSION For the entirely calcified type, CNB should be considered first to improve diagnosis. For other types, FNAB can be performed, and whirling technique may be an alternative technique in thicker macrocalcification. Malignancy in intermediate and high suspicion nodules with macrocalcification have non-negligible rates.
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Affiliation(s)
- Sungmok Kim
- Department of Radiology, St. Vincent's Hospital, Suwon, Republic of Korea
| | - Jae Ho Shin
- Department of Radiology, St. Vincent's Hospital, Suwon, Republic of Korea
| | - Yon Kwon Ihn
- Department of Radiology, St. Vincent's Hospital, Suwon, Republic of Korea
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Beheshti Firoozabadi J, Mahdavi R, Shamsi K, Ataee H, Shafiee A, Ebrahiminik H, Chegini H, Hoseinpour P, Moradi A, Yousefpour N, Aghaei F, Fardoost A, Ghelichli A, Mokhtari Dowlatabad H, Hajighasemi F, Sami N, Rouhollah Miri S, Akbari ME, Abdolahad M. Intraoperative Assessment of High-Risk Thyroid Nodules Based on Electrical Impedance Measurements: A Feasibility Study. Diagnostics (Basel) 2022; 12:diagnostics12122950. [PMID: 36552958 PMCID: PMC9776834 DOI: 10.3390/diagnostics12122950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/06/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022] Open
Abstract
Precise diagnosis of thyroid nodules is challenging due to non-diagnostic/inconclusive results and uncertainties about the malignancy of follicular neoplasms (FNs), even in frozen-section pathology. Therefore, surgical management, especially in Bethesda III and IV categories, may be complicated, and sometimes a second surgery may be required. The Thyroid Nodule Impedance Measurement System (TN-IMS) consists of a metallic patch attached to submental skin and a G20 I.V. cannula inserted into the targeted nodules. Two impedance-based parameters named Z1kHz and impedance phase slope (IPS) in 100 kHz to 500 kHz of the thyroid nodules are recorded and compared with their histopathological results as the gold standard. TN-IMS was intra-surgically applied to 103 human thyroid nodules and normal thyroid tissues. A remarkable consistency between defined co-ranges of Z1kHz/IPS and the histopathological status of specimens was achieved (p < 0.001). Based on these measurements, it was concluded that intraoperative bioelectrical impedance scanning of thyroid nodules would be a helpful complementary approach to detecting high-risk excision-required thyroid nodules.
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Affiliation(s)
- Jalil Beheshti Firoozabadi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
| | - Reihane Mahdavi
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Khosro Shamsi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
| | - Hossein Ataee
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
- Department of Electrical Engineering, Amirkabir University of Technology, Tehran 15916-34311, Iran
| | - Abdollah Shafiee
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Department of Surgery, Farmanieh Hospital, Tehran 19537-34411, Iran
| | - Hojat Ebrahiminik
- Department of Internentional Radiology and Radiation Sciences Research Center, Aja University of Medical Sciences, Tehran 14117-18541, Iran
- Interventional Radiology Department, Tirad Imaging Institute, Tehran 15867-36513, Iran
| | - Hossein Chegini
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Interventional Radiology Department, Tirad Imaging Institute, Tehran 15867-36513, Iran
| | - Parisa Hoseinpour
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Department of Pathology, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran 15179-64311, Iran
| | - Afshin Moradi
- Department of Pathology, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
| | - Narges Yousefpour
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Faeze Aghaei
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Ali Fardoost
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
| | - Alireza Ghelichli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Hadi Mokhtari Dowlatabad
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Farzane Hajighasemi
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Nafiseh Sami
- Department of Medicine, Islamic Azad University of Medical Sciences, Tehran 19395-1495, Iran
| | - Seyed Rouhollah Miri
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
- Department of Surgical Oncology, Tehran University of Medical Science, Tehran 14176-14411, Iran
- Cancer Institute, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran 14166-34793, Iran
| | - Mohammad Esmaeil Akbari
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Correspondence: (M.E.A.); (M.A.)
| | - Mohammad Abdolahad
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
- Cancer Institute, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran 14166-34793, Iran
- Correspondence: (M.E.A.); (M.A.)
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9
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Abstract
PURPOSE OF REVIEW Thyroid cancers are endocrine neoplasms with diverse gene expression and behavior, for which constantly evolving anatomic and functional imaging/theranostic agents have an essential role for diagnosis, staging, and treatment. RECENT FINDINGS To achieve definitive diagnosis, neck ultrasound and associated risk stratification systems, notably Thyroid Imaging Reporting and Data System (TI-RADS), allow improved thyroid nodule characterization and management guidance. Radioactive iodine-131 (RAI) has long played a role in management of differentiated thyroid cancer (DTC), with recent literature emphasizing its effectiveness for intermediate-high risk cancers, exploring use of dosimetry for personalized medicine, and potential for retreatment with RAI following tumor redifferentiation. Iodine-124 positron emission tomography/computed tomography (PET/CT) has promising application for DTC staging and dosimetry. F18-fluorodeoxyglucose (FDG) PET/CT is used for staging of high risk DTC and identification of noniodine-avid disease recurrences, with metabolic uptake consistently portending poor prognosis. Poorly differentiated and anaplastic thyroid cancers are best assessed with anatomic imaging and F18-FDG PET/ CT, though recent studies show a potential theranostic role for Ga68/Lu177-prostate-specific membrane antigen. Medullary thyroid cancers are evaluated with ultrasound, CT, magnetic resonance imaging, and various positron-emitting radiotracers for PET imaging (F18-DOPA, F18-FDG, and recently Ga68-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-octreotate (DOTATATE)); the latter may enable treatment with Lu177-DOTATATE. SUMMARY Multidisciplinary collaboration is essential to streamline appropriate management, given the wide array of available imaging and new therapies for metabolic and genetically complex cancers.
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Affiliation(s)
- Molly E. Roseland
- Division of Nuclear Medicine, Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Division of Body Imaging, Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Yuni K. Dewaraja
- Division of Nuclear Medicine, Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Ka Kit Wong
- Division of Nuclear Medicine, Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
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10
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Li R, Zhang Q, Feng D, Jin F, Han S, Yu X. Case report: Lymph node metastases of breast cancer and thyroid cancer encountered in axilla. Front Oncol 2022; 12:983996. [PMID: 36248999 PMCID: PMC9561385 DOI: 10.3389/fonc.2022.983996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/13/2022] [Indexed: 11/26/2022] Open
Abstract
Occurrences of breast cancer and thyroid cancer metachronously or synchronously are common for women, but axillary lymph node metastasis from both cancers is rarely seen. We report a patient who had two metastatic lymph nodes from papillary thyroid carcinoma after axillary lymph node dissection with mastectomy. Papillary thyroid carcinoma diagnosis was ensured after thyroidectomy. A literature review revealed that even the co-occurrence of breast cancer and thyroid cancer is not rare, but the etiology behind this phenomenon is not elucidated well. Genetic disorders, thyroid dysfunction, and hormone receptors may be relevant. Considering the rareness of axillary lymph node metastasis of thyroid cancer, adjuvant therapy and surgery treatment for this kind of case should be considered elaborately.
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Affiliation(s)
- Rihan Li
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, China
- Department of Breast and Reconstructive Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Qingfu Zhang
- Department of Pathology, The First Hospital of China Medical University, Shenyang, China
| | - Dongdong Feng
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, China
- Department of Breast and Reconstructive Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Feng Jin
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Siyuan Han
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, China
- Department of Breast and Reconstructive Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Xinmiao Yu
- Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, China
- Department of Breast and Reconstructive Surgery, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Xinmiao Yu,
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11
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Wildman-Tobriner B, Ho LM, Bowman AW. Needle types used in abdominal cross-sectional interventional radiology: a survey of the Society of Abdominal Radiology emerging technology commission. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:2623-2631. [PMID: 34128102 DOI: 10.1007/s00261-021-03145-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/11/2021] [Accepted: 05/22/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE To identify commonly used needle types in cross-sectional interventional radiology (CSIR) and to review features and safety profiles of those needles. METHODS Members of the Society of Abdominal Radiology (SAR) emerging technologies commission (ETC) on CSIR were sent a 13-question survey about what needles they use for common CSIR procedures: random and targeted solid organ biopsy, ultrasound-guided paracentesis, and ultrasound-guided thyroid fine needle aspiration (FNA). Results were compiled with descriptive statistics, and features of the most commonly used needles were reviewed. RESULTS 19 surveys were completed (response rate 57.6%, 19/33) from 16 institutions. For solid organ biopsies, the majority of respondents reported using an 18-gauge needle with an automatic firing mechanism and a variable throw length option. The most commonly used needle for both random and targeted biopsies was the Argon BioPince (26.3%, 5/19) The three most commonly used needles for solid organ biopsies all featured automatic firing, variable throw length options, and 18-gauge size. A 5 French Cook Yueh needle was most the most commonly used paracentesis needle (36.8%, 7/19). For thyroid FNA, all respondents used spinal needles, and 25-gauge was the most common size (72.2%, 13/18). CONCLUSION Abdominal radiologists use a variety of needles when performing common interventional procedures. Members of the SAR CSIR ETC commonly use automatic, 18-gauge, variable throw length needles for solid organ biopsies, 5 French catheter style needles for paracentesis, and 25-gauge spinal needles for thyroid FNA.
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Affiliation(s)
| | - Lisa M Ho
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
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12
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Chen X, Kutaiba N, Pearce S, Digby S, Van Gelderen D. Application of TIRADS guidelines to thyroid nodules with cytopathological correlation and impact on healthcare costs. Intern Med J 2021; 52:1366-1373. [PMID: 33942959 DOI: 10.1111/imj.15343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/06/2021] [Accepted: 03/06/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Xiao Chen
- Department of Radiology, Austin Hospital, Melbourne, Australia
| | - Numan Kutaiba
- Department of Radiology, Austin Hospital, Melbourne, Australia
| | - Sam Pearce
- Department of Radiology, Austin Hospital, Melbourne, Australia
| | - Sam Digby
- Department of Radiology, Austin Hospital, Melbourne, Australia
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13
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Wang Y, Zhou S, Wang D, Wei T, Zhu J, Li Z. Complement C4-A and Plasminogen as Potential Biomarkers for Prediction of Papillary Thyroid Carcinoma. Front Endocrinol (Lausanne) 2021; 12:737638. [PMID: 34803909 PMCID: PMC8603925 DOI: 10.3389/fendo.2021.737638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/17/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Early diagnosis and therapy of papillary thyroid carcinoma (PTC) is essential for reducing recurrence and improving the long-term survival. In this study, we aimed to investigate the proteome profile of plasma and screen unique proteins which could be used as a biomarker for predicting PTC. METHODS Serum samples were collected from 29 PTC patients and 29 nodular goiter (NG) patients. Five PTC serum samples and five NG serum samples were selected for proteome profiles by proteomics. Eight proteins in PTC and NG serum samples were selected for confirmation by enzyme-linked immunosorbent assay analysis. Receiver operating characteristic curves was used to evaluate the diagnostic value of potential biomarkers. RESULTS Complement C4-A (C4A) and plasminogen (PLG) were significantly lower in serum samples of PTC patients compared with NG patients. C4A was observed to have excellent diagnostic accuracy for PTC, with a sensitivity of 91.67% and specificity of 83.33%. The diagnostic value of PLG for PTC was demonstrated by a sensitivity at 87.50% and specificity at 75.00%. The AUC for C4A and PLG was 0.97 ± 0.02 and 0.89 ± 0.05. CONCLUSION C4A and PLG appeared to be excellent potential biomarkers for the prediction of PTC.
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Affiliation(s)
- Yichao Wang
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Shengliang Zhou
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Dun Wang
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Wei
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Jingqiang Zhu
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Zhihui Li
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Zhihui Li,
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