Search Results

1.Comparison of the diagnostic performance of ultrasound-based Thyroid Imaging Reporting and Data System (TIRADS) Classification with American Thyroid Association (ATA) guidelines in the prediction of Thyroid Malignancy in a single tertiary center in Manila, Philippines

Ryan James Gacayan ; Ruben Kasala ; Ma. Patricia Puno-Ramos ; Dondee Jules Mojica ; Ma. Krisha Castro

Journal of the ASEAN Federation of Endocrine Societies 2021;36(1):69-75

Objective: To compare the diagnostic performance of American College of Radiology-Thyroid Image Reporting and Data Systems (ACR-TIRADS) and the American Thyroid Association (ATA) guidelines on screening for thyroid malignancy. Methodology: A cross-sectional criterion-referenced study involving Filipino patients with thyroid nodules, 18-80 years old, who underwent ultrasound guided fine needle aspiration biopsy at the Thyroid Clinic of The Medical City from July to December 2019. The ACR-TIRADS and the ATA guidelines were compared for 197 nodules. Standard diagnostic parameters were calculated, namely sensitivity, specificity, PPV, NPV, positive and negative likelihood ratios and overall accuracies. Results: The risks of malignancy were 15% and 22% for TIRADS 4 and 5 respectively. For ATA guidelines, it’s 2%, 20%, and 15% for nodules with low, intermediate, and high suspicion respectively. The sensitivity, specificity, PPV, NPV, and accuracy of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS) in relation to Fine Needle Aspiration Cytology (FNAC) is 100%, 52.2%, 16.5%, 100%, and 56.4% respectively. For the American Thyroid Association (ATA) guidelines it is 88.2%, 57.8%, 16.5%, 98.1%, and 60.4% respectively. Conclusion The ACR TIRADS classifications appears to be more sensitive than the ATA classification. The ATA guidelines prove to be a more specific test. Each tool has its unique advantages and disadvantages. Therefore, clinicians must use these tools with utmost vigilance to avoid over or under diagnosis and to avoid unnecessary thyroid nodule biopsies.
Thyroid Neoplasms ; Thyroid Nodule

2.Preoperative Staging of Well Differentiated Thyroid Cancer: US Is Enough?.

Jin Young KWAK

Journal of Korean Thyroid Association 2011;4(1):18-21

3.Revised Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Thyroid Cancer.

Ka Hee YI ; Young Joo PARK ; Sung Soo KOONG ; Jung Han KIM ; Dong Gyu NA ; Jin Sook RYU ; So Yeon PARK ; In Ae PARK ; Chung Hwan BAEK ; Young Kee SHONG ; Young Don LEE ; Jaetae LEE ; Jeong Hyun LEE ; Jae Hoon CHUNG ; Chan Kwon JUNG ; Seung Ho CHOI ; Bo Youn CHO

Endocrinology and Metabolism 2010;25(4):270-297

4.2016 Revised Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Thyroid Cancer.

Ka Hee YI ; Eun Kyung LEE ; Ho Cheol KANG ; Yunwoo KOH ; Sun Wook KIM ; In Joo KIM ; Dong Gyu NA ; Kee Hyun NAM ; So Yeon PARK ; Jin Woo PARK ; Sang Kyun BAE ; Seung Kuk BAEK ; Jung Hwan BAEK ; Byung Joo LEE ; Ki Wook CHUNG ; Yuh Seog JUNG ; Gi Jeong CHEON ; Won Bae KIM ; Jae Hoon CHUNG ; Young Soo RHO

International Journal of Thyroidology 2016;9(2):59-126

5.2016 Revised Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Thyroid Cancer.

Ka Hee YI ; Eun Kyung LEE ; Ho Cheol KANG ; Yunwoo KOH ; Sun Wook KIM ; In Joo KIM ; Dong Gyu NA ; Kee Hyun NAM ; So Yeon PARK ; Jin Woo PARK ; Sang Kyun BAE ; Seung Kuk BAEK ; Jung Hwan BAEK ; Byung Joo LEE ; Ki Wook CHUNG ; Yuh Seog JUNG ; Gi Jeong CHEON ; Won Bae KIM ; Jae Hoon CHUNG ; Young Soo RHO

International Journal of Thyroidology 2016;9(2):59-126

6.Revised Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Thyroid Cancer.

Ka Hee YI ; Young Joo PARK ; Sung Soo KOONG ; Jung Han KIM ; Dong Gyu NA ; Jin Sook RYU ; So Yeon PARK ; In Ae PARK ; Chung Hwan BAEK ; Young Kee SHONG ; Young Don LEE ; Jaetae LEE ; Jeong Hyun LEE ; Jae Hoon CHUNG ; Chan Kwon JUNG ; Seung Ho CHOI ; Bo Youn CHO

Korean Journal of Otolaryngology - Head and Neck Surgery 2011;54(1):8-36

7.Association of clinicodemographic factors and tissue biopsy results among patients with thyroid nodules at the Southern Philippines Medical Center

Madonna L. Aujero ; John Michael P. Tagsa ; Gleno Lon Q. Llamera, Jr.

Philippine Journal of Otolaryngology Head and Neck Surgery 2023;38(2):26-30

Objective: To compare selected clinicodemographic factors of patients with thyroid nodules who underwent thyroid surgeries with their tissue biopsy results and determine any association between clinicodemographic factors and tissue biopsy results. Methods: Design: Retrospective review of records. Setting: Tertiary Government Training Hospital. Participants: 251 patients with thyroid nodules. Results: Of 251 patients with thyroid nodules, the majority (218; 86.9%) were females while 33 (13.1%) were males. The average age in years was 41.5±13.3 The same population also had malignant outcomes at 79.3%. Most of the patients did not have family history of thyroid malignancy (54%) and had no palpable cervical lymph nodes at presentation (75.9%). Furthermore, there was no distant metastasis at presentation for both lungs (97.7%) and bones (98.9%). There were no significant differences in tissue biopsy results when correlated with age (df=249; t=-.144; p = .886), duration of goiter (df=249; t=-.829; p = .408), and distant metastasis at presentation for lungs (Z=-5.977; p = .052) and bones (Z=-.457; p = .648). Significant differences were only evident for clinicodemographic factors such as sex (Z=-2.570; p = .010), family history (Z=-2.239; p = .020), palpable cervical lymph nodes at presentation (Z=-5.977; p = .000), and the following comorbidities: pulmonary tuberculosis (Z=-2.388; p = .017) and bronchial asthma (Z=-2.148; p = .032) and smoking history (Z=-3.455; p=.001). Furthermore, having no palpable cervical lymph nodes at presentation were associated with malignant tissue biopsy results (B=3.616; p=.001). Patients without palpable cervical lymph nodes at presentation were 37.204 times [OR=37.204] more likely to have benign biopsy results [95% CI: 4.705 – 294.168]. Conclusion There are greater odds of having benign biopsy results for patients without palpable cervical lymph nodes at presentation.
Thyroid Nodule ; Thyroid Neoplasms ; Biopsy, Fine-Needle

8.An executive summary of the Philippine Interim Clinical Practice Guidelines for the Diagnosis and Management of Well Differentiated Thyroid Cancer 2021

Acta Medica Philippina 2024;58(8):5-30

Objectives: Thyroid cancer is the most common endocrine cancer in the Philippines affecting primarily women in the reproductive age group. Considering the burden of thyroid cancer in the country, the Department of Health (DOH) called for the development of a national clinical practice guideline that would address patient needs, and aid physicians in clinical decision-making while considering therapeutic cost and availability in the local setting. The 2021 guidelines are aimed at providing optimal care to Filipino patients by assisting clinicians in the evaluation of thyroid nodules and management of well differentiated thyroid cancer. Methods: A steering committee convened to formulate clinical questions pertaining to the screening and evaluation of thyroid nodules, surgical and post operative management of thyroid cancer, and palliative care for unresectable disease. A technical working group reviewed existing clinical guidelines, retrieved through a systematic literature search, synthesized clinical evidence, and drafted recommendations based on the ADAPTE process of clinical practice guideline development. The consensus panel reviewed evidence summaries and voted on recommendations for the final statements of the clinical practice guidelines. Results: The guidelines consist of clinical questions and recommendations grouped into six key areas of management of well differentiated thyroid cancer: screening, diagnosis, surgical treatment, post operative management, surveillance, and palliative care. Conclusion The 2021 guidelines for well differentiated cancer could direct physicians in clinical decision making, and create better outcomes for Filipino patients afflicted with the disease. However, patient management should still be governed by sound clinical judgement and open physician-patient communication.
Consensus ; Carcinoma ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy

9.RE: Thyroid Core Needle Biopsy: The Strengths of Guidelines of the Korean Society of Thyroid Radiology.

Anna CRESCENZI ; Pierpaolo TRIMBOLI

Korean Journal of Radiology 2017;18(5):867-869

10.FDG Uptake in the Pathologically Proven Papillary Thyroid Cancer.

Tae Sung KIM ; Mijin YUN ; Arthur CHO ; Jong Doo LEE

Nuclear Medicine and Molecular Imaging 2007;41(1):22-29

PURPOSE: Metastatic thyroid cancers with I-131 uptake have been known to show no increase of FDG uptake whereas those without I-131 uptake tend to demonstrate increased uptake on PET. In this study, we evaluated the degree of FDG uptake in primary thyroid cancers of papillary histology before surgery. MATERIAL AND METHODS: Forty FDG PET studies were performed on the patients who had papillary cancer proven by fine needle aspiration. The degree of FDG uptake was visually categorized as positive or negative (positive if the tumor showed discernible FDG; negative if the tumor didn't) and the peak standard uptake value (peak SUV) of the papillary thyroid cancer (PTC) were compared with the size of PTC. RESULTS: The mean size of 26 PTC with positive FDG uptake was 1.9+/-1.4 cm(0.5~5 cm). In 13 PTC with negative FDG uptake, the mean size of those was 0.5+/-0.2 cm (0.2~0.9 cm). All PTC larger than 1cm (2.5+/-1.4 cm, 1~5 cm) have positive FDG uptake (peak SUV=6.4+/-5.7, 1.7~22.7). Among the micropapillary thyroid cancer (microPTC; PTC smaller than 1cm), 8 microPTC show positive FDG uptake(peak SUV=2.9+/-1.3, 1.7~5.5), while 13 microPTC show negative finding(peak SUV=1.3+/-0.2, 1.1~1.7). The size of microPTC with positive FDG uptake is significantly larger than that of microPTC with negative FDG uptake (0.7+/-0.1 cm vs 0.4+/-0.2 cm, p=0.01). CONCLUSION: All PTCs larger than 1cm show positive FDG uptake in our study. In other words, thyroid lesions larger than 1cm with negative FDG uptake are unlikely to be PTC. So far, only poorly differentiated thyroid cancers are known to show increased FDG uptake. Our results seem to be contradictory to what is known in the literature. Further study is needed to understand better the significance of increased FDG uptake in PTC in relation to expression of NIS and GLUT.
Biopsy, Fine-Needle ; Humans ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule