Objective To evaluate the role of ultrasound for thyroid nodules with atypia of undetermined significance(AUS).Methods From January 2014 to December 2015,83 thyroid nodules with AUS diagnosed by ultrasound-guided fine-needle aspiration biopsy were collected from 1984 subjects. On the basis of ultrasonic features,each thyroid nodule was prospectively classified into one of three categories: low suspicion for malignancy,intermediate suspicion for malignancy,and high suspicion for malignancy. Results Among 83 lesions,19 lesions(22.9%) were confirmed malignant,8 lesions (9.6%)were benign,56 lesions (67.5%)had no abnormal changes during clinical follow-up. The nodules were solitary in 36 cases (43.4%)and multiple in 47 cases(56.6%).The maximum diameter was (1.2±0.7)cm. Based on the ultrasonic feature of 19 malignant cases,16 cases (84.2%) were classified as high suspicion for malignancy,2 cases(10.5%) as intermediate suspicion for malignancy,and 1 case(5.3%) for low suspicion for malignancy. Univariate and multivariate analyses revealed that the degree of malignancy of thyroid nodules was significantly associated with ultrasound image classification[OR=9.23(2.96-28.79),P=0.00],but not with age,gender,nodule number,and nodule size (all P>0.05).Conclusion Ultrasound diagnosis by using the present thyroid ultrasound classification system can be helpful for distinguishing malignant and benign AUS thyroid nodules.
Biopsy, Fine-Needle ; Humans ; Thyroid Gland ; diagnostic imaging ; Thyroid Neoplasms ; diagnostic imaging ; Thyroid Nodule ; diagnostic imaging ; Ultrasonography

BACKGROUND AND OBJECTIVES: The level of thyroid-stimulating hormone (TSH)-stimulated thyroglobulin (Tg) after thyroid hormone withdrawal (THW) is the most sensitive marker for detecting recurrence of differentiated thyroid cancer (DTC). In DTC, Tg production is regulated by TSH; however, TSH values after THW are never identical, even in the same patient. The objective of this study was to evaluate the influence of TSH on Tg levels after THW. MATERIALS AND METHODS: TSH and Tg concentrations were measured twice at 2 and 3 weeks after THW in 309 patients with DTC. TSH and Tg levels at these time points were compared. The percent change in TSH (ΔTSH) and change in Tg level (%ΔTg) from 2 to 3 weeks after THW were calculated, and Pearson's correlation coefficients were calculated to determine whether ΔTSH could affect %ΔTg. Tg cutoff value for diagnostic imaging was 2 ng/mL. RESULTS: The TSH and Tg values at 3 weeks were significantly higher than those at 2 weeks after THW. Tg values increased significantly to >2 ng/mL after 1 week in 38.5% of the patients with Tg values of 0.2-2 ng/mL at 2 weeks after THW. In patients with Tg values ≥2 ng/mL at 2 weeks after THW, Tg values increased significantly after an additional week of THW. ΔTSH correlated significantly with %ΔTg. CONCLUSION: TSH values differed according to time after THW, and Tg values differed significantly according to TSH values. Therefore, TSH values should be considered carefully when interpreting the meaning of Tg levels in patients with DTC.
Diagnostic Imaging ; Humans ; Recurrence ; Thyroglobulin* ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyrotropin*

OBJECTIVEUsing radioactive nano tracer with different sizes (average diameter were 50, 80 and 100 nm) and dosages (0.01 and 0.02 ml) in the thyroids of rabbits, to study the drainage of thyroid to cervical lymph nodes (LNs) in rabbits and to provide experimental evidence for the choice of ideal sizes and dosages of radioactive Nano tracer for the sentinel lymph node biopsy (SLNB) in thyroid cancer patients.

METHODSThirty adult rabbits were randomly divided into six groups (50 nm - 0.01 ml, 50 nm - 0.02 ml, 80 nm - 0.01 ml, 80 nm - 0.02 ml, 100 nm - 0.01 ml, 100 nm - 0.02 ml of (99m)Tc-Sb(2)S(3)) with five rabbits in each group. A total of 60 sides of thyroids were included. The mean number of LNs with radioactivity, the initial, the strangest and the lasting time of radioactivity in LNs in each group were measured.

RESULTSOne to three LNs were identified in one side neck of rabbits, totally 86 LNs. Most of LNs with radioactivity existed in level VI, counting for 75.6% (65/86). (99m)Tc-Sb(2)S(3) with 50 nm particles was significantly better than that with 80 nm or 100 nm particles with regarding the initial and the strangest radioactive time of (99m)Tc-Sb(2)S(3) in LNs (P < 0.05). There were no significant difference in the mean number of LNs with radioactivity, the initial, the strangest and the lasting time of radioactivity between the dosages of 0.01 ml and 0.02 ml of (99m)Tc-Sb(2)S(3) with same size of particles (P > 0.05).

CONCLUSION(99m)Tc-Sb(2)S(3) with 50 nm particles, in the dosage of 0.01 ml or 0.02 ml, could be good choice for SLNB of thyroid cancer.

Animals ; Lymph Nodes ; diagnostic imaging ; Male ; Nanostructures ; Neck ; diagnostic imaging ; Rabbits ; Radioactive Tracers ; Radionuclide Imaging ; Thyroid Gland ; diagnostic imaging

Autoantibodies ; blood ; immunology ; Child ; Diagnosis, Differential ; Humans ; Radiography ; Radionuclide Imaging ; Thyroid Diseases ; blood ; diagnosis ; diagnostic imaging ; Thyroid Function Tests ; methods ; Thyroid Gland ; diagnostic imaging ; immunology ; Thyroid Hormones ; blood

BACKGROUNDThe incidence of thyroid cancer has been increasing. Our aim was to evaluate the efficacy of low-dose dual-phase helical computed tomography (CT) in the characterization of thyroid lesions, and to discuss the relationship between image characteristics and their pathology.

METHODSOne hundred and six patients with thyroid lesions underwent low-dose dual-phase helical CT after the injection of contrast material. CT scans were obtained at arterial and venous phase with delays of 25 and 65 seconds, and tube current of 60 and 120 mA, respectively. The attenuation change in the lesion between the arterial and venous phase was analyzed and categorized as "increased," "decreased," "mixed" or "no change."

RESULTSHistopathologic diagnosis was obtained by surgery in 106 patients (115 lesions). Of the 106 patients, 45 had nodular goiter, 5 thyroid adenoma, 6 thyroiditis, and 50 papillary thyroid carcinoma (PTC) (59 lesions). The attenuation value showed a significant difference (P < 0.05) between the arterial and venous phase for the high attenuation area. There was statistical significant difference in terms of attenuation value in high attenuation areas at both phases and in low attenuation areas on arterial phase between nodular goiter and PTC (P < 0.05). However, there was no significant difference in attenuation value between adenoma and PTC. Twenty-nine cases (76.3%) of goiter manifested mixed type, 3 cases (3/5) of adenoma showed decreased type, 6 cases (6/6) of thyroiditis showed increased type, and 55 cases (93.2%) of PTC showed decreased type attenuation. The sensitivity, specificity for thyroid carcinoma by dual-phase CT were 94.9% and 80.4% respectively. The overall diagnostic accuracy for thyroid lesions by dual-phase CT was 87.8%.

CONCLUSIONSThe performance of dual-phase helical CT is related to the pathological structure of the lesions. The analysis of enhancement patterns by using dual-phase helical CT will be helpful in the differential diagnosis of thyroid lesions.

Adolescent ; Adult ; Aged ; Carcinoma ; diagnostic imaging ; pathology ; Carcinoma, Papillary ; Female ; Goiter, Nodular ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Thyroid Gland ; diagnostic imaging ; pathology ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Thyroiditis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo explore the values of ultrasonographic features in differentially diagnosing benign and malignant thyroid nodules, and attempt to establish a quantitative ultrasound classification system.

METHODSWe retrospectively analyzed 20 ultrasound features of 926 thyroid nodules in 527 patients. Using logistic regression analysis, we obtained the probability function for predicting the malignancy in thyroid nodules and established a preliminary ultrasound classification system.

RESULTSThe ages of patients with thyroid nodules was older than that of the patients with thyroid carcinoma (t = 6.496, P < 0.001). The correctness rate of ultrasonic diagnosis was 80.1%. The logistic multivariate regression analysis showed that among all ultrasonographic features, aspect ratio ≥ 1, obscure boundary, irregular margin, significant internal hypoecho, internal hypoecho, internal micro-calcifications, posterior echo attenuation, thyroid capsule invasion, abnormal adjacent lymph nodes, and ultrasonic elastography 5-point evaluation scores > 3 were contributing factors for thyroid carcinoma. The equation was P (us) = 1 /[1+e(-)Z], where z is the logit of malignant thyroid nodule, and taking P (us) > 0.50 as boundary value, the prediction accuracy rate was 84.1%. Using this model, 92.2% of the thyroid nodules were predicted as nodular goiter, and 69.4% of the thyroid carcinomas were correctly predicted. P (us) was stratified into four levels: Level 1: 0-16% malignancy; Level 2: 17%-50% malignancy; Level 3: 51%-70% malignancy; and level 4: 71%-100% malignancy.

CONCLUSIONSThe quantitative thyroid imaging reporting and data system developed in this study makes ultrasound reports more objective, normalized and standardized. It can be used to evaluate the malignancy risk of thyroid nodules and help to make right decision in clinics.

Adult ; Calcinosis ; diagnostic imaging ; pathology ; Diagnosis, Differential ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Gland ; diagnostic imaging ; pathology ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Thyroid Nodule ; diagnostic imaging ; pathology ; Ultrasonography

To explore the optimum laser power and energy in porcine thyroid ablation in vitro with 1 064 nm Nd:YAG laser of different power and energy guided by ultrasound after comparison of size and pathology of ablation lesions. The experimental results showed that Laser ablation effect of porcine thyroid in vitro is definite, the size of ablation lesions increases as the laser power and energy increases, when the laser power and energy are 3 W and 1 800 J, the ablation lesion effect reaches ideal level.
Animals ; Laser Therapy ; instrumentation ; methods ; Lasers, Solid-State ; Swine ; Thyroid Gland ; diagnostic imaging ; surgery ; Ultrasonography

Borderline thyroid tumors are composed of hyalinizing trabecular tumor (HTT), well differentiated tumor of uncertain malignant potential (WDT-UMP), follicular tumor of uncertain malignant potential (FT-UMP) and non-invasive follicular tumor with papillary like nuclear feature (NIFTP) by World Health Organization (WHO) definition. They have different pathological feature from each other. However, it is difficult to diagnose with diagnostic imaging, fine needle aspiration (FNA) or core biopsy preoperatively. Thus, the diagnosis is usually made after diagnostic lobectomy. Main surgical concerns about borderline tumor are not performing total thyroidectomy because of relatively indolent nature of these tumors. Unfortunately, some of these tumors can be diagnosed as malignant tumor preoperatively. The other surgical concern is performing completion thyroidectomy or not after diagnostic lobectomy. Decision making is difficult even though it is generally considered that lobectomy alone is enough. In this article, we will discuss clinical features of borderline malignant tumors and surgical strategy for these tumors.
Biopsy ; Biopsy, Fine-Needle ; Decision Making ; Diagnosis ; Diagnostic Imaging ; Hyalin ; Thyroid Gland ; Thyroidectomy ; World Health Organization

OBJECTIVETo determine the relationship between velocimetric parameters by using color Doppler ultrasonography and microvessel density (MVD) in papillary thyroid carcinoma and its clinical significance for preoperative diagnosis of papillary thyroid carcinoma. Methods Twenty-nine thyroid tumors were examined preoperatively by color Doppler ultrasonography. The velocimetric parameters including peak systolic velocity (V(max)), end-diastolic velocity (V(min)) were evaluated respectively and resistance index (RI) was calculated. Immunohistochemistry was applied by using polyclonal rabbit anti-human Von Willebrand factor in all cases after operation and microvessel density was calculated based on it.

RESULTSOf the twenty-nine patients who underwent surgery, seventeen patients were diagnosed in papillary thyroid carcinoma and twelve patients in thyroid adenoma. In velocimetric analysis, the RI was significantly higher in patients with papillary thyroid carcinoma than those with thyroid adenoma (t = 3.3108, P < 0.01). V(max) and Vmin were no significance in those two tumors respectively (Z = 0.9520, P > 0.05; Z = - 1.6618, P > 0.05). MVD was also significantly increased in patients with papillary thyroid carcinoma (t = 8.1991, P < 0.01). There was a significant positive association between RI and MVD (r = 0.7924, P < 0.01).

CONCLUSIONSColor Doppler ultrasonography could well display the blood flow of thyroid tissue and its nodules. The velocimetric parameter RI was higher in papillary thyroid carcinoma than in adenoma and was along with its MVD. RI may provide valuable information for diagnosis of papillary thyroid carcinoma preoperatively.

Adult ; Aged ; Female ; Humans ; Male ; Microvessels ; Middle Aged ; Rheology ; Thyroid Gland ; blood supply ; diagnostic imaging ; pathology ; Thyroid Neoplasms ; blood supply ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color

The Korean Society of Thyroid Radiology (KSThR) was founded as an affiliated subspecialty society of Korean Society of Radiology in 2010. The KSThR was originated from the thyroid radiology research committee which had started within the Korean Society of Neuroradiology in 2005. In the beginning, the research committee was organized to make a clinical guideline for ultrasonography (US) diagnosis and US-guided biopsy of thyroid nodules to cope with the rapidly increasing role of US imaging and the increasing burden of US-guided biopsy for thyroid nodules in the early 2000s. The KSThR proposed a subspecialty of thyroid radiology which is a medical subspecialty dealing with the imaging-based diagnosis and interventional treatment of thyroid disease. The KSThR has made an effort to make an advance in the research of thyroid imaging and intervention, which could provide scientific evidences for imaging-based management of nodular thyroid disease and thyroid cancers. The KSThR has published clinical guidelines of diagnostic imaging and interventional management of thyroid nodules, which included the US diagnosis and imaging-based management, fine-needle aspiration, core needle biopsy, and radiofrequency ablation therapy in thyroid nodules. The KSThR has a mission to play a leading role in the research and clinical practice of imaging-based management of thyroid disease, and the KSThR will make an advance in collaboration with Korean Thyroid Association.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Catheter Ablation ; Cooperative Behavior ; Diagnosis ; Diagnostic Imaging ; Thyroid Diseases ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography