Caracterizacion de nódulos tiroideos: concordancia entre estudio citopatologico y ecografia en la detección de nódulos malignos


Autoria(s): Blanco Ruiz, Héctor Daniel
Contribuinte(s)

Morón, Lina Sofía

Data(s)

31/07/2015

Resumo

: Los métodos imagenológicos para evaluar los nódulos tiroideos han sido motivo de estudio en las últimas décadas, especialmente la ecografía sobresale sobre las otras modalidades diagnósticas por su accesibilidad, portabilidad, y seguridad. A pesar de ello, las características ecográficas de cada nódulo han sido objeto de controversia en cuanto a su potencial detección de malignidad o benignidad. Se presenta un estudio de concordancia entre el estudio citopatológico y la ecografía para la caracterización nódulos tiroideos de naturaleza maligna y benigna, y su análisis de pruebas diagnósticas. Metodología: Se realizó un estudio descriptivo de concordancia con estudio de pruebas diagnósticas anidado. Se escogieron todos los pacientes con nódulos tiroideos a quienes se les realizó ecografía y estudio citopatológico de la lesión y se estudiaron los hallazgos ecográficos para evaluar su potencial diagnóstico para malignidad. Se incluyeron un total de 100 pacientes con nódulos tiroideos potencialmente malignos. La concordancia entre la ecografía en modo B y el estudio citopatológico fue moderada (índice kappa 0.55). La característica con mayor potencial para detectar malignidad fue la presencia de Microcalcificaciones (sensibilidad 75%, especificidad 92%).

Universidad del Rosario

Imaging methods for evaluating thyroid nodules have been studied in recent decades, especially ultrasound excels over other diagnostic modalities for its accessibility, portability, and security. However, the ultrasound characteristics of each node have been controversial in terms of its potential detection of malignancy or benignity. A study of correlation between cytopathological study and ultrasound for thyroid malignant and benign nodule characterization, and analysis of diagnostic tests is presented. A descriptive study according to study nested diagnostic tests performed. All patients with thyroid nodules who underwent ultrasound and cytopathology study of the lesion and the ultrasound findings were studied to evaluate their potential for malignancy diagnosis were selected. A total of 100 patients with potentially malignant thyroid nodules were included. The correlation between B-mode ultrasound and cytopathology study was moderate (kappa 0.55). The most promising feature for detecting malignancy was the presence of microcalcifications (sensitivity 75%, specificity 92%)

Formato

application/pdf

Identificador

http://repository.urosario.edu.co/handle/10336/10627

Idioma(s)

spa

Publicador

Facultad de Medicina

Direitos

info:eu-repo/semantics/openAccess

Fonte

instname:Universidad del Rosario

reponame:Repositorio Institucional EdocUR

Cooper D. Revised American Thyroid Association management guidelines for patients with nodules and differenciated thyroid cancer. Thyroid 2009; 19 (11): 1167-1176.

2. Frates MC. Management of thyroid nodules detected at US. Society of radiologists in ultrasound consensus conference statement. Radiology 2005; 237:794–800

Kim HC, Incidental thyroid lesions identified by ultrasound in patients with Non-thyroidal head and neck cancer. Acta Radiologica. 54 (10), 1153-1158

Wang HL, Application of Real-time Ultrasound Elastography in Diagnosing Benign and Malignant Thyroid Solid Nodules. Cancer Biol Med 2012; 9: 124-127

Bonavita Jhon. Pattern Recognition of Benign Nodules at Ultrasound of the Thyroid: Which Nodules Can Be Left Alone? AJR 2009; 193:2017-213

Rumack CM. Diagnóstico por ecografía: 4 Edición. Marban libros. Vol 2: 703-727. 7. Lee Stephanie. Microcalcification and Intranodular Coarse Calcification are often found on preoperative ultrasounds of papillary Thyroid Carcinoma. Clin Thyroidolo 2012; 24:2-3

Hughes DT. The most common thyroid cancer is -1cm in a +45 year old, but not all small cancers are significant. Clin Thyroidolo 2011; 23:10-14

Mukasa K. Ultrasonography may detect malignant nodules in patients with Hashimoto´s disease. Thyroid 2011; 21-37

Anil Gopinathan. Thyroid Nodules: Risk stratification for malignancy with ultrasound and guided biopsy. Cancer Imaging 2011; 11: 209-223

Coquia SF. The role of sonography in thyroid cancer. Radiol Clin Am 2014; 52: 1283-1294

Greenspan FS. The thyroid gland. Basic and clinical endocrinology. 6 th ed. New York: McGraw-Hill; 2003. P.201-72

Virmani V. Sonographic Patterns of benign thyroid nodules: Verification at our institution. AJR 2011; 196: 891-895

Kim MJ. US-guided fine needle aspiration of thyroid nodules: Indications, techniques, results. Radiographics 2008; 28: 1869-1889

Joang JK. US features of thyroid malignancy: Pitfalls and pearls. Radiographics 2007; 27: 847-865

Schi C. Correlation between thyroid nodule calcification morphology on ultrasound and thyroid carcinoma. J Int Med 2012; 40:350-7

Hershman JM. Malignancy of a Thyroid nodule can be predicted by ultrasonography if it has microcalcifications and is solid and larger than 2 cm. Clin Thyroidol 2013; 25:256-258

Paschke RH. Thyroid nodule guidelines: agreement, disagreement and need for future research. Nat Rev Endocrinol 2011; 7: 354 – 361

Hong YJ. Positive predictive values of sonographic features of solid thyroid nodule. Clinical Imaging 2010; 34:127-133

Wu G. DO hyperechoic thyroid nodules on B-ultrasound represent calcification? Journal of international Medical Research. 2013; 41 (3): 848-854

Shrestha M. The impact of thyroid nodule size on the risk of malignancy and accuracy of fine needle aspiration: a 10 year study from a single institution.- Thyroid 2012; 12: 1251-6

Kamran SC. Thyroid nodule size and prediction of cancer. J Clin Endocrinol Metab 2013; 2: 564-70

Sakashita T. The potential diagnostic role of the number of ultrasonographic characteristics for patients with thyroid nodules evaluated as Bethesda I-V. Frontiers in oncology. 2014; 4:1-4.

McHenry CR. Is nodule size an independent predictor of thyroid malignancy? Surgery 2008; 6: 1068-8

Moon WJ. Ultrasonography and Ultrasound-Based Management of thyroid nodules: Consensus Statement and Recommendations. Korean J Radiol. 2011; 12 (1): 1-14.

Moon HJ. A taller-than-wide shape in thyroid nodules in transverses and longitudinal ultrasonographic planes and the prediction of malignancy. Thyroid 2011; 21:1249-1253

Gharib H. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and EuropeanThyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract 2010; 16(Suppl 1), 1-4

Sholosh B. Thyroid Ultrasound Part 1: Ultrasound technique and Diffuse Disease. Radiol Clin N Am 2011; 49:391-416

Moon HJ. Can vascularity at power Doppler US help predict thyroid malignancy? Radiology 2010; 255 (1): 260-269

Algin O. Role of duplex power Doppler ultrasound in differentiation between malignant and benign thyroid nodules. Korean J Radiol 2010; 11 (6): 594-602

Chiorean AR. Accuracy, reproducibility and reliability of ultrasound elastography Vs histopathology of malignancy in patients with solid thyroid nodules. Endocrine care 2014; 10: 414-424

Moon HJ. Diagnostic performance of gray-scale and elastography in solid thyroid nodules. Radiology 2012; 262 (3): 1002-1013.

Kim EK. New sonographic criteria for recommending fine-needle aspiration biopsy of non-palpable solid nodules of the thyroid. AJR 2002; 178:687-691

Ahn SS. Biopsy of thyroid nodules: Comparision of three sets of guidelines. AJR 2010; 194: 31-37.

Cibas ES. Fine needle aspiration in the work up of thyroid nodules. Otolaryngol Clin North Am 2010; 43:257-71

Campanella P- Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: A systematic review and meta-analysis. European Journal of Endocrinology 2014; 170: 203-211.

Cibas ES. Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009;11:1159–1165

Nachiappan A. The thyroid, Review of imaging features and biopsy techniques with radiologic-pathologic correlation. Radiographics 2014; 34: 276-293. 39. Heller MT. Correlation of ultrasound findings with Bethesda cytopathology classification for thyroid nodules fine-needle aspiration: A primer for radiologists. AJR 2013; 201:W487-W494

Lee YH. Differentiation between benign and malignant solid thyroid nodules using an US classification systema. Korean J Radiol 2011; 12(5): 559-567

Hovarth E. An ultrasonogram Reporting System for Thyroid Nodules Stratifying Cancer Risk for Clinical Management. J Clin Endocrinol Metab 2009; 94 (5): 1748-51

Kwak JY: Thyroid Imaging Reporting and Data System for US features of nodules: A step in establishing better stratification of cancer risk. Radiology 2011; 260 (3): 892-899

TEME

Palavras-Chave #Radiologia #Diagnóstico por imágenes #Patología celular #616.44 #Enfermedades de la tiroides #Neoplasias de la tiroides #thyroid nodules #ultrasound #thyroid cytology
Tipo

info:eu-repo/semantics/bachelorThesis

info:eu-repo/semantics/acceptedVersion