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1.
Medicine (Baltimore) ; 103(36): e39602, 2024 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-39252246

RESUMO

PURPOSE: The purpose was to evaluate the pathological nature of focal thyroid uptake seen in 11C-Choline PET/CT performed for prostate cancer. MATERIAL AND METHODS: The study was IRB-approved. All 11C-Choline PET/CT exam reports for studies performed between January 01, 2018, and July 30, 2021, in male patients with prostate cancer in our institution were retrospectively reviewed. Exams with "focal thyroid uptake" on their final report were selected. Patients with surgery or ablation in the thyroid prior to the PET/CT, proven parathyroid adenomas or absent thyroid ultrasound were excluded. Repeated PET/CT exams of same patient were excluded. PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax) of the focal thyroid uptake. Available thyroid ultrasound images, cytology and pathology reports were reviewed. Statistical analyses were performed. RESULTS: Out of 10,047 sequential 11C-Choline PET/CT studies, 318 reports included "focal thyroid uptake." About 128 of these studies were repeat exams and were excluded. Additional 87 patients were excluded, because the uptake was determined to be adjacent, rather than confined to the thyroid gland. Out of the remaining 103 patients, 74 patients had focal thyroid uptake and concurrent thyroid sonographic evaluation. Out of the 74 focal uptakes evaluated with ultrasound, 21 were presumed benign thyroid nodules based on the ultrasound and 53 had further evaluation with biopsy. Sixty three nodules were benign (21 presumed benign on ultrasound and 42 cytology or surgical pathology-proven), 9 nodules were malignant and 2 remained indeterminate. There was no significant difference between the SUVs of the benign and malignant groups (P > .3). CONCLUSION: In this retrospective study of patients with prostate cancer who underwent 11C-Choline PET/CT, we identified a group of patients who underwent thyroid ultrasound for incidental finding of focal 11C-Choline thyroid uptake. Incidence of malignancy in this group was 12%. Therefore, further investigation with ultrasound and possibly ultrasound-guided biopsy may be warranted when a choline avid thyroid nodule is found incidentally on choline PET.


Assuntos
Radioisótopos de Carbono , Colina , Achados Incidentais , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Próstata , Nódulo da Glândula Tireoide , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Masculino , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Colina/farmacocinética , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Ultrassonografia/métodos , Idoso de 80 Anos ou mais , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Compostos Radiofarmacêuticos/farmacocinética
2.
Sci Rep ; 14(1): 20946, 2024 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-39251751

RESUMO

Simultaneous imaging of the SPECT tracer 131I and PET tracer 18F is important in the diagnosis of high- and low-grade thyroid cancers because high-grade thyroid cancers have high 18F-FDG and low 131I uptake, while low-grade thyroid cancers have high 131I and low 18F-FDG uptake. In this study, Na131I and 18F-FDG were simultaneously imaged using the Compton-PET system, in vivo. The angular resolution and sensitivity of the Compton camera with 356 keV gamma ray measured using a 133Ba point source were 12.3° and 2 × 10-5, respectively. The spatial resolution and sensitivity of PET were measured with a 22Na point source. The transaxial and axial spatial resolutions of the PET at the center of the FOV were 1.15 mm and 2.04 mm, respectively. Its sensitivity was 1.2 × 10-4. In-vivo images of the 18F and 131I isotopes were simultaneously acquired from mice. These showed that 18F-FDG was active in the heart, brown fat, and brain, while Na131I was active in the thyroid, stomach, and bladder. Artifacts were found in the Compton camera images when the activity of 131I was much lower than that of 18F. This study demonstrates the potential of simultaneous clinical imaging of 18F and 131I.


Assuntos
Fluordesoxiglucose F18 , Imageamento Tridimensional , Radioisótopos do Iodo , Tomografia por Emissão de Pósitrons , Animais , Tomografia por Emissão de Pósitrons/métodos , Camundongos , Imageamento Tridimensional/métodos , Compostos Radiofarmacêuticos , Glândula Tireoide/diagnóstico por imagem
3.
BMC Endocr Disord ; 24(1): 174, 2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-39223506

RESUMO

BACKGROUND: The European Thyroid Association Thyroid Imaging Data and Reporting Systems (EU-TIRADS) is widely used in the risk stratification of thyroid nodule malignancy. However, data on the subject in Sub-Saharan Africa are limited. The objective of this study is to evaluate the clinical, sonographic and histopathological concordance of thyroid nodules in the diagnosis of thyroid cancer. METHODS: This was an analytical cross-sectional study that examined the clinical, ultrasound and pathological data of 61 patients from 4 hospitals in the city province of Kinshasa over a period of 24 months, from June 01, 2020 to May 31, 2022. RESULTS: Of the 61 patients, their mean age was 47.38 ± 8.8 years. The mean clinical score of the patients was 3.4 ± 0.84 with the extremes ranging from 1 to 5. The majority of the patients were classified as having an intermediate risk, ie 85.2% of the cases. It was noted that 41% of the nodules had a high risk according to the EU-TIRADS score and 8.2% of the nodules were malignant after histopathological analysis. The ROC curves reported at the diagnosis of malignancy show an area under the curve of 0.709 with 95% CI (0.486-0.931), a Youden index of 0.769 for the clinical score, and an area under the curve of 0.830 with 95% CI (0.605-0.995), a Youden index of 0.772 for the EU-TIRADS score. CONCLUSION: In a low-income country, a well-performed thyroid ultrasound and the well-applied clinical score could be an important tool in the selection of thyroid nodules suspected of malignancy and requiring histopathological examination to avoid excessive acts in the patient.


Assuntos
Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Ultrassonografia , Humanos , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Estudos Transversais , Masculino , Feminino , Pessoa de Meia-Idade , Ultrassonografia/métodos , República Democrática do Congo/epidemiologia , Adulto , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/epidemiologia , Prognóstico , Glândula Tireoide/patologia , Glândula Tireoide/diagnóstico por imagem , Seguimentos
4.
J Med Life ; 17(6): 593-600, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39296443

RESUMO

A thyroid nodule is managed according to the clinical context, ultrasound (US) findings, and fine needle aspiration (FNA) results. Most thyroid nodules are benign; however, nodule classification is crucial to avoid unnecessary thyroid surgery. We conducted this study to compare the findings of fine-needle aspiration cytology (FNAC) expressed using the Bethesda system with the features of thyroid US classified using the EU-TIRADS classification to assess the risk of malignancy. A descriptive and analytical study involving 99 patients with thyroid nodules followed up in the Department of Endocrinology-Diabetology and Nutrition. Data were collected from medical records and analyzed using SPSS software V21. FNA was performed on 121 nodules using the BETHESDA system. These nodules were classified as malignant, suspicious for follicular neoplasm, and suspicious for malignancy in 5.8%, 5%, and 1.7% of cases, respectively. As for the EU-TIRADS 2017 classification, 59.5% of benign nodules were classified as EU-TIRADS III, whereas 66.7% of malignant nodules were classified as EU-TIRADS V and significantly related to malignant prediction (P = 0.000). The size of nodules was significantly correlated to the risk of malignancy (P = 0.013). Seventy-five percent of nodules with central vascularity were malignant (P = 0.012). Irregularity of nodule contours was significantly associated with the risk of malignancy, as 30% of nodules with irregular contours were Bethesda VI (P = 0.003). Hypoechogenicity was found in 77.8% of malignant nodules (P = 0.004). Additionally, only 9.2% of the nodules were taller than wide, of which 37.5% were malignant (P = 0.012). For a safe management strategy, US-guided FNAC should be performed on each suspicious thyroid nodule, given the correlation between EU-TIRADS classification features and the risk of malignancy.


Assuntos
Nódulo da Glândula Tireoide , Ultrassonografia , Humanos , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Estudos Transversais , Ultrassonografia/métodos , Feminino , Masculino , Biópsia por Agulha Fina , Pessoa de Meia-Idade , Adulto , Glândula Tireoide/patologia , Glândula Tireoide/diagnóstico por imagem , Idoso
5.
Radiol Oncol ; 58(3): 335-347, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39287171

RESUMO

BACKGROUND: To evaluate the role of the novel quantitative imaging biomarker (QIB) SUVX% of 18F-FDG uptake extracted from early 18F-FDG-PET/CT scan at 4 weeks for the detection of immune-related adverse events (rAE) in a cohort of patients with metastatic melanoma (mM) patients receiving immune-checkpoint inhibitors (ICI). PATIENTS AND METHODS: In this prospective non-interventional, one-centre clinical study, patients with mM, receiving ICI treatment, were regularly followed by 18F-FDG PET/CT. Patients were scanned at baseline, early point at week four (W4), week sixteen (W16) and week thirty-two (W32) after ICI initiation. A convolutional neural network (CNN) was used to segment three organs: lung, bowel, thyroid. QIB of irAE - SUVX% - was analyzed within the target organs and correlated with the clinical irAE status. Area under the receiver-operating characteristic curve (AUROC) was used to quantify irAE detection performance. RESULTS: A total of 242 18F-FDG PET/CT images of 71 mM patients were prospectively collected and analysed. The early W4 scan showed improved detection only for the thyroid gland compared to W32 scan (p=0.047). The AUROC for detection of irAE in the three target organs was highest when SUVX% was extracted from W16 scan and was 0.76 for lung, 0.53 for bowel and 0.81 for thyroid. SUVX% extracted from W4 scan did not improve detection of irAE compared to W16 scan (lung: p = 0.54, bowel: p = 0.75, thyroid: p = 0.3, DeLong test), as well as compared to W32 scan in lungs (p = 0.32) and bowel (p = 0.3). CONCLUSIONS: Early time point 18F-FDG PET/CT at W4 did not lead to statistically significant earlier detection of irAE. However, organ 18F-FDG uptake as quantified by SUVX% proved to be a consistent QIB of irAE. To better assess the role of 18F-FDG PET/CT in irAE detection, the time evolution of 18F-FDG PET/CT quantifiable inflammation would be of essence, only achievable in multi centric studies.


Assuntos
Fluordesoxiglucose F18 , Inibidores de Checkpoint Imunológico , Melanoma , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Compostos Radiofarmacêuticos , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Melanoma/diagnóstico por imagem , Melanoma/imunologia , Estudos Prospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Inibidores de Checkpoint Imunológico/efeitos adversos , Adulto , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Curva ROC , Glândula Tireoide/diagnóstico por imagem
6.
Medicina (Kaunas) ; 60(9)2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39336486

RESUMO

Background and Objectives: The interrelationship between thyroid function and the state of the cardiovascular system has been investigated both in preclinical and human studies. However, it remains unclear whether there is any association between thyroid hormones and features of subclinical cardiovascular dysfunction in euthyroid patients. Material and Methods: This study involved 45 people (females: 57.8%) with no thyroid disease who, during planned hospitalization, underwent thyroid ultrasound, determination of biochemical parameters of thyroid function, and measurement of ankle-brachial index (ABI) and toe-brachial index (TBI). People with signs of acute illness or a deterioration of their health were excluded. Results: Significant correlations were found between free triiodothyronine (FT3) and several parameters of both ABI (R = 0.347; p = 0.019 for the mean ABI taken from right side and left side values) and TBI (R = 0.396; p = 0.007 for the mean TBI taken from right side and left side values), as well as the maximal toe pressure (TP) taken from right side and left side values (R = 0.304; p = 0.045). Thyrotropin (TSH) was shown to be significantly correlated only with the maximal TBI value (taken from right side and left side values) (R = 0.318; p = 0.033), whereas free thyroxin (FT4) was shown to be significantly correlated only with the minimal TBI value (taken from right side and left side values) (R = 0.381; p = 0.01). Thyroid volume (TV) was shown to be correlated with TP (R = 0.4; p = 0.008 for the mean TP taken from right side and left side values) and some parameters of TBI value (R = 0.332; p = 0.028 for the mean TBI taken from right side and left side values), but no significant correlations were found between TVand ABI parameters. Patients with a mean ABI value ≤ 1.0 or a mean TBI value ≤ 0.75 have lower TSH, FT3, FT4, and TV than the rest of the study population, but the difference was statistically significant only for FT3. Conclusions: Even in a population of euthyroid patients with no diagnosed thyroid disease, there are some significant correlations between the volume and function of the thyroid gland and the selected features of subclinical cardiovascular dysfunction such as ABI and TBI.


Assuntos
Índice Tornozelo-Braço , Glândula Tireoide , Dedos do Pé , Humanos , Masculino , Feminino , Índice Tornozelo-Braço/métodos , Pessoa de Meia-Idade , Glândula Tireoide/fisiopatologia , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/fisiologia , Adulto , Idoso , Dedos do Pé/irrigação sanguínea , Dedos do Pé/fisiopatologia , Adolescente , Pressão Sanguínea/fisiologia , Tireotropina/sangue , Tri-Iodotironina/sangue , Testes de Função Tireóidea/métodos , Ultrassonografia/métodos
7.
Medicina (Kaunas) ; 60(9)2024 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-39336559

RESUMO

Background and Objectives: This study analyzes the issues of position dislocation of the head of the superior poles and lateral points of the outer edge of the middle divisions of each of the thyroid lobes (TL) changes. The purpose was to provide an intravital position study of the clinical anatomy of the middle and superior poles of the thyroid gland (TG). Materials and Methods: We used data on anthropometry obtained during the study and data from MRI of the neck organs and anatomical formations of 100 healthy individuals, comprising 55 (55%) female and 45 (45%) male participants. To evaluate the data obtained in the examined group, the minimum probability value was 0.95 (95% confidence interval or p < 0.05). Results: Maximum flexion of the neck the distance from the center of the jugular notch to the lateral points of the outer edge of the middle parts of the TL decreases in all groups of but mostly in male ectomorphs; the same distance to the superior poles of the TG changes most in ectomorphic males on the right by 38.9% (p value < 0.001) and mesomorphic females on the left by 37.8% (p value < 0.001); in rotation to the left, the maximum was found in male ectomorphs, which decreased by 9.5% on the left (p value < 0.001) and by 7.3% on the right (p value < 0.001). Conclusions: this study provided new information about the intravital anatomy of the TG position, of the superior poles, and the lateral points of the middle part of its lobes.


Assuntos
Imageamento por Ressonância Magnética , Glândula Tireoide , Humanos , Masculino , Feminino , Glândula Tireoide/anatomia & histologia , Glândula Tireoide/diagnóstico por imagem , Adulto , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Antropometria/métodos
8.
Sensors (Basel) ; 24(18)2024 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-39338849

RESUMO

The thyroid gland, which is sensitive to electromagnetic radiation, plays a crucial role in the regulation of the hormonal levels of the human body. Biosensors, on the other hand, are essential to access information and derive metrics about the condition of the thyroid by means of of non-invasive techniques. This paper provides a systematic overview of the recent literature on bioelectromagnetic models and methods designed specifically for the study of the thyroid. The survey, which was conducted within the scope of the radiation transmitter-thyroid model-sensor system, is centered around the following three primary axes: the bands of the frequency spectrum taken into account, the design of the model, and the methodology and/or algorithm. Our review highlights the areas of specialization and underscores the limitations of each model, including its time, memory, and resource requirements, as well as its performance. In this manner, this specific work may offer guidance throughout the selection process of a bioelectromagnetic model of the thyroid, as well as a technique for its analysis based on the available resources and the specific parameters of the electromagnetic problem under consideration.


Assuntos
Técnicas Biossensoriais , Glândula Tireoide , Humanos , Glândula Tireoide/diagnóstico por imagem , Técnicas Biossensoriais/métodos , Algoritmos
9.
Med Sci Monit ; 30: e945444, 2024 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-39318065

RESUMO

BACKGROUND Technetium (99mTc)-labelled Methoxy-2-Isobutylisonitrile (MIBI) is a diagnostic lipophilic cationic radiotracer used to evaluate the cardiac, breast, thyroid, and parathyroid pathology. This study aimed to evaluate the role of MIBI combined with Tc-99m pertechnetate thyroid scintigraphy, thyroid ultrasonography, and measurement of thyrotropin, thyroid hormones, and autoantibodies to subtype amiodarone-induced thyrotoxicosis (AIT) and the contribution of semi-quantitative analysis of MIBI uptake. MATERIAL AND METHODS This cross-sectional study included 36 patients with AIT who underwent thyrotropin, thyroid hormone, and autoantibody analysis using chemiluminescent method, ultrasonography, pertechnetate, and MIBI thyroid scintigraphy with semi-quantitative uptake, including calculation of the target-to-background ratio (TBR) with 2 different background regions. The MIBI washout rate (WR) was analyzed in all groups. Statistical analysis was performed using descriptive statistics, correlations, and the receiver operating characteristic curve - area under the curve (ROC-AUC). The results were compared with the control group. RESULTS Based on visual and semi-quantitative analyses, patients were successfully categorized into AIT groups (AIT-1, AIT-2 and AIT-3) but the latter method enabled better differentiation of MIBI uptake between all groups. Additionally, ROC-AUC analysis determined cutoff values which enabled discerning between AIT-1 and AIT-2 groups, and AIT-1 and AIT-3 groups. WR showed no significant difference between all AIT groups and controls (P>0.05). CONCLUSIONS Visual MIBI analysis enabled differentiation between AIT-1 and 2 groups, but the method was substantially improved with semi-quantitative analysis, especially in defining AIT-3 group. However, multicenter collaboration with larger studies is needed to standardize the method and obtain more accurate and consistent results.


Assuntos
Amiodarona , Tecnécio Tc 99m Sestamibi , Glândula Tireoide , Tireotoxicose , Humanos , Amiodarona/efeitos adversos , Tireotoxicose/induzido quimicamente , Tireotoxicose/diagnóstico por imagem , Feminino , Projetos Piloto , Masculino , Pessoa de Meia-Idade , Estudos Transversais , Idoso , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/metabolismo , Cintilografia/métodos , Adulto , Tireotropina/sangue , Tireotropina/metabolismo , Ultrassonografia/métodos , Compostos Radiofarmacêuticos , Curva ROC , Hormônios Tireóideos/metabolismo , Autoanticorpos/sangue
10.
Medicine (Baltimore) ; 103(39): e39843, 2024 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-39331869

RESUMO

The purpose of this study was to evaluate the diagnostic value of ultrasound-guided fine needle aspiration biopsy (US-FNAB) and contrast-enhanced ultrasound (CEUS) in the presence of thyroid nodules of different sizes. We retrospectively analyzed 110 patients with surgically operated unimodular thyroid nodules in Yichang City Central Hospital from July 1, 2021, to April 1, 2023, all of whom underwent conventional thyroid ultrasound, CEUS, and US-FNAB, and all of whom were classified according to the size of nodules into <0.5, 0.5 to 1, and ≥1 cm groups. The diagnostic accuracy, sensitivity, and specificity of the 2 methods for benign and malignant nodules were calculated. Among 110 thyroid nodules, 102 were malignant nodules and 8 were benign nodules. In patients with nodule diameters <1 cm the sensitivity of US-FNAB and CEUS was 87.02% and 93.89%, respectively, and the specificity was 100.00% and 66.67%, with an accuracy of 87.31% and 93.28%, respectively. In patients with nodule diameter <0.5 cm, the sensitivities of US-FNAB and CEUS were 74.29% and 100.00%, respectively, and the differences were statistically significant (P < 0.05); in patients with nodule diameter 0.5 to 1 cm, the sensitivities of US-FNAB and CEUS were 79.59% and 95.92%, respectively, and the differences were statistically significant (P < 0.05); among patients with nodule diameters ≥1 cm, the sensitivities of US-FNAB and CEUS were 88.89% and 77.78%, respectively, with no statistically significant difference (P > 0.05). For thyroid nodules ≤1 cm in diameter, the sensitivity of CEUS examination was higher than that of US-FNAB; and CEUS still has good diagnostic accuracy in the diagnosis of benign and malignant thyroid nodules <0.5 cm, CEUS is recommended for thyroid nodules diagnosed negatively by US-FNAB with a diameter of <1 cm; and CEUS should be preferred for thyroid nodules with a diameter of <0.5 cm. CEUS should be preferred for thyroid nodules <0.5 cm in diameter.


Assuntos
Meios de Contraste , Sensibilidade e Especificidade , Nódulo da Glândula Tireoide , Humanos , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto , Biópsia por Agulha Fina/métodos , Ultrassonografia/métodos , Idoso , Biópsia Guiada por Imagem/métodos , Ultrassonografia de Intervenção/métodos , Glândula Tireoide/patologia , Glândula Tireoide/diagnóstico por imagem
11.
Korean J Radiol ; 25(10): 924-933, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39344549

RESUMO

OBJECTIVE: This study aimed to evaluate the performance of an integrated risk stratification system (RSS) based on ultrasound (US) RSSs, nodule size, and cytology subcategory for diagnosing malignancy in thyroid nodules initially identified as Bethesda category III on fine-needle aspiration. MATERIALS AND METHODS: This retrospective study was conducted at two institutions and included consecutive patients with Bethesda category III nodules, and final diagnoses confirmed by repeat biopsy or surgery. A total of 320 Bethesda category III nodules (≥1 cm) from 309 patients (223 female and 86 male; mean age, 50.9 ± 12.0 years) were included. The malignancy risk of Bethesda category III nodules and predictors of malignancy were assessed according to US RSSs, nodule size, and cytology subcategory. The diagnostic performances of US-size cytology (USC) RSS and US RSS alone for malignancy were compared. RESULTS: The intermediate or high suspicion US category independently increased the malignancy risk in all US RSSs (P ≤ 0.001). Large nodule size (≥3 cm) independently increased the malignancy risk of low- or intermediate suspicion US category nodules. Additionally, the atypia of undetermined significance cytology subcategory independently increased the malignancy risk of low suspicion US category nodules in most US RSSs. The area under the receiver operating characteristic curve of the USC RSSs was greater than that of the US RSSs alone (P < 0.048). Malignancy was not found in the very low risk category of USC RSS. CONCLUSION: The diagnostic performance of USC RSS for malignancy was superior to that of US RSS alone in Bethesda category III nodules. Malignancy can be ruled out in the very low-risk category of USC RSS.


Assuntos
Nódulo da Glândula Tireoide , Ultrassonografia , Humanos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Feminino , Masculino , Estudos Retrospectivos , Pessoa de Meia-Idade , Ultrassonografia/métodos , Medição de Risco , Biópsia por Agulha Fina , Adulto , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Glândula Tireoide/patologia , Glândula Tireoide/diagnóstico por imagem , Idoso
12.
Psychopharmacol Bull ; 54(4): 18-34, 2024 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-39263200

RESUMO

Introduction: Lithium is a gold-standard agent for bipolar disorder (BD) and can affect the size, structure and/or function of thyroid gland with long-term exposure. Thyroid ultrasound can detect structural thyroid abnormalities, but it is under-reported with few prior studies in lithium users. The study aimed to evaluate thyroid volume and echogenicity in lithium users with BD and healthy participants, and explores its association with clinical variables and thyroid functions. Method: This was an observational study with 102 participants in total. Study group consisted of 52 clinically-stable (HAM-D ≤ 13, YMRS <8) follow-up patients with DSM-5 BD on lithium maintenance. Healthy controls (HC) comprised 50 participants with no illness in self and family. Assessments included NIMH Life-chart, IGLSI typical/atypical scale, lithium response scale (LRS) and CGI-BP. Fasting venous sample was taken for thyroid functions, Anti-TPO antibodies and serum lithium. Thyroid ultrasonography was also conducted. Results: Mean age of cases was 39.42 ± 12.62 years, with 42.3% females, which was comparable to HC. Median duration of illness was 10.5 years (Q1-Q3 = 6-19 years), with median lithium exposure for 4.5 years (Q1-Q3:2.2-7.75), and serum lithium 0.67 mmol/L (SD:0.31). Thyroid volume was significantly higher for cases than HC (10.67 ± 5.46 mL vs 4.30 ± 2.06 mL; p < 0.001). Relative to HC, serum TSH was higher in cases (p = 0.018), while anti-TPO positivity was comparable (14.0% vs 3.85%, p = 0.089). Thyroid nodules were more frequent in male cases (p = 0.013) compared to male controls.Thyroid volume did not show association with serum TSH (p = 0.277) and lithium response (p = 0.36). Conclusion: Findings indicate a uniform enlargement of thyroid gland in lithium users with BD. Thyroid volume did not show association with thyroid functions and lithium response, however prospective studies may give better insight about their trajectories over time.


Assuntos
Transtorno Bipolar , Glândula Tireoide , Ultrassonografia , Humanos , Masculino , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/diagnóstico por imagem , Feminino , Adulto , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/efeitos dos fármacos , Pessoa de Meia-Idade , Estudos de Casos e Controles , Compostos de Lítio/administração & dosagem , Compostos de Lítio/farmacologia , Antimaníacos/administração & dosagem , Antimaníacos/farmacologia , Tamanho do Órgão/efeitos dos fármacos , Lítio/administração & dosagem
13.
Sci Rep ; 14(1): 19813, 2024 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-39191901

RESUMO

Thyroid nodule (TN) has been becoming a great concern worldwide due to its high incidence. Although some studies have reported associations between trace elements exposure and the risk of TNs, the linkage was not inconclusive. The present study aimed to identify the association of selected serum trace elements (Ca, Mg, V, Fe, Co, Cu, Zn, Se, Mn and Mo) with TNs among general adults. A cross-sectional study was conducted in January 2021 in Chengdu, China. 1282 subjects completed the questionnaire and gave at least one human biological material after an overnight fast, venous blood, and urine, including 377 TN participants defined through ultrasound. Various trace elements in serum specimens were determined by inductively coupled plasma mass spectrometry. Thyroid functions were tested by chemiluminescent microparticle immunoassay (CMIA). The associations between trace elements levels and the risk of TNs were examined by restricted cubic splines (RCS) regression and bayesian kernel machine regression (BKMR) models. TNs were more common in females (P < 0.001) and in the elderly (P < 0.001) and that they were also frequently associated with fertility, marital status, annual household income, drinking, anxiety, vitamin supplement, tea consumption, hypertension and hyperlipidemia. After adjusting for confounders by a propensity score matching model, the association between trace elements concentrations and TNs risk was found to be statistically insignificant in the RCS (P for nonlinear > 0.05) and BKMR models. FT3 or T4 (total or free) increased significantly with increasing total trace elements mixture levels. In TI-RADS-4 TN subjects, TPO-Ab level increased significantly with increasing total trace elements mixture levels in the high-dose range. Ca, Zn, Mo at their 75th percentile showed positive individual effects on TPO-Ab, which was examined to be interactive. The detection of trace elements for TNs in general adults may be of no significance, but once individuals classified as TI-RADS-4 TNs are detected with abnormal TPO-Ab, Ca, Zn and Mo level are recommended to measure. The substantive association on it still needs to be continuously explored in the future.


Assuntos
Autoanticorpos , Nódulo da Glândula Tireoide , Oligoelementos , Humanos , Feminino , Oligoelementos/sangue , Masculino , Autoanticorpos/sangue , Pessoa de Meia-Idade , Nódulo da Glândula Tireoide/sangue , Nódulo da Glândula Tireoide/diagnóstico por imagem , Estudos Transversais , Adulto , Iodeto Peroxidase/imunologia , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia , Idoso , China/epidemiologia
14.
Front Endocrinol (Lausanne) ; 15: 1434787, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39205684

RESUMO

Purpose: The present study aimed to analyze and compare sonographic features of papillary thyroid carcinoma (PTC) subtypes to determine whether ultrasound (US) may aid in differentiating particular subtypes. Methods: This retrospective study enrolled 133 patients diagnosed with 142 histopathologically proven PTCs as per the fifth edition of the World Health Organization classification of thyroid neoplasms between January 2013 and May 2023. US features based on the American College of Radiology and European Thyroid Imaging and Reporting Data Systems (TIRADS), and histopathological characteristics of nodules were assessed and compared. Results: Histopathological analysis yielded 55 (38.7%) classic PTC, 32 (22.5%) invasive encapsulated follicular variant (IEFV) PTC, 20 (14.1%) oncocytic subtype, 14 (9.9%) non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), 11 (7.8%) infiltrative follicular subtype, 7 (4.9%) tall cell subtype, 2 (1.4%) solid subtype, and 1 (0.7%) diffuse sclerosing subtype. The US findings indicating malignancy, such as taller-than-wide shape, irregular margins, echogenic foci, and higher TIRADS categories, were more frequently demonstrated in nodules with classic PTC and the tall cell subtype, in line with their histopathological features. Conversely, IEFV-PTC and NIFTP rarely exhibited these high-risk sonographic features. US appearance of the oncocytic subtype more frequently overlapped with IEFV-PTC, yet hypo/very hypoechoic nodules with larger nodular diameters and higher TIRADS scores may favor the diagnosis of this subtype. Conclusion: US features of certain subtypes may guide the differential diagnosis regarding shape, margin, echogenic foci, and TIRADS category of nodules; however, definitive subtyping is not yet possible using US images alone.


Assuntos
Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Ultrassonografia , Organização Mundial da Saúde , Humanos , Masculino , Feminino , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/classificação , Neoplasias da Glândula Tireoide/patologia , Ultrassonografia/métodos , Estudos Retrospectivos , Pessoa de Meia-Idade , Adulto , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/classificação , Idoso , Adulto Jovem , Diagnóstico Diferencial , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia
15.
Lupus ; 33(11): 1235-1241, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39120530

RESUMO

OBJECTIVE: Increased frequency of autoimmune thyroid disease, particularly Hashimoto's thyroiditis (HT) was reported several studies in the literature, in individuals with childhood-onset systemic lupus erythematosus (cSLE). Our study aimed to investigate the prevalence and contributing factors of thyroid dysfunction and HT among cSLE patients. METHODS: Thyroid function tests were obtained cross-sectionally from cSLE patients. Demographic, clinical, and laboratory characteristics and activity scores were collected from medical records. Patients diagnosed with cSLE were compared to the healthy control group for the frequency of thyroid dysfunction. The Mann-Whitney U, independent samples t test, and the Chi-square or Fisher's exact test were used to compare study groups. A p-value below 0.05 was considered statistically significant. RESULTS: Out of 73 cSLE patients, 14 (19.1%) had subclinical hypothyroidism, 9 (12.3%) had clinical hypothyroidism, 12 (16.4%) were diagnosed with HT, and 12 (16.4%) had a family history of HT. Thyroid USG was performed in 5 euthyroid patients and 1 borderline subclinical hypothyroid patient with positive thyroid autoantibody and reported as diffuse heterogeneous echogenicity enlargement in the thyroid gland. There were no significant differences in clinical and laboratory data or medication used between the groups with and without HT; however, patients with HT had a higher frequency of clinical hypothyroidism and family history of HT. Cumulative prednisolone dose was significantly lower in patients diagnosed with HT. The frequency of HT was considerably higher in patients with cSLE compared to the healthy control group. CONCLUSION: The results demonstrate an increased incidence of HT in cSLE patients, even if they are euthyroid, and recommend that cSLE patients be screened more frequently.


Assuntos
Doença de Hashimoto , Lúpus Eritematoso Sistêmico , Testes de Função Tireóidea , Humanos , Doença de Hashimoto/epidemiologia , Doença de Hashimoto/complicações , Feminino , Masculino , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/epidemiologia , Criança , Estudos Transversais , Adolescente , Fatores de Risco , Glândula Tireoide/fisiopatologia , Glândula Tireoide/diagnóstico por imagem , Prevalência , Idade de Início , Hipotireoidismo/epidemiologia , Hipotireoidismo/complicações , Estudos de Casos e Controles , Adulto Jovem
16.
Neuroradiology ; 66(10): 1795-1803, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39136714

RESUMO

PURPOSE: The present study aimed to investigate CT imaging features, pathological findings, and prognosis in patients with thyroid hemiatrophy (THA) associated with papillary thyroid carcinoma (PTC). METHODS: This retrospective study included 225 patients with histopathologically proven PTC treated by surgical resection who underwent preoperative CT scanning. On CT images, THA was defined as thyroid parenchymal hemiatrophy on the ipsilateral side of PTC. CT findings, overall survival, and disease-free survival were compared between patients with and without THA. Pathological findings were also assessed in PTCs with and without THA. RESULTS: THA was observed in 35 of 225 (16%) patients with PTC. Atrophic thyroid parenchyma was observed in the right lobe of 20 patients (57%) and in the left lobe of the remaining 15 patients (43%). With respect to the solid components within PTCs, contrast-enhanced CT attenuation (114.2 ± 18.2 vs. 126.7 ± 31.3 HU; p < 0.05) and CT attenuation change for contrast-enhanced CT minus unenhanced CT (60.2 ± 18.1 vs. 72.3 ± 31.0 HU; p < 0.05) were significantly lower in PTCs with THA than in those without THA. Histopathologically, almost all PTCs with THA (97%) had keloid-like collagen, which is broad bundles of hypocellular collagen with bright eosinophilic hyalinization, typically observed in keloid. However, no significant differences were observed in the prognosis between the two groups. CONCLUSION: THA was occasionally observed in patients with PTC. Weak contrast-enhancement was distinct characteristic of PTC patients with THA, which is probably caused by keloid-like collagen.


Assuntos
Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Tomografia Computadorizada por Raios X , Humanos , Masculino , Feminino , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/complicações , Câncer Papilífero da Tireoide/cirurgia , Adulto , Atrofia , Idoso , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/patologia , Carcinoma Papilar/cirurgia , Carcinoma Papilar/complicações , Meios de Contraste , Prognóstico , Taxa de Sobrevida , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/patologia
17.
Curr Med Imaging ; 20: e250724232275, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39185658

RESUMO

The funding details have been incorporated upon author's request in the funding section of this articles entitled "Superresolution based Nodule Localization in Thyroid Ultrasound Images through Deep Learning," 2024, 20, e15734056269264 [1]. The original article can be found online at: https://www.eurekaselect.com/article/140408 Details of the error and a correction are provided here. Original: FUNDING None. Corrected: FUNDING This research is funded by the research project of Qingpu Branch of Zhongshan Hospital affiliated with the Fudan University (Project Number: QYM2022-09) and the research project of Qingpu District Health Commission (Project Number: QWJ2023-19).


Assuntos
Aprendizado Profundo , Nódulo da Glândula Tireoide , Ultrassonografia , Humanos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia/métodos , Glândula Tireoide/diagnóstico por imagem
18.
J Radiol Prot ; 44(3)2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39121874

RESUMO

In computed tomography (CT), organ dose modulation (ODM) reduces radiation exposure from the anterior side to reduce radiation dose received by the radiosensitive organs located anteriorly. We investigated the effects of ODM applied to a part of the scan range on radiation dose in body CT. The thorax and thoraco-abdominopelvic region of an anthropomorphic whole-body phantom were imaged with and without ODM. ODM was applied to various regions, and the tube current modulation curves were compared. Additionally, the dose indices were compared with and without ODM in thoracic and thoraco-abdominopelvic CTs in 800 patients. ODM was applied to the thyroid in male patients and to the thyroid and breast in female patients. In phantom imaging of the thorax, the application of ODM below the scan range decreased the tube current, and that to the breast showed a further decrease. Decreased tube current was also observed in phantom imaging of the thoraco-abdominopelvic regions with ODM below the scan range, and the application of ODM to the whole scan range, thyroid, breast, and both thyroid and breast further reduced the tube current in the region to which ODM was applied. In patient imaging, the dose indices were significantly lower with ODM than without ODM, regardless of the scan range or sex. The absolute reduction in dose-length product was larger for thoraco-abdominopelvic CT (male, 43.2 mGy cm; female, 59.7 mGy cm) than for thoracic CT (male, 30.8 mGy cm; female, 37.6 mGy cm) in both sexes, indicating dose reduction in the abdominopelvic region to which ODM was not applied. In conclusion, The application of ODM in body CT reduces radiation dose not only in the region to which ODM is applied but also outside the region. In radiation dose management, it should be considered that even ODM applied to a limited region affects the dose indices.


Assuntos
Imagens de Fantasmas , Doses de Radiação , Tomografia Computadorizada por Raios X , Humanos , Feminino , Masculino , Adulto , Proteção Radiológica , Glândula Tireoide/efeitos da radiação , Glândula Tireoide/diagnóstico por imagem , Pessoa de Meia-Idade , Mama/diagnóstico por imagem , Mama/efeitos da radiação , Idoso , Imagem Corporal Total
19.
Surg Radiol Anat ; 46(10): 1673-1681, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39191992

RESUMO

PURPOSE: To systematically review published studies on the prevalence of the thyroid foramen (TF), perform a meta-analysis to generate pooled prevalence estimates, and identify factors associated with its presence. METHODS: A systematic literature search was conducted in Google Scholar, PubMed, and Journal Storage databases. Studies reporting the prevalence of the thyroid foramen were included without language or date restrictions. Quality assessment was performed using AQUA tool. A random-effects meta-analysis was performed with subgroup analyses. Heterogeneity was assessed using Higgins' I2 statistics, and publication bias was evaluated using funnel plots and Egger's test. RESULTS: Out of 271 entries, 38 studies met the inclusion criteria, comprising 3,030 subjects from various continents. The overall TF prevalence was 24.5% (95% CI: 19.2-29.8%, I2 = 93.44%), with unilateral TF present in 16.9% and bilateral TF in 6.2%. Prevalence was highest in North America (31.4%,) and lowest in Africa (12.3%). No significant prevalence difference was found between adults and younger populations (p = 0.15). Publication bias, or the small-study effect, was detected (p < 0.01). CONCLUSION: This meta-analysis reveals a 24.5% overall prevalence of TF, with significant heterogeneity primarily explained by geographical differences. The TF's clinical relevance necessitates awareness among surgeons and radiologists to avoid complications during laryngeal surgeries and prevent misdiagnosis in imaging studies.


Assuntos
Variação Anatômica , Glândula Tireoide , Humanos , Prevalência , Glândula Tireoide/anormalidades , Glândula Tireoide/diagnóstico por imagem
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