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Risk of TIRADS-based inappropriate FNAC in autonomous thyroid nodules is clinically negligible.
Leoncini, Andrea; Camponovo, Chiara; Paone, Gaetano; Gamarra, Elena; Treglia, Giorgio; Trimboli, Pierpaolo.
Afiliação
  • Leoncini A; Clinic for Radiology, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.
  • Camponovo C; Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.
  • Paone G; Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.
  • Gamarra E; Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland.
  • Treglia G; Thyroid Unit, Clinic for Endocrinology and Diabetology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.
  • Trimboli P; Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.
Eur Thyroid J ; 13(4)2024 Aug 01.
Article em En | MEDLINE | ID: mdl-38968004
ABSTRACT

Objective:

Thyroid nodule (TN) is usually managed according to Thyroid Imaging And Reporting Data Systems (TIRADS) with the major aim to reduce as much as possible unnecessary fine-needle aspiration cytologies (UN-FNACs). Since the assessment of autonomously functioning thyroid nodule (AFTN) according to TIRADS is heterogeneous, that virtually benign entity may increase the rate of UN-FNAC. This study retrospectively analyzed the appropriateness of TIRADS-based FNAC indication in AFTNs, also looking at the impact of TSH and nodule size.

Methods:

Cases diagnosed with AFTN on scintigraphy were searched. Patients who had undergone AFTN treatment, were on medications or supplementation that could affect thyroid function, or had multiple AFTNs were excluded. The AFTNs were assessed according to ACR-TIRADS.

Results:

Forty-eight AFTNs were included of which 37.5% had FNAC indication according to TIRADS. The FNAC indication rate in the case of TSH lower than 0.4 mIU/L was significantly higher than in other cases (P = 0.0078). The most accurate TSH cut-off and AFTN size associated with UN-FNAC were ≤ 0.41 mIU/L and > 22 mm, respectively. The multivariate analysis showed that both TSH and nodule size were independent predictors of UN-FNAC with OR of 6.65 and 6.46, respectively. According to these data, the rate of FNAC indication dropped to 4.16%.

Conclusion:

Inappropriate FNACs in AFTNs are primarily observed in patients with low TSH and large AFTN. Since these cases typically undergo scintigraphy, the risk of TIRADS-based UN-FNAC is clinically negligible. There is no need for integrating other imaging procedures into the TIRADS model.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Nódulo da Glândula Tireoide Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Thyroid J Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Nódulo da Glândula Tireoide Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur Thyroid J Ano de publicação: 2024 Tipo de documento: Article