Real-Time Ultrasonography and the Evaluation of Static Images Yield Different Results in the Assessment of EU-TIRADS Categories.

The studies on the effectiveness of various TIRADS in the diagnostics of thyroid nodules differ in the method of ultrasound image assessment: real time (rtUS) vs. static ultrasonography (stUS). The aim of the study was to evaluate the impact of those two methods on the categorization of nodules in EU-TIRADS.

Effective Use of microRNA, BRAF and Sonographic Risk Assessment in Bethesda III Thyroid Nodules Requires a Different Approach to Nodules with Features of Nuclear Atypia and Other Types of Atypia.

The aim of the study was to analyze the diagnostic usefulness of the combined assessment of the ultrasound risk category of the nodule (evaluated with EU-TIRADS system), the presence of BRAF V600E mutation and the expression of selected microRNAs (miR-146b, miR-221 and miR-222) in Bethesda category III thyroid nodules, separately for cases with nuclear atypia (AUS-nuclear) and cases with other types of atypia (AUS-other). We evaluated 161 nodules (66 AUS-nuclear and 95 AUS-other) with known results of postoperative histopathological examination. The rate of cancer and the rate of PTC among cancers were nearly three times higher in the AUS-nuclear than the AUS-other group.

Optimization of the Management of Category III Thyroid Nodules Using Repeat FNA and TIRADS.

The aim of the study was to examine the benefits of the joint use of repeat FNA (rFNA) and EU-TIRADS in category III nodules in relation to the kind of atypia: nuclear vs. architectural (denoted by AUS and FLUS respectively). The study included 127 AUS and 1739 FLUS nodules with a known category of EU-TIRADS.

Hashimoto's Thyroiditis Does Not Influence the Malignancy Risk in Nodules of Category III in the Bethesda System.

The aim of this study was to evaluate the risk of malignancy (RoM) in category III thyroid nodules of the Bethesda system in patients with and without Hashimoto thyroiditis (HT) and to analyze whether obtaining category III with a repeat FNA (rFNA) increases RoM. The study included 563 HT and 1250 non-HT patients; rFNA was performed in 349 and 575 patients, and surgical treatment in 160 and 390, respectively. There was no difference in RoM between HT and non-HT patients in the whole examined population (lower limit of RoM), nor in operated patients (upper limit of RoM), HT: 5.

Validation of Four Thyroid Ultrasound Risk Stratification Systems in Patients with Hashimoto's Thyroiditis; Impact of Changes in the Threshold for Nodule's Shape Criterion.

The aim of the study was to validate thyroid US malignancy features, especially the nodule's shape, and selected Thyroid Imaging Reporting and Data Systems (EU-TIRADS; K-TIRADS; ACR-TIRADS, ATA guidelines) in patients with or without Hashimoto's thyroiditis (HT and non-HT groups). The study included 1188 nodules (HT: 358, non-HT: 830) with known final diagnoses. We found that the strongest indications of nodule's malignancy were microcalcifications (OR: 22.

Low reproducibility of equivocal categories of the Bethesda System for Reporting Thyroid Cytology makes the associated risk of malignancy specific to the diagnostic center.

Purpose: Equivocal categories (III, IV, V) of the Bethesda System for Reporting Thyroid Cytology (BSRTC) are characterized by high variability of the estimated risk of malignancy. The aim of the study was to analyze the reproducibility of classification of nodules into an equivocal category and the frequency of malignancy (FoM) observed in such categories.

Methods: Five experienced cytopathologists from three centers (A, B, C) independently performed reclassification of smears obtained from 213 thyroid nodules with equivocal routine cytology and known results of the postoperative histopathological examination.

The Presence of Hypoechoic Micronodules in Patients with Hashimoto's Thyroiditis Increases the Risk of an Alarming Cytological Outcome.

The aim of the study was to identify a possible relation between various ultrasonographic (US) appearances of Hashimoto's thyroiditis (HT) and the risk of obtaining an alarming cytology of coexisting nodules. The study included 557 patients with HT, who had been referred for fine needle aspiration biopsy (FNA). We divided US patterns of HT (UP-HT) into eight groups: (a) Hypoechoic (compared to submandibular glands), homogeneous/fine echotexture; (b) hypoechoic, heterogeneous/coarse echotexture; (c) marked hypoechoic (darker than strap muscles), heterogeneous/coarse echotexture; (d) heterogeneous echotexture with hyperechoic, fibrous septa; (e) multiple, discrete marked hypoechoic areas (sized as 1 to 6 mm); (f) normoechoic pseudo-nodular areas; (g) echostructure similar to connective tissue; (h) thyroid parenchyma with no signs of HT.

Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology.

The aim of this study was to compare the diagnostic effectiveness of EU-TIRADS in two groups of nodules with equivocal cytology (categories III-V of Bethesda system), with and without Hürthle cells (HC and non-HC). The study included 162 HC and 378 non-HC nodules with determined histopathological diagnosis (17.9% and 15.

Diagnostic Value of Six Thyroid Imaging Reporting and Data Systems (TIRADS) in Cytologically Equivocal Thyroid Nodules.

The aim was to compare the usefulness of selected thyroid sonographic risk-stratification systems in the diagnostics of nodules with indeterminate/suspicious cytology or unequivocal cytology in a population with a history of iodine deficiency. The diagnostic efficacy of ACR-TIRADS (the American College of Radiology Thyroid Imaging Reporting and Data Systems), EU-TIRADS (European Thyroid Association TIRADS), Korean-TIRADS, Kwak-TIRADS, AACE/ACE-AME-guidelines (American Association of Clinical Endocrinologists/ American College of Endocrinology-Associazione Medici Endocrinologi guidelines) and ATA-guidelines (American Thyroid Association guidelines) was evaluated in 1000 nodules with determined histopathological diagnosis: 329 FLUS/AUS (10.6% cancers), 167 SFN/SHT (11.

The efficiency of elastography in the diagnostics of follicular lesions and nodules with an unequivocal FNA result.

Introduction: The aim was to assess the usefulness of strain elastography (SEG) in the diagnostics of two groups of thyroid nodules (TNs): follicular lesions (FL) with low malignancy risk (< 20.0%) and low percentage of papillary carcinomas (PTCs) among cancers as well as TNs with unequivocal cytology (UC) and high percentage of PTCs among cancers.

Material And Methods: 168 TNs were analysed and eventually surgically treated: 100 UC (50 benign and 50 malignant - 90.

The predictive value of sonographic images of follicular lesions - a comparison with nodules unequivocal in FNA - single centre prospective study.

Background: To determine the diagnostic efficacy of ultrasonographic malignancy risk features (UMRFs) in follicular lesions (FL) in a population with low risk of malignancy in FL and to compare it with a similar analysis in a group of patients with unequivocal cytology (UC): benign lesion (BL) or malignant neoplasm (MN).

Methods: Presence of UMRFs (hypoechogenicity, solid echostructure, taller-than-wide shape, pathological vascularization, irregular margins, microcalcifications and macrocalcifications) and their sets were assessed in 322 FL: 202 follicular lesions of undetermined significance (FLUS) and 120 suspicious for follicular neoplasm (SFN) and 300 nodules with UC: 200 BL and 100 MN, subsequently evaluated histopathologically.

Results: Cancers were confirmed in 100% nodules in MN group (89.

Analysis of clinical significance of equivocal thyroid cytology with a special consideration for FLUS category - five years of new classification of FNA results.

Introduction: The diagnostic category of follicular lesion of undetermined significance (FLUS) was intended to allow selection of cases with low risk of malignancy from all smears with indeterminate, suspicious cytology (ISC), which can potentially take advantage from repeat fine-needle aspiration (rFNA). Aim of the study was a comparison of the risk of malignancy related to FLUS nodules and other nodules with ISC: suspected follicular neoplasm (SFN) and suspected malignancy (SM), as well as analysis of the usefulness of assessing ultrasonographic malignancy risk features (UMRF) in nodules with ISC.

Material And Methods: We analysed UMRF, rFNA, and results of histopathological examination (H) in 441 FLUS, 135 SFN, and 72 SM nodules.

Secondary tumours revealed during fine needle aspiration of the thyroid--analysis of prevalence and characteristics of ultrasound image.

Introduction: Metastases to the thyroid are revealed at autopsy with a frequency of 2-24%; however, clinically they appear less frequently, at 0.1-3%. The aim of the study was analysis of the frequency of revealing metastases to the thyroid (TM) and to the regional lymph nodes (NM) (neoplasms other than primary thyroid tumours) in preoperative diagnostics of the thyroid in patients with positive (C+) and negative (C-) history of cancer; analysis of ultrasound (US) images of metastases.

New classification of thyroid FNAB results - a three-year observation from one clinic.

Introduction: Fine needle aspiration biopsy (FNAB) is the main examination in diagnostics of thyroid nodules. Yet, it does not allow the differentiation of follicular lesions (FL). A new classification of thyroid biopsy results (newC) might improve pre-operative diagnostics mainly due to the introduction of a new subcategory of 'follicular lesion of undetermined significance', as well as the clarification of definitions of other categories.

[Effect of subclinical hypothyroidism treatment on selected cardiovascular parameters].

Unlabelled: The impact of subclinical hypothyroidism (SH) on the cardiovascular system has not been well determined. Due to contradictory views on clinical consequences of SH there is no clear opinion on the indications for treatment of this disorder. The aim of study was to analyse the L-thyroxin therapy effect on normalization of cardiac irregularities in patients with SH observed in physical, electrocardiographic (at rest and 24-hour) and echocardiographic examinations.

[The incidence of hypothyroidism symptoms and risk factors for cardiovascular events in subclinical hypothyroidism].

Unlabelled: The clinical significance of subclinical hypothyroidism (SH) has not been determined. There are different opinions with regard to symptoms and clinical consequences of SH as well as effectiveness of treatment. Aim of study was the analysis of incidence of hypothyroidism symptoms and selected cardiovascular risk factors in patients with SH in comparison to euthyroid individuals and the evaluation of the effect of treatment of SH on the above parameters.

Repeat FNA Significantly Lowers Number of False Negative Results in Patients with Benign Nodular Thyroid Disease and Features of Chronic Thyroiditis.

Purpose. The aim of the study was to compare the risk of thyroid malignancy and efficacy of repeat FNA in patients with thyroid nodules diagnosed cytologically as benign lesion (BL) with features of chronic thyroiditis (BL-CT) and BL without CT features (BL-nCT). Methods.

Usefulness of PTH measurements in FNAB washouts in the identification of pathological parathyroids--analysis of the factors that influence the effectiveness of this method.

Introduction: The aim of this investigation was to assess the usefulness of the measurement of PTH concentration in the material obtained during FNAB (PTH-FNAB) in the identification of pathological parathyroids in patients with frequently coexisting thyroid abnormalities (nodular goitre, chronic thyroiditis, previous thyroidectomy). Additionally, the influence of the size of goitre, parathyroid localisation and size on the results of PTH-FNAB measurement was examined.

Material And Methods: Fifty patients with primary hyperparathyroidism and sonographically detected focal lesion that was suggestive of parathyroid gland were included in this study.

Low malignancy risk of thyroid follicular lesion of undetermined significance in patients from post-endemic areas.

Objective: New classification of the thyroid fine-needle aspiration biopsy (FNAB) results tries to stratify the risk of malignancy of thyroid follicular lesions using 'follicular lesion of undetermined significance' (FLUS) subcategory. Clinical significance of this category in the endemic (or post-endemic) areas has not been clearly established.

Design: The aim of the study was to determine the risk of malignancy for FLUS as well as to evaluate ultrasound (US) malignancy risk features (MRF) in such nodules in comparison with 'suspicious for neoplasm' (SFN) and 'benign lesions' (BL).

The influence of fine-needle aspiration biopsy of the thyroid gland on the size of the examined nodule and its ultrasound image.

Introduction: The aim of the study was to assess the influence of thyroid fine-needle aspiration biopsy (FNAB) on the size and ultrasound (US) features of the lesions and to examine whether the possible effects are persistent.

Material And Methods: One hundred and fifty biopsied and 50 control thyroid nodules underwent two US examinations, 10-20 days and 8-10 weeks after the biopsy. The study took into account lesion volume alterations, both absolute and relative (with reference to its initial value), and the presence of US features of malignancy: hypoechogenicity, microcalcifications, internal blood flow, irregular or blurred margins and suspicious shape of the lesions.

E-cadherin expression is more associated with histopathological type of thyroid cancer than with the metastatic potential of tumors.

The aim of this study was to evaluate the relationship between abnormal expression of E-cadherin (E-CAD) and the extracapsular extension of tumors, lymph node involvement and the presence of metastasis in various types of thyroid cancers. Histopathological specimens of 35 benign thyroid lesions and 122 malignant tumors (papillary, follicular, poorly differentiated and undifferentiated cancers) were analyzed. E-CAD immunostaining intensity, its subcellular localization, homogeneity within lesion, and the relation of staining intensity between tumor and surrounding thyroid parenchyma were evaluated.

The recurrent goitre unusually located near the hyoid bone.

Introduction: Recurrent goitre is a significant clinical problem among patients who have been operated due to benign lesions. An atypical localization of recurrent goitre - near the hyoid bone - poses additional difficulties as there are no data available on the clinical significance of such lesions. The aim of this study was to analyze if this unusual localization of recurrence is related to any significant differences in the clinical course, and if it significantly increases the risk of thyroid neoplasm.

The usefulness of sonographic features in selection of thyroid nodules for biopsy in relation to the nodule's size.

Objective: To evaluate the efficacy of selected ultrasound (US) features of thyroid focal lesions useful for establishing indications for fine-needle aspiration biopsy (FNAB) with regard to the lesion's size.

Methods: US imaging features of 1141 thyroid nodules (shape, echogenicity, pattern of blood flow, presence of microcalcifications and the presence of other nodules in the thyroid) and their palpability were compared with the post-operative histopathological outcomes. The efficacy of the selected sets of the features was assessed for small nodules (SN)< or =15 mm and large nodules (LN)>15 mm, as well as separately for nodules< or =10 mm.

The fine-needle aspiration biopsy efficacy of small thyroid nodules in the area of recently normalized iodine supply.

Objective: To evaluate the incidence of focal lesions in the thyroid in the area of recently normalized iodine supply as well as to compare the efficacy of fine-needle aspiration biopsy (FNAB) of small (infracentimetric) and large thyroid lesions in this area.

Methods: The outcomes of 13,646 ultrasound (US) examinations, 13,437 US-guided FNABs of the thyroid and 1694 results of post-operative histopathological examinations were analysed.

Results: Infracentimetric nodules (INs < or = 10 mm) were revealed by US examinations in 43.

[Chronic thyroiditis--current issue in the cytological diagnostics of the thyroid gland].

Introduction: Lowered and non-homogenous echogenicity in patients with chronic thyroiditis (CT) may cause problems in revealing focal lesions in ultrasound scans. Moreover, frequent anisocytosis of thyroid follicular cells and of oncocytes may falsely suggest neoplastic growth. The aim of the study was to evaluate the frequency of CT diagnosed in patients subjected to fine-needle aspiration biopsy (FNAB) of the thyroid in years 1994-2005, as well as to assess the cancer frequency in the operated patients with CT.