Artificial Intelligence for Pre-operative Diagnosis of Malignant Thyroid Nodules Based on Sonographic Features and Cytology Category.

Background: Current diagnosis and classification of thyroid nodules are susceptible to subjective factors. Despite widespread use of ultrasonography (USG) and fine needle aspiration cytology (FNAC) to assess thyroid nodules, the interpretation of results is nuanced and requires specialist endocrine surgery input. Using readily available pre-operative data, the aims of this study were to develop artificial intelligence (AI) models to classify nodules into likely benign or malignant and to compare the diagnostic performance of the models.

Preoperative serum calcitonin may improve initial surgery for medullary thyroid cancer in patients with indeterminate cytology.

Background: Medullary thyroid cancer (MTC) is rare, with poorer outcomes than differentiated thyroid cancer. We aimed to identify areas for improvement in the pre-operative evaluation of patients with possible MTC in a high-volume endocrine surgery unit in accordance with current practice guidelines. We hypothesised that the selective use of serum calcitonin (sCT) as a biomarker for possible MTC could guide the extent of initial surgical management.

Patient Reported Experience on Consenting for Surgery - Elective Versus Emergency Patients.

Introduction: Informed consent for surgery is a medical and legal requirement, but completing these does not necessarily translate to high patient satisfaction. This patient-reported experience study aimed to examine the surgical consent process, comparing the patients' experience in elective and emergency settings.

Methods: Over a 6-mo period, postoperative patients at The Alfred Hospital Breast and Endocrine Surgical Unit were invited to participate in a survey on the surgical consent process - including perceived priorities, information provided and overall experience.

Investigation of recurrent laryngeal palsy rates for potential associations during thyroidectomy.

Background: There are many clinical associations and potential mechanisms of injury resulting in recurrent laryngeal nerve palsy (RLNP) after thyroidectomy. One possible cause of RLNP is focal intralaryngeal compression of the recurrent laryngeal nerve (RLN), which may be associated with the tracheal tube (TT). Therefore, we examined current RLNP rates to investigate potential associations, including intralaryngeal, airway, anaesthetic and anthropometric factors.

Anti-Thyroid Antibodies and TSH as Potential Markers of Thyroid Carcinoma and Aggressive Behavior in Patients with Indeterminate Fine-Needle Aspiration Cytology.

Background: Indeterminate fine-needle aspiration cytology (FNAC) imposes challenges in the management of thyroid nodules. This study aimed to examine whether preoperative anti-thyroid antibodies (Abs) and TSH are indicators of thyroid malignancy and aggressive behavior in patients with indeterminate FNAC.

Methods: This was a retrospective study of thyroidectomy patients from 2008 to 2016.

Routine Preoperative Laryngoscopy for Thyroid Surgery Is Not Necessary Without Risk Factors.

Routine preoperative vocal cord (VC) assessment with laryngoscopy in patients undergoing thyroidectomy allows clear documentation of baseline VC function, aids in surgical planning in patients with palsies, and facilitates interpretation of intraoperative neuromonitoring (IONM) findings. We aimed to determine the incidence of preoperative vocal cord palsy (VCP); to evaluate the associated risk factors for preoperative VCP; and to calculate the cost-savings potential of implementing a selective approach. Patients with a pre-thyroidectomy VC assessment by fiberoptic laryngoscopy were retrospectively recruited from the Monash University Endocrine Surgery Unit database from 2000 to 2018.

Thyroidectomy Then and Now: A 50-Year Australian Perspective.

Background: Since the mid-1800s, thyroidectomy has transformed from a procedure associated with high to near-zero mortality. Nonetheless, surgeons must continue to strive to improve patient care. Using historical records and contemporary data, this study compares the practice and outcomes of thyroid surgery at a tertiary institution during two periods, 50 years apart.

Adrenal incidentaloma follow-up is influenced by patient, radiologic, and medical provider factors: A review of 804 cases.

Background: The majority of adrenal incidentalomas are benign, although some are large, functional, or malignant and may require surgery. Therefore all require follow-up. This study aimed to determine the pattern of adrenal incidentaloma follow-up in a level 1 trauma center, focusing on the factors that influence whether follow-up is facilitated.

Body weight change is unpredictable after total thyroidectomy.

Background: There is a common perception that total thyroidectomy causes weight gain beyond expected age-related changes, even when thyroid replacement therapy induces a euthyroid state. The aim of this study was to determine whether patients who underwent total thyroidectomy for a wide spectrum of conditions experienced weight gain following surgery.

Methods: We retrospectively studied 107 consecutive total thyroidectomy patients treated between January 2013 and June 2014.

Stressing the recurrent laryngeal nerve during thyroidectomy.

Background: In thyroidectomy, little has been reported on the differential recurrent laryngeal nerve (RLN) palsy rates between the left and right sides. Even less is known about the potential differences causing these differential rates. This study reports the left versus right RLN palsy rates of total thyroidectomy cases in a single institution, relating them to the comparative stiffness of the left and right porcine RLNs.

Differential recurrent laryngeal nerve palsy rates after thyroidectomy.

Introduction: Recurrent laryngeal nerve (RLN) palsy is a devastating complication of thyroidectomy. Although neurapraxia is thought to be the most common cause, the underlying mechanisms are poorly understood. The objectives of this study were to examine the differential palsy rates between the left and right RLNs, and the role of intraoperative nerve swelling as a risk factor of postoperative palsy.

The prevalence of thyroglossal tract thyroid tissue on SPECT/CT following (131) I ablation therapy after total thyroidectomy for thyroid cancer.

Objective: To determine the prevalence of thyroglossal tract thyroid tissue on SPECT/CT and to assess the contribution of this tissue to total neck radioactive iodine (RAI) activity in patients given (131) I ablation therapy after total thyroidectomy for thyroid cancer.

Patients And Methods: Eighty-three consecutive patients with thyroid cancer treated with total thyroidectomy underwent whole-body planar and SPECT/CT imaging of the neck following initial RAI ablation. On SPECT/CT, thyroglossal tract thyroid tissue was defined as RAI in the anterior neck, superior to the thyroid bed in close proximity to the midline without evidence of localization to lymph nodes.

Fine-needle aspiration of the thyroid: correlating suspicious cytology results with histological outcomes.

Purpose: Fine-needle aspiration cytology (FNAC) assists the diagnosis of thyroid malignancy. A 'suspicious for malignancy' on FNAC creates a management dilemma. The aims of this study were to investigate the malignancy rate for patients with suspicious cytology, and to describe a management approach for those with a suspicious result.

Anti-thyroid antibodies as a predictor of thyroid cancer.

Background: Recent literature has suggested an association between autoimmune thyroiditis and papillary thyroid cancer. The aims of this study were to evaluate if positive thyroid antibodies are associated with thyroid carcinoma and to examine the role of thyroid antibodies in the management of thyroid nodules.

Methods: This is a database study of all patients undergoing thyroidectomy with recorded preoperative thyroid antibodies (autoantibodies to thyroglobulin and/or thyroid peroxidase) levels from 2010 to 2012.