• Korean Journal of Radiology
• /
• 제24권1호
• /
• pp.22-30
• /
• 2023

Ultrasonography (US) is a primary imaging modality for diagnosing nodular thyroid disease and has an essential role in identifying the most appropriate management strategy for patients with nodular thyroid disease. Standardized imaging techniques and reporting formats for thyroid US are necessary. For this purpose, the Korean Society of Thyroid Radiology (KSThR) organized a task force in June 2021 and developed recommendations for standardized imaging technique and reporting format, based on the 2021 KSThR consensus statement and recommendations for US-based diagnosis and management of thyroid nodules. The goal was to achieve an expert consensus applicable to clinical practice.

• 대한두경부종양학회지
• /
• 제18권2호
• /
• pp.168-172
• /
• 2002

Objectives: This study was done to determine the diagnostic efficacy of fine needle aspiration cytology (FNA), frozen section biopsy (FSx) and ultrasonography in a palpable thyroid mass. Materials and Methods: During the period from July 1999 to March 2002, the medical records of 98 patients who underwent a thyroidectomy for thyroid mass, at the Department of Surgery, Chonbuk National University Hospital, were reviewed retrospectively. Ninety eight cases were classified according to whether the FNA cytological diagnosis inadequate, benign, suspicious, or malignant and the FSx diagnosis benign or malignant and the ultrasonographic examination was benign, suspicious, or malignant. The diagnostic correlations of ultrasonography, FNA cytology, frozen section, and both FNA cytology and frozen section with definite histologic diagnosis were evaluated. Results: According to the FNA cytological interpretation, 76 cases were diagnosed as benign, 6 cases suspicious, 13 cases malignant, and 3 cases inadequate. The sensitivity and specificity for FNA were 86.3% and 95.9% and for FSx 95.5% and 100% respectively. The diagnostic accuracy of FNA and FSx were 93.5% and 98.9% respectively. Based on a definite histologic diagnosis, the ultrasonographic examination had a sensitivity and a specificity of 77.2% and 78.9%. Conclusion: The results confirm that FNA cytology is a reliable and useful tool in the initial evaluation of a palpable thyroid mass compared to the ultrasonographic examination. Intraoperative FSx is a valuable diagnostic procedure to confirm the cytological diagnosis with undetermined or unsatisfactory cytological diagnosis.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권23호
• /
• pp.10307-10311
• /
• 2015

Background: The Bethesda System for Reporting Thyroid Cytopathology is one of the main classification systems for thyroid nodules. It expects that 7% of all fine needle aspiration biopsies will be reported as atypia or follicular lesions of undetermined significance, and 5-15% of these undetermined nodules are malignant. Our study is a retrospective analysis of variables that may be associated with outcome in patients with indeterminate thyroid nodules. Materials and Methods: Patients who underwent thyroidectomy in our institution between 2010 and 2014 were retrieved from the institutional records database. Patient demographics and medical histories were recorded. All ultrasonography reports were examined for nodule features and biochemical blood levels, hormone levels and complete blood counts were recorded. Results: A total of 103 patient cytopathology reports were regarded as belonging to the undetermined category. Some 35% of patients had malignant nodules. Median preoperative red cell distribution width (RDW) level was 13.6 inthe benign group, while it was 14.3 in patients with malignancy, demonstrating a significant correlation (p=0.003). Only calcification presence was significantly different between benign and malignant groups on ultrasonography (p=0.034). Conclusions: Ultrasonography is one of the primary tools for this matter. RDW levels may become another promising tool to predict malignancy.

• 대한영상의학회지
• /
• 제81권5호
• /
• pp.1250-1254
• /
• 2020

미만성 경화 변종 갑상선 유두암은 갑상선 유두암의 드문 변종이다. 저자들은 통증을 동반하지 않은 미만성 갑상선 비대를 보였던 9세 여자 환아에서 발생한 미만성 경화 변종 갑상선 유두암의 드문 증례에 대해 보고하고자 한다. 환아는 갑상선 과산화효소 항체에 양성이었고, 처음에는 하시모토 갑상선염으로 진단받았다. 하지만 갑상선 초음파 상에서 미만성 경화 변종 갑상선 유두암의 특징적인 초음파 소견을 보였고, 수술 후 미만성 경화 변종 갑상선 유두암으로 확진되었다. 비록 소아에서 갑상선암은 드물지만 갑상선 비대를 보일 때 미만성 경화 변종 갑상선 유두암의 가능성을 고려해야 한다. 또한 초음파를 시행함으로써 갑상선암의 진단이 지연되는 것을 막을 수 있다.

• 대한두경부종양학회지
• /
• 제29권2호
• /
• pp.37-40
• /
• 2013

Background and Objectives : To assess the usefulness of computed tomography image before papillary thyroid cancer surgery, focus on confirmation of lateral cervical lymph node metastasis not detected by ultrasonography. Material and Methods : From January 2008 to May 2009, total 150 patients who had undergone thyroid surgery and been confirmed papillary thyroid cancer pathologically were enrolled. They had taken neck computed tomography following the ultrasonography. Results : Computed tomography had found suspicious metastatic lateral neck lesion in 13 patients. After the image study, lateral neck lymph node dissection had been included in their surgical plan. Of these, only 7 cases were confirmed pathologically lateral neck lymph node metastasis(positive predictive value=0.54). Taken as whole 150 patients, additionally 4.7% of patients confirmed lateral neck lymph node metastasis by preoperative computed tomography. Conclusion : If preoperative ultrasonography was performed precisely, additional benefits that could be achieved by computed tomography were not much.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권2호
• /
• pp.935-940
• /
• 2013

Background: To evaluate the diagnostic utility of conventional ultrasonography and real time ultrasound elastography in differentiating degenerating cystic thyroid nodules mimicking malignancy from papillary thyroid carcinoma. Methods: We retrospectively analyzed conventional ultrasonographic and elastographic characteristics of 19 degenerating cystic thyroid nodules mimicking malignancy in 19 patients, with 30 surgically confirmed PTCs as controls. Based on size, the nodules had been grouped into less than 10mm (group A) and greater than 10 mm (group B). We evaluated conventional parameters and elasticity pattern. Color-scaled elastograms were graded as to stiffness of nodules using an elasticity pattern from I (soft) to IV (stiff). Results: Degenerating cystic thyroid nodules were similar to PTCs in conventional ultrasonographic findings, but the former frequently showed oval to round in shape (group A, 69.2% vs 18.8%, P=0.017; group B, 66.7% vs 7.14%, P=0.017) and punctuate hyperechoic foci (group A, 61.5% vs 0, P<0.001; group B, 50% vs 0, P<0.001). On real time ultrasound elastography, 7 of 13 degenerating cystic thyroid nodules in group A were pattern I, 5 were pattern II, 1 was pattern III. One degenerating cystic thyroid nodule in group B was pattern II, 5 were pattern III. The area under the curve for elastography was 0.98 in group A (sensitivity 92.3%, specificity 100%, P = 0.002), and 0.88 in group B (sensitivity 16.7%, specificity 100%, P = 0.014). Conclusions: As a dependable imaging technique, elastography helps increase the performance in differential diagnosis of degenerating cystic thyroid nodule and malignancy.

• 대한영상의학회지
• /
• 제81권5호
• /
• pp.1164-1174
• /
• 2020

목적 수술 전 초음파 검사에서 갑상선 종양의 재발을 예측할 수 있는 심층 학습 모델을 개발하고자 한다. 대상과 방법 수술 전 초음파에서 병리학적으로 확진된 갑상선 수술을 받은 229명의 환자(남성:여성 = 42:187, 평균 연령, 49.6세)의 대표적인 초음파 이미지를 포함시켰다. 각각 대표적인 횡축 또는 종축 초음파 이미지가 선택되었다. 신경 네트워크용 Python 2.7.6 및 Keras 2.1.5, convolutional neural network을 사용한 심층 학습이 사용되었다. 재발한 환자와 재발이 없는 환자의 임상 및 조직학적 특징을 비교하였다. 그룹 간의 심층 학습 모델의 receiver operating characteristic curve 곡선 아래의 영역은 재발 갑상선암을 예측하기 위한 심층 학습 모델의 예측에 사용되었다. 결과 전체 환자 229명 중 49명이 종양 재발(21.4%)을 보였다. 종양의 크기, 다원성은 재발이 없는 군과 재발 군에서 유의한 차이가 있었다(p < 0.05). 재발성 갑상선암 예측을 위한 심층 학습 모델의 전반적인 평균 area under the curve (이하 AUC) 값은 0.9 ± 0.06이었다. 평균 AUC는 macrocarcinoma에서 0.87 ± 0.03, microcarcinoma에서 0.79 ± 0.16이었다. 결론 갑상선암의 초음파 이미지를 이용한 심층 학습 모델로 갑상선암 재발의 예측 모델 구축의 가능성을 보여주었다.

• 대한기관식도과학회지
• /
• 제7권2호
• /
• pp.168-173
• /
• 2001

Background and Objectives： The introduction of highly sensitive imaging techniques has made it possible to detect many non-palpable nodules, or“incidentaloma”in the thyroid. Discovery of these lesions raises concerns about their malignancy, but the optimal strategy for managing these lesions has not been clearly established. This study was designed to evaluate the usefulness of ultrasonographic exam with new diagnostic criteria and presume the value of mass screening for thyroid cancer. Materials and Methods : Mass screening for thyroid cancer were carried out in conjunction with mass screening for breast cancer. The subjects were 630 women aged 30 years or over. Thyroid glands were examined with 10 MHz transducer ultrasonography by one radiologist. Needle aspiration biopsy were performed when suspicious of malignancy under the new diagnostic criteria. Results and Conclusion : The new ultrasonographic criteria to diagnose thyroid cancer provided useful information and ensured more accurate evaluation. 7 cases of thyroid cancer were discovered and successfully managed. It should be further demonstrated that there is sufficient value of mass screening for thyroid cancer to perform it independently despite early cancer detection.

• Investigative Magnetic Resonance Imaging
• /
• 제19권4호
• /
• pp.224-230
• /
• 2015

Purpose: To determine whether we should recommend ultrasonography (US) for an incidental thyroid nodule identified by additional cervicothoracic sagittal T2-weighted image (C-T sag T2WI) of lumbar spine magnetic resonance imaging (MRI). Materials and Methods: A retrospective study of 61 patients who underwent both lumbar spine MRI and thyroid US between December 2011 and April 2015 was conducted. For all US-found thyroid nodules > 1 cm, investigators evaluated whether there was any correlation between thyroid nodule detectability by C-T sag T2WI and US features such as echogenicity, composition, or suspicion of malignancy. Results: Solid hypoechoic (2/4; 50%) or mixed echoic nodules (4/8; 50%) appeared to be found relatively more easily by C-T sag T2WI than more benign-looking solid isoechoic (1/4; 25%) or spongiform nodules (0/6; 0%). Among six nodules with ultrasonographic suspicion for malignancy, only one nodule was detected by C-T sag T2WI. Conclusion: If an incidental thyroid nodule is seen by C-T sag T2WI, it would be better to recommend thyroid US for identifying malignancy.

• 대한영상의학회지
• /
• 제84권1호
• /
• pp.92-109
• /
• 2023

갑상선 결절 환자에서 초음파 검사는 일차적 영상 진단법으로 정립되어 있으며 치료 결정을 위한 핵심적인 진단 역할을 갖는다. Korean Thyroid Imaging Reporting and Data System(이하 K-TIRADS)는 초음파 유형에 기초한 암 위험도 분류체계로서 실시간 초음파 검사를 시행하면서 쉽게 결절 진단이 가능하다는 장점을 갖고 있다. 개정된 2021 K-TIRADS는 결절의 초음파 분류 기준을 보다 명확히 하였고, 고위험 갑상선암의 의심 소견이 없는 환자에서 병리진단검사를 결정하는 결절 크기 기준을 개정하여 불필요한 병리진단검사를 최소화하고 적절한 갑상선암 진단 예민도가 유지되도록 개정하였다. 갑상선영상의학진료는 갑상선 결절 환자의 진단 및 비수술적 치료를 수행하는 중요한 임상적 역할을 가지고 있으며, 적절한 환자 진료를 위해서는 표준적 진료 지침에 근거하여 진료가 수행되어야 한다.