Cargando…
Introducing a Pole Concept for Nodule Growth in the Thyroid Gland: Taller-than-Wide Shape, Frequency, Location and Risk of Malignancy of Thyroid Nodules in an Area with Iodine Deficiency
Purpose: (i) To examine the criterion taller-than-wide (TTW) for the sonographic assessment of thyroid nodules in areas of iodine deficiency in terms of frequency, anatomical distribution within the thyroid gland and risk of malignancy. (ii) To develop a model for nodule growth in the thyroid gland....
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104008/ https://www.ncbi.nlm.nih.gov/pubmed/35566675 http://dx.doi.org/10.3390/jcm11092549 |
_version_ | 1784707689730801664 |
---|---|
author | Petersen, Manuela Schenke, Simone A. Zimny, Michael Görges, Rainer Grunert, Michael Groener, Daniel Seifert, Philipp Stömmer, Peter E. Kreissl, Michael C. Stahl, Alexander R. |
author_facet | Petersen, Manuela Schenke, Simone A. Zimny, Michael Görges, Rainer Grunert, Michael Groener, Daniel Seifert, Philipp Stömmer, Peter E. Kreissl, Michael C. Stahl, Alexander R. |
author_sort | Petersen, Manuela |
collection | PubMed |
description | Purpose: (i) To examine the criterion taller-than-wide (TTW) for the sonographic assessment of thyroid nodules in areas of iodine deficiency in terms of frequency, anatomical distribution within the thyroid gland and risk of malignancy. (ii) To develop a model for nodule growth in the thyroid gland. Methods: German multicenter study consisting of two parts. In the prospective part, thyroid nodules were sonographically measured in all three dimensions, location within the thyroid gland and contact to a protrusion-like formation (horn) in the dorsal position of thyroid gland was noted. In addition, further sonographic features such as the composition, echogenity, margins and calcifications were investigated. All nodules from the prospective part were assessed for malignancy as part of clinical routine at the decision of the treating physician adhering to institutionally based algorithms. In the retrospective part, only nodules with fine needle aspiration and/or histology were included. The risk of malignancy in TTW nodules was determined by correlating them with cyotological and histological results. Results: Prospective part: out of 441 consecutively evaluated thyroid nodules, 6 were found to be malignant (1.4%, 95% CI 0.6–2.7%). Among the 74 TTW nodules (17%), 1 was malignant (1%, 95% CI 0–4%). TTW nodules were more often located in the dorsal half of the thyroid than non-TTW nodules (factor 2.3, p = 0.01, 95% CI 2.1–2.5) and more often located in close proximity to a horn than non-TTW nodules (factor 3.0, p = 0.01, 95% CI 2.4–3.8). Retrospective part: out of 1315 histologically and/or cytologically confirmed thyroid nodules, 163 TTW nodules were retrieved and retrospectively analyzed. A TTW nodule was 1.7 times more often benign when it was dorsal (95% CI 1.1–2.5) and 2.5 times more often benign when it was associated with a horn (95% CI 1.2–5.3). The overall probability of malignancy for TTW nodules was 38% (95% CI 30–46%) in this highly preselected patient group. Conclusion: TTW nodules are common in iodine deficient areas. They are often located in the dorsal half of the thyroid gland and are frequently associated with a dorsal protrusion-like formation (horn) of the thyroid. Obviously, the shape of benign nodules follows distinct anatomical preconditions within the thyroid gland. The frequency of TTW nodules and their predominant benignity can be explained by a pole concept of goiter growth. The difference between the low malignancy risk of TTW nodules found on a prospective basis and the high risk found retrospectively may be the result of a positive preselection in the latter. |
format | Online Article Text |
id | pubmed-9104008 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91040082022-05-14 Introducing a Pole Concept for Nodule Growth in the Thyroid Gland: Taller-than-Wide Shape, Frequency, Location and Risk of Malignancy of Thyroid Nodules in an Area with Iodine Deficiency Petersen, Manuela Schenke, Simone A. Zimny, Michael Görges, Rainer Grunert, Michael Groener, Daniel Seifert, Philipp Stömmer, Peter E. Kreissl, Michael C. Stahl, Alexander R. J Clin Med Article Purpose: (i) To examine the criterion taller-than-wide (TTW) for the sonographic assessment of thyroid nodules in areas of iodine deficiency in terms of frequency, anatomical distribution within the thyroid gland and risk of malignancy. (ii) To develop a model for nodule growth in the thyroid gland. Methods: German multicenter study consisting of two parts. In the prospective part, thyroid nodules were sonographically measured in all three dimensions, location within the thyroid gland and contact to a protrusion-like formation (horn) in the dorsal position of thyroid gland was noted. In addition, further sonographic features such as the composition, echogenity, margins and calcifications were investigated. All nodules from the prospective part were assessed for malignancy as part of clinical routine at the decision of the treating physician adhering to institutionally based algorithms. In the retrospective part, only nodules with fine needle aspiration and/or histology were included. The risk of malignancy in TTW nodules was determined by correlating them with cyotological and histological results. Results: Prospective part: out of 441 consecutively evaluated thyroid nodules, 6 were found to be malignant (1.4%, 95% CI 0.6–2.7%). Among the 74 TTW nodules (17%), 1 was malignant (1%, 95% CI 0–4%). TTW nodules were more often located in the dorsal half of the thyroid than non-TTW nodules (factor 2.3, p = 0.01, 95% CI 2.1–2.5) and more often located in close proximity to a horn than non-TTW nodules (factor 3.0, p = 0.01, 95% CI 2.4–3.8). Retrospective part: out of 1315 histologically and/or cytologically confirmed thyroid nodules, 163 TTW nodules were retrieved and retrospectively analyzed. A TTW nodule was 1.7 times more often benign when it was dorsal (95% CI 1.1–2.5) and 2.5 times more often benign when it was associated with a horn (95% CI 1.2–5.3). The overall probability of malignancy for TTW nodules was 38% (95% CI 30–46%) in this highly preselected patient group. Conclusion: TTW nodules are common in iodine deficient areas. They are often located in the dorsal half of the thyroid gland and are frequently associated with a dorsal protrusion-like formation (horn) of the thyroid. Obviously, the shape of benign nodules follows distinct anatomical preconditions within the thyroid gland. The frequency of TTW nodules and their predominant benignity can be explained by a pole concept of goiter growth. The difference between the low malignancy risk of TTW nodules found on a prospective basis and the high risk found retrospectively may be the result of a positive preselection in the latter. MDPI 2022-05-01 /pmc/articles/PMC9104008/ /pubmed/35566675 http://dx.doi.org/10.3390/jcm11092549 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Petersen, Manuela Schenke, Simone A. Zimny, Michael Görges, Rainer Grunert, Michael Groener, Daniel Seifert, Philipp Stömmer, Peter E. Kreissl, Michael C. Stahl, Alexander R. Introducing a Pole Concept for Nodule Growth in the Thyroid Gland: Taller-than-Wide Shape, Frequency, Location and Risk of Malignancy of Thyroid Nodules in an Area with Iodine Deficiency |
title | Introducing a Pole Concept for Nodule Growth in the Thyroid Gland: Taller-than-Wide Shape, Frequency, Location and Risk of Malignancy of Thyroid Nodules in an Area with Iodine Deficiency |
title_full | Introducing a Pole Concept for Nodule Growth in the Thyroid Gland: Taller-than-Wide Shape, Frequency, Location and Risk of Malignancy of Thyroid Nodules in an Area with Iodine Deficiency |
title_fullStr | Introducing a Pole Concept for Nodule Growth in the Thyroid Gland: Taller-than-Wide Shape, Frequency, Location and Risk of Malignancy of Thyroid Nodules in an Area with Iodine Deficiency |
title_full_unstemmed | Introducing a Pole Concept for Nodule Growth in the Thyroid Gland: Taller-than-Wide Shape, Frequency, Location and Risk of Malignancy of Thyroid Nodules in an Area with Iodine Deficiency |
title_short | Introducing a Pole Concept for Nodule Growth in the Thyroid Gland: Taller-than-Wide Shape, Frequency, Location and Risk of Malignancy of Thyroid Nodules in an Area with Iodine Deficiency |
title_sort | introducing a pole concept for nodule growth in the thyroid gland: taller-than-wide shape, frequency, location and risk of malignancy of thyroid nodules in an area with iodine deficiency |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104008/ https://www.ncbi.nlm.nih.gov/pubmed/35566675 http://dx.doi.org/10.3390/jcm11092549 |
work_keys_str_mv | AT petersenmanuela introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT schenkesimonea introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT zimnymichael introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT gorgesrainer introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT grunertmichael introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT groenerdaniel introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT seifertphilipp introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT stommerpetere introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT kreisslmichaelc introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT stahlalexanderr introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency AT introducingapoleconceptfornodulegrowthinthethyroidglandtallerthanwideshapefrequencylocationandriskofmalignancyofthyroidnodulesinanareawithiodinedeficiency |