El gammagrama negativo con MIBI descarta cáncer diferenciado o medular de tiroides en 100% de los pacientes con nódulo tiroideo hipofuncional

Revista de Endocrinología y Nutrición 01/2008; 16:32-35.
1 Follower
34 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Reporting schemes for thyroid fine-needle aspirations in the literature were reviewed and classified according to the number of categories in the scheme and the significance of each category. The sensitivity, specificity, and positive predictive and negative values were determined for each scheme, if possible. A reporting scheme based on the probability of finding carcinoma on histology is proposed.
    Diagnostic Cytopathology 01/2006; 34(1):67-76. DOI:10.1002/dc.20400 · 1.12 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fine-needle aspiration biopsy (FNAB) and frozen-section analysis of managing solitary thyroid nodules continue to generate considerable controversy. This study was a retrospective review of 619 patients with solitary thyroid nodules who underwent thyroidectomy. Of 540 FNABs, 35 (6.5%) were positive for malignancy, 276 (51.1%) were benign, and 229 (42.4%) were suspicious. Only 5.1% were false negative, and 11.4% were false positive. Diagnostic FNAB sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for malignancy were 86.1%, 59.7%, 33.0%, 94.9%, and 64.6%, respectively. Of 569 patients analyzed by frozen section, diagnosis was deferred in 86 (15.1%) patients, and results were positive for malignancy in 92 (16.2%) and benign in 391 (68.7%). No false-positive results were noted, but 2.3% (391) were false negative. Of 86 deferred frozen sections, 11 (12.8%) patients had malignant tumors confirmed by permanent section. Diagnostic frozen-section sensitivity, specificity, PPV, NPV, and accuracy for carcinoma were 82.1%, 100%, 100%, 95.8%, and 96.5%, respectively. Sensitivity, specificity, PPV, NPV, and accuracy for frozen-section analysis for diagnosis of carcinoma in patients with suspicious FNAB were 83.9%, 100%, 100%, 94.9%, and 96.0%, respectively. FNAB is a sensitive diagnostic modality in selecting patients who require surgery. Routine use of frozen-section analysis is unwarranted for benign FNAB results. Frozen section is specific and cost-effective in determining the extent of surgery in patients with suspicious or malignant FNABs.
    Annals of Surgical Oncology 03/2007; 14(2):712-8. DOI:10.1245/s10434-006-9083-z · 3.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Thyroid nodules are common, with an estimated incidence of 5%-10% in the United States. The current gold standard for diagnosis is fine needle aspiration biopsy (FNAB). The incidence of indeterminate diagnoses varies from 10% to 25%. Surgical resection is usually indicated to exclude the diagnosis of cancer in these patients. However, only a minority (about 20%) of indeterminate thyroid nodules actually harbor a malignancy, resulting in surgery for diagnostic purposes alone in many patients. The increased detection of benign nodules and microcarcinomas reinforces the need for improved non-operative methods to differentiate benign from malignant disease and discriminate low-risk from high-risk cancers. In this article we present a current, rational diagnostic approach to the patient with a thyroid nodule, evaluate new advances including thyroid genomic and predictor models, and propose the development of prospective trials to incorporate these new additions into clinical decision making. Given how many questions still exist for patients with thyroid nodules, partnership and collaboration, or the "bench to bedside" concept should find its way into most every thyroid surgeon and endocrinologist's lexicon.
    Journal of Surgical Oncology 12/2006; 94(8):649-61. DOI:10.1002/jso.20701 · 3.24 Impact Factor
Show more


34 Reads
Available from