Publications (14)25.98 Total impact
-
Article: Ultrasound-Based Diagnosis for Solid Thyroid Nodules with the Largest Diameter <5 mm.
[show abstract] [hide abstract]
ABSTRACT: This study was aimed at assessing the efficacy of using an ultrasound (US)-based classification system to diagnose solid thyroid nodules with the largest diameter <5 mm (i.e., small solid nodules). For 406 small solid nodules in 365 patients who underwent thyroid US and US-guided fine-needle aspiration, each thyroid nodule was prospectively classified into one of five diagnostic categories: benign, probably benign, borderline, possibly malignant and malignant. Of 406 nodules, 145 were surgically removed: 95 papillary thyroid carcinomas, 1 follicular thyroid carcinoma, 1 poorly differentiated carcinoma, 3 pseudonodules related to thyroiditis and 45 nodular hyperplasias. On the basis of the histopathologic results, the diagnostic accuracies of US diagnosis and cytologic diagnosis were similar, but the sensitivity of US diagnosis was higher than that of cytologic diagnosis, and the specificity and positive predictive values of US diagnosis were lower those of cytologic diagnosis. An US-based classification system may be helpful for the diagnosis and management of small solid nodules.Ultrasound in medicine & biology 04/2013; · 2.02 Impact Factor -
Article: Author response to Rosario PW.
[show abstract] [hide abstract]
ABSTRACT: na.Thyroid: official journal of the American Thyroid Association 03/2013; · 2.60 Impact Factor -
Article: Comparison of sample adequacy, pain-scale ratings, and complications associated with ultrasound-guided fine-needle aspiration of thyroid nodules between two radiologists with different levels of experience.
[show abstract] [hide abstract]
ABSTRACT: This study aimed to assess and compare the sample adequacy, patient pain ratings, and complications associated with ultrasound-guided fine-needle aspiration of thyroid nodules between two radiologists with different levels of experience. From March 2012 to May 2012, two radiologists performed ultrasound-guided fine-needle aspiration to diagnose thyroid nodules in consecutive patients using the same techniques. 157 patients were divided into two groups: group 1 consisted of 75 patients who underwent ultrasound-guided fine-needle aspiration by an experienced radiologist and group 2 consisted of 82 patients who underwent ultrasound-guided fine-needle aspiration by a less experienced radiologist. The sample adequacy, pain-scale ratings, and complications related to ultrasound-guided fine-needle aspiration were compared between the two groups. There was no statistical difference in sex, age, nodule size, or location between the two groups. There was no statistical difference (p = 0.710) in the prevalence of adequate cytology between group 1 (94.7 % [71/75]) and group 2 (96.3 % [79/82]). The mean ± standard deviation of pain-scale ratings was 1.99 ± 1.68 in group 1 and 2.30 ± 1.83 in group 2, but there was no statistical difference (p = 0.326). There were no significant complications related to the procedure and no sonographic changes on follow-up ultrasound for either group. The study results demonstrated good outcomes for ultrasound-guided fine-needle aspiration of thyroid nodules and no statistically significant differences in sample adequacy, pain-scale ratings, or complication rates between two radiologists with different levels of experience.Endocrine 02/2013; · 1.42 Impact Factor -
Article: Solid and Isoechoic Thyroid Nodules Without Malignant Sonographic Features: Comparison of Malignancy Rate According to Nodule Size, Shape and Color Doppler Pattern.
[show abstract] [hide abstract]
ABSTRACT: This study aimed to assess the malignancy rate of solid and isoechoic thyroid nodules without malignant sonographic features (SITNs) and to compare the malignant and benign SITNs according to nodule size, shape and color Doppler pattern. Of 382 SITNs with the largest diameter ≥10 mm, nodule size, nodule shape (i.e. spherical vs. ovoid) and color Doppler pattern (i.e. scant, peripheral, central, and mixed type) of each nodule were retrospectively evaluated. A total of 114 SITNs were histopathologically confirmed by surgery (called surgical SITN) and the malignancy rate of surgical SITNs was 8.8% (10/114). There was no statistical association between the incidence of malignancy of SITNs and nodule size but the malignancy rate of spherical SITNs was higher than that of ovoid SITNs. A significant relationship between peripheral vascularity of SITNs and benignity was found but the other vascularity patterns showed no significant association with malignancy or benignity of SITNs.Ultrasound in medicine & biology 12/2012; · 2.02 Impact Factor -
Article: Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules Measuring Less than 5 mm: Effects on Specimen Adequacy and Diagnosis.
[show abstract] [hide abstract]
ABSTRACT: Objective: We aimed to assess the adequacy and efficacy of ultrasound (US)-guided fine-needle aspiration (US-FNA) for small solid thyroid nodules (SSTNs) with the largest diameter <5 mm and compared these according to nodule size. Study Design: Among 656 SSTNs in 569 patients, each SSTN was classified into 1 of 4 groups according to the largest diameter: 1 mm ≤ group A < 2 mm; 2 mm ≤ group B < 3 mm; 3 mm ≤ group C < 4 mm, and 4 mm ≤ group D < 5 mm. We compared the adequacy and efficacy of US-FNA between these groups using histopathologic results as a reference standard. Results: 571 (87.0%) SSTNs were adequately sampled by US-FNA and 200 of these were histopathologically confirmed. The adequacy of US-FNA for SSTNs varied according to the nodule diameter: the smaller the nodule diameter, the lower the diagnostic adequacy. The diagnostic efficacy of US-FNA for SSTNs showed a significant relationship with nodule size: diagnostic efficacy in groups A and B was lower than in groups C and D. Conclusions: The adequacy of US-FNA for SSTNs tended to decrease with decreased nodule size, and diagnostic efficacy of US-FNA for SSTNs with the largest diameter <3 mm was lower than for those ≥3 mm.Acta cytologica 12/2012; 57(1):38-44. · 0.49 Impact Factor -
Article: Color Doppler Features of Solid, Round, Isoechoic Thyroid Nodules without Malignant Sonographic Features: A Prospective Cytopathological Study.
[show abstract] [hide abstract]
ABSTRACT: Background: No study has examined the malignancy rate and color Doppler pattern of solid, round, isoechoic thyroid nodules without coexistent malignant sonographic features (i.e., SRINs). We aimed to assess the cytopathological results and color Doppler patterns of SRINs through a prospectively designed study. Methods: Between January and December 2010, 727 patients underwent consecutive ultrasound (US)-guided fine-needle aspiration (US-FNA), and twenty-seven patients who had SRINs with the largest diameter ≥5 mm were prospectively selected. Twenty-seven patients who had SRINs with the largest diameter ≥5 mm at US were enrolled in the study. The color Doppler pattern of each nodule was classified into 1 of 4 categories: scant, peripheral, central, or mixed type. Results: Out of 27 SRINs, 14 were histopathologically confirmed, and 13 were non-surgically diagnosed by 2 consecutive US-FNAs. Among the 14 surgical SRINs, there were 7 papillary thyroid carcinomas, 2 follicular adenomas, and 5 nodular hyperplasias. All 13 non-surgical SRINs were finally determined to be benign on the basis of results of US-FNAs and/or long-term US follow-up, and thus, the malignancy rate of the SRINs was 25.9% (7/27). There was no significant correlation between color Doppler pattern and malignancy rate of SRINs. Conclusion: We recommend that US-FNA should be performed for SRIN to rule out malignancy, regardless of its color Doppler pattern.Thyroid: official journal of the American Thyroid Association 10/2012; · 2.60 Impact Factor -
Article: Diagnostic value of antithyroid peroxidase antibody for incidental autoimmune thyroiditis based on histopathologic results.
[show abstract] [hide abstract]
ABSTRACT: Detection of antithyroid peroxidase antibody (TPOAb) is widely used in the diagnosis of autoimmune thyroiditis (AIT), but no research has evaluated the diagnostic accuracy of TPOAb detection using histopathologic reference standards. To fill this research gap, this study assessed the diagnostic accuracy of detection of TPOAb and that of other serological markers in asymptomatic patients who had been diagnosed with AIT by histopathologic analysis after thyroid surgery. After review of patient records, 598 patients who had undergone thyroid nodule surgery were enrolled for examination for thyroid parenchyma by a pathologist and classification into no co-existing lymphocytic thyroiditis, Hashimoto thyroiditis, or non-Hashimoto type of lymphocytic thyroiditis (NHLT). The correlation between patient serological data and thyroid parenchyma pathology was analyzed. Statistically significant differences (P < 0.05) were found between co-existing lymphocytic thyroiditis and no co-existing lymphocytic thyroiditis groups regarding thyroid-stimulating hormone (TSH) and TPOAb levels. And, TPOAb titer was significantly associated with the degree of inflammation. An abnormal TPOAb titer was found in 86 of the 598 patients (14.4 %) and the specificity of TPOAb detection for AIT diagnosis was found to be 96.9 %. The prevalence of Hashimoto thyroiditis and NHLT in the 560 papillary thyroid cancer (PTC) patients was found to be 7.9 and 17.9 %, respectively. The results indicate that TPOAb titer is associated with the degree of thyroid inflammation and that detection of TPOAb is a very specific means of diagnosing AIT. The results also indicate that the incidence of AIT and PTC coexistence is relatively high.Endocrine 05/2012; · 1.42 Impact Factor -
Article: Role of ultrasound diagnosis in assessing and managing thyroid nodules with inadequate cytology.
[show abstract] [hide abstract]
ABSTRACT: This study aimed to assess the diagnostic accuracy of a specific ultrasound classification system in evaluating thyroid nodules with inadequate cytology, defined as a cytologic result that shows insufficient cellularity and does not provide useful information. Ultrasound diagnoses were made in accordance with a specially devised ultrasound classification system. From January 2008 to December 2009, 1036 patients with 1289 thyroid nodules (largest diameter ≥ 5 mm) diagnosed by ultrasound and subsequent ultrasound-guided fine-needle aspiration (FNA) were enrolled in the study. Each thyroid nodule was prospectively classified on the basis of its ultrasound features by a single radiologist into one of five diagnostic categories: benign, probably benign, borderline, possibly malignant, or malignant. Solid nodules were classified using all five categories, whereas partially cystic thyroid nodules were classified using four (borderline was omitted). Repeated ultrasound-guided FNA was performed on all nodules for which the initial ultrasound-guided FNA revealed inadequate cytology. Of 96 nodules with inadequate cytology (96/1289, 7.4%), 22 were surgically removed, and the ultrasound diagnoses and cytopathology results of all 96 were compared. A borderline ultrasound diagnosis was assigned to 13 nodules. The sensitivity, specificity, positive and negative predictive values, and accuracy were calculated for all nodules excluding all the borderline nodules (100%, 95.1%, 33.3%, 100%, and 95.2%, respectively) and with four borderline nodules reclassified as benign (100%, 95.3%, 33.3%, 100%, and 95.4%, respectively). The values obtained with these approaches were not significantly different (p > 0.05). The selective use of repeated ultrasound-guided FNA for nodules with initial inadequate cytology may be preferable to its unconditional use depending on the ultrasound diagnoses of thyroid nodules.American Journal of Roentgenology 11/2011; 197(5):1213-9. · 2.78 Impact Factor -
Article: Differentiation between benign and malignant solid thyroid nodules using an US classification system.
[show abstract] [hide abstract]
ABSTRACT: To evaluate the diagnostic accuracy of a new ultrasound (US) classification system for differentiating between benign and malignant solid thyroid nodules. In this study, we enrolled 191 consecutive patients who received real-time US and subsequent US diagnoses for solid thyroid nodules, and underwent US-guided fine-needle aspiration. Each thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by real-time US: "malignant," "suspicious for malignancy," "borderline," "probably benign," and "benign". We evaluated the diagnostic accuracy of thyroid US and the cut-off US criteria by comparing the US diagnoses of thyroid nodules with cytopathologic results. Of the 191 solid nodules, 103 were subjected to thyroid surgery. US categories for these 191 nodules were malignant (n = 52), suspicious for malignancy (n = 16), borderline (n = 23), probably benign (n = 18), and benign (n = 82). A receiver-operating characteristic curve analysis revealed that the US diagnosis for solid thyroid nodules using the 5-category US classification system was very good. The sensitivity, specificity, positive and negative predictive values, and accuracy of US diagnosis were 86%, 95%, 91%, 92%, and 92%, respectively, when benign, probably benign, and borderline categories were collectively classified as benign (negative). The diagnostic accuracy of thyroid US for solid thyroid nodules is high when the above-mentioned US classification system is applied.Korean journal of radiology: official journal of the Korean Radiological Society 09/2011; 12(5):559-67. · 1.32 Impact Factor -
Article: Ultrasonography-guided fine-needle aspiration cytology for thyroid nodules: an emphasis on one-sampling and biopsy techniques.
[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to assess the adequacy and efficacy of ultrasonography (US)-guided fine-needle aspiration cytology (US-FNAC) with one-sampling technique (only one specimen through a single needle pass was obtained during the procedure on each thyroid nodule in each study patient) for the cytological diagnosis of thyroid nodules. In this study, US-FNAC techniques, including "free two-hand," "mixed sampling," "flipping-extraction," and "single-needle-pass" procedures were used to collect thyroid cells from July 2007 to June 2009. The cytopathology results and patients' complications were reviewed retrospectively. Of the 1456 thyroid-nodule samples obtained from 977 patients (1.49 per patient), the incidence of adequate and inadequate samplings was 88.5% (1289/1456) and 11.5% (167/1456), respectively. After thyroid surgery in 396 patients, 568 nodules were confirmed as 353 papillary thyroid carcinomas including one diffuse sclerosing variant, five follicular thyroid carcinomas, three medullary thyroid carcinomas, one anaplastic thyroid carcinoma, one metastatic renal cell carcinoma, two poorly differentiated carcinomas, 17 follicular adenomas, two nodular thyroiditis, two pseudonodules related to thyroiditis, and 182 cases of nodular hyperplasia. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, false-negative rate, and false-positive rate for the US-FNAC were 94.3%, 91.9%, 96.2%, 88.3%, 93.6%, 3.9%, and 2.6%, respectively. There were no significant patients' complications, but 87 patients (8.9%) reported mild pain during or after the procedure. This study showed a good adequacy and efficacy of US-FNAC for thyroid nodules despite one-sampling.Diagnostic Cytopathology 03/2011; 40 Suppl 1:E48-54. · 1.16 Impact Factor -
Article: Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules: comparison in efficacy according to nodule size.
[show abstract] [hide abstract]
ABSTRACT: The objective of this study was to compare the efficacy and procedure time of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules, according to the nodule size. US-FNABs of thyroid nodules performed between June 2007 and December 2007 were studied. We divided these patients into three groups according to the largest diameter of their nodules. Group A consisted of patients with thyroid nodules less than or equal to 5 mm, group B of patients with thyroid nodules greater than 5 mm and less than or equal to 10 mm, and group C of patients with thyroid nodules greater than 10 mm. We retrospectively reviewed the cytopathology results and complications in all three patient groups and measured the separate, total US-FNAB procedure time for each of 20 randomly selected thyroid nodules. US-FNAB was performed on 438 thyroid nodules in 253 patients. In groups A, B, and C, the adequacy rates from the first US-FNAB were 79.6% (90/113), 90.6% (125/138), and 95.2% (178/187), respectively. In groups A, B, and C, 113, 138, and 187 thyroid nodules in 100, 120, and 169 patients, respectively, revealed 59, 75, and 126 benign; 12, 11, and 9 suspicious for malignancy; 9, 32, and 29 malignant; 10, 7, and 14 inderminate for malignancy; and 23, 13, and 9 inadequate on the first US-FNAB. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were determined to be 85.7%, 100%, 100%, 94.9%, and 96.1% in group A; 97.7%, 100%, 100%, 98.7%, and 99.1% in group B; and 100%, 99.2%, 97.1%, 100%, and 99.4% in group C. The mean procedure times in groups A, B, and C were 2 minutes 33 seconds, 1 minute 50 seconds, and 1 minute 32 seconds, respectively. There were no significant patient complications in any of the three patient groups. US-FNAB of thyroid nodules smaller than 5 mm in maximum diameter was less successful, and the sensitivity was lower than those of nodules larger than 5 mm. We considered, however, that the sampling adequacy and efficacy of US-FNAB of thyroid nodules less than 5 mm in maximum diameter was satisfactory in our series and should be similar in other centers with similar characteristics to ours.Thyroid: official journal of the American Thyroid Association 12/2008; 19(1):27-31. · 2.60 Impact Factor -
Article: Percutaneous ethanol injection for benign cystic thyroid nodules: is aspiration of ethanol-mixed fluid advantageous?
[show abstract] [hide abstract]
ABSTRACT: We evaluated the differences between percutaneous ethanol injection with and without aspiration of ethanol-mixed fluid for treatment of benign cystic thyroid nodules. We examined 60 patients with benign cystic thyroid nodules confirmed by fine-needle aspiration biopsy and divided them into 2 groups according to nonaspiration (group A, n = 30) or aspiration (group B, n = 30) of ethanol-mixed fluid after intracystic ethanol injection. We evaluated in both groups the complete disappearance of the cystic portion of the thyroid nodule on follow-up ultrasonography (first follow-up ultrasonography; mean, 4.6 months in group A; mean, 4.4 months in group B) (chi-square test), side effects or complications during and after the procedure (chi-square test), and the total procedure time (Student t test). Most patients showed complete disappearance of the cystic portion of the thyroid nodule (group A, n = 29; group B, n = 28), and they revealed no recurrence on follow-up ultrasonography. There was no statistical difference in the success rates between group A and group B (P > .05). Pain, the most common side effect, and other mild side effects or complications occurred in small numbers of patients in each group, but there was no significant difference in side effects or complications between the 2 groups (P > .05), except for intracystic hemorrhage (P < .05) and the complaint of all group B patients due to a double puncture (P < .001). The total procedure time was nearly double in group B than in group A because of the additional procedures, such as complete evacuation of the ethanol-mixed fluid and the 10-minute compression. Percutaneous ethanol injection without aspiration of ethanol-mixed fluid seems to be the preferable method of treatment of benign cystic thyroid nodules from the perspective of both the physician and the patient.American Journal of Neuroradiology 10/2005; 26(8):2122-7. · 2.93 Impact Factor -
Article: Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules smaller than 5 mm in the maximum diameter: assessment of efficacy and pathological findings.
[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to determine the efficacy of the use of an ultrasound-guided fine-needle aspiration biopsy (US-FNAB) to diagnose thyroid nodules smaller than 5 mm in the maximum diameter and to evaluate pathological findings of small thyroid malignancies. From May 2007 to April 2008, we evaluated the findings of US-FNABs of small thyroid nodules less than 5 mm in the maximum diameter. The cytopathological findings were retrospectively reviewed and the diagnostic performance of the use of an US-FNAB was examined in all patients. Of 201 small thyroid nodules in 180 patients, there were 162 adequate specimens (81%). Among 180 patients, 75 patients underwent thyroid surgery and 50 malignant and 33 benign nodules were identified based on a pathological examination. All small malignant thyroid nodules were identified as papillary thyroid microcarcinomas (PTMCs). There were 34 (55%) true positive, 0 (0%) false positive, 23 (37%) true negative and five (8%) false negative results for malignancy after performing a first US-FNAB in 62 surgically confirmed nodules. The sensitivity (87%), specificity (100%), positive predictive value (100%), negative predictive value (82%), accuracy (92%), false positive rate (0%) and false negative rate (8%) for an US-FNAB were determined. In 23 patients with a primary PTMC, capsular invasion (9%, 2 of 23), a perithyroidal lymph node metastasis (30%, 7 of 23), the rate of multifocality (9%, 2 of 23) and bilaterality (4%, 1 of 23) were also determined. An US-FNAB of thyroid nodules smaller than 5 mm in the maximum diameter is an effective diagnostic procedure.Korean journal of radiology: official journal of the Korean Radiological Society 10(5):435-40. · 1.32 Impact Factor -
Article: Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules: is it necessary to use local anesthesia for the application of one needle puncture?
[show abstract] [hide abstract]
ABSTRACT: This study was designed to evaluate the difference in the degree of patient pain for an ultrasound-guided fine-needle aspiration biopsy (USFNAB) of a thyroid nodule with one needle puncture with and without local anesthesia. A total of 50 patients participated in the study. We examined prospective patients who would undergo US-FNABs of two thyroid nodules (larger than 10 mm maximum diameter), which were located in separate thyroid lobes. For one of these thyroid nodules, US-FNAB was performed following the administration of local anesthesia; for the other nodule, no anesthesia was administered. The application of anesthesia was alternatively administered between patients (either prior to the first US-FNAB procedure or prior to the second procedure). For all patients, the degree of pain during and after each US-guided FNAB was evaluated according to a 4-category verbal rating scale (VRS), an 11-point numeric rating scale (NRS) and a 100-mm visual analogue scale (VAS). The mean maximum diameters of thyroid nodules examined by US-FNAB with the use of local anesthesia and with no local anesthesia were 13.6 mm and 13.0 mm, respectively. There was no significant difference in nodule size (p > 0.05) between two groups. For the VRS, there were 27 patients with a higher pain score when local anesthesia was used and four patients with a higher pain score when no local anesthesia was administered. Nineteen patients had equivalent pain score for both treatments. This finding was statistically significant (p < 0.001). For the NRS, there were 33 patients with a higher pain score when local anesthesia was used and 10 patients with a higher pain score when no local anesthesia was administered. Seven patients had an equivalent pain score for each treatment. This finding was statistically significant (p < 0.001). For the VAS, there were 35 patients with a higher pain score when local anesthesia was used and 11 patients with a higher pain score where no local anesthesia was administered. Four patients had an equivalent pain score for both treatments. This finding was also statistically significant (p = 0.001). In our study, patient pain scales were significantly lower when no local anesthesia was used prior to US-FNABs of thyroid nodules as compared to when local anesthesia was administered. Therefore, we believe that when one needle puncture is used, US-FNAB should be performed without administering local anesthesia.Korean journal of radiology: official journal of the Korean Radiological Society 10(5):441-6. · 1.32 Impact Factor
Top co-authors
Top Journals
Institutions
-
2008–2013
-
Inje University Paik Hospital
Goyang, Gyeonggi, South Korea
-
-
2012
-
Kangbuk Samsung Hospital
Seoul, Seoul, South Korea
-
-
2005
-
Sungkyunkwan University
- Department of Radiology
Seoul, Seoul, South Korea
-
