Endocrinology and Metabolism

Original Articles

Thyroid
Risk Stratification of Thyroid Nodules Diagnosed as Follicular Neoplasm on Core Needle Biopsy: Byeong-Joo Noh, Won Jun Kim, Jin Yub Kim, Ha Young Kim, Jong Cheol Lee, Myoung Sook Shim, Yong Jin Song, Kwang Hyun Yoon, In-Hye Jung, Hyo Sang Lee, Wooyul Paik, Dong Gyu Na; Endocrinol Metab. 2025;40(4):610-622. Published online May 28, 2025; DOI: https://doi.org/10.3803/EnM.2024.2256

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Abstract PDF Supplementary Material PubReader ePub: Background
This study assessed risk stratification and diagnostic performance for malignancy in thyroid nodules diagnosed as follicular neoplasm (FN) based on core needle biopsy (CNB) subcategories.
Methods
A total of 313 consecutive nodules (>1 cm) diagnosed as FN on CNB with corresponding surgical histology were included. FN subcategories were classified retrospectively for nodules diagnosed before 2022 (retrospective dataset) and prospectively for nodules diagnosed since 2022 (prospective dataset). CNB subcategories were determined using histologic criteria based on architectural uniformity and nuclear atypia, as modified from the 2019 Korean CNB pathology guideline. The diagnostic performance of CNB subcategories, nodule size, and ultrasound risk stratification systems (RSSs) for malignancy was assessed.
Results
CNB subcategory IVb showed a significantly higher malignancy risk compared to other subcategories in both datasets (34.5%–83.7% vs. 4.2%–13.6%, P<0.001). It was also identified as an independent predictor of malignancy in both datasets (P< 0.001), whereas nodule size and all ultrasound RSSs were not predictive of malignancy, including noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) (P≥0.079). CNB subcategory IVb demonstrated higher sensitivity for malignancy and a lower surgical rate for benign nodules compared to the nodule size criterion (>2 cm). The combined criterion of CNB subcategory IVb or nodule size >3 cm identified all malignant tumors, excluding NIFTP, in the prospective dataset.
Conclusion
CNB subcategory IVb effectively stratifies malignancy risk in thyroid nodules and outperforms nodule size (>2 cm) and ultrasound RSSs in diagnostic performance. Non-IVb nodules ≤3 cm can be safely managed with ultrasound surveillance instead of immediate surgery.

Thyroid
Microvascular Ultrasonography Vascularity Index as a Rapid and Simplified Assessment Tool for Differentiating Graves’ Disease from Destructive Thyroiditis and Managing Thyrotoxicosis: Han-Sang Baek, Chaiho Jeong, Jeonghoon Ha, Dong-Jun Lim; Endocrinol Metab. 2025;40(3):394-404. Published online February 25, 2025; DOI: https://doi.org/10.3803/EnM.2024.2206

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Background
Thyrotoxicosis presents significant diagnostic challenges in distinguishing Graves’ disease (GD) from destruction-induced thyrotoxicosis (DT) using ultrasound imaging. We evaluated a new technology, microvascular ultrasonography (MVUS) to effectively differentiate between GD and DT, and observe the MVUS changes during follow-up.
Methods
A total of 264 consecutive patients were prospectively enrolled into two cohorts from August 2022 to March 2024 at one tertiary referral hospital: cohort 1 comprised patients initially presenting with thyrotoxicosis (n=185; 98 with GD and 87 with DT). Cohort 2 included patients either with GD considering antithyroid drug discontinuation or with DT in the follow-up phase after treatment (n=77). Ultrasound imaging was conducted using the MVUS technique, and the vascularity index (MVUS-VI) was automatically calculated as the percentage ratio of color pixels to total grayscale pixels within a specified region of interest.
Results
Diagnostic accuracy highlighted MVUS-VI as the most accurate diagnostic tool, achieving a sensitivity of 79.6%, specificity of 84.3%, with an area under the curve of 0.856 (95% confidence interval, 0.800 to 0.911). Presence of thyroid peroxidase antibody or thyroglobulin antibody affected MVUS-VI’s performance, requiring a higher cut-off value for specificity in this subgroup. Follow-up in cohort 2 (n=77) demonstrated significant normalization in thyroid function and reductions in MVUS-VI from an initial 32.6%±23.4% to 20.8%±13.5% at follow-up (P<0.001).
Conclusion
MVUS-VI provides a rapid, non-invasive diagnostic alternative to traditional methods in differentiating GD from DT, thus aiding in the management of patients with thyrotoxicosis.

Citations

Citations to this article as recorded by

Update on newer ultrasound systems to study the microvasculature
Orlando Catalano, Antonio Pio Masciotra
La radiologia medica.2025; 130(8): 1283. CrossRef
Diagnostic Approach and Therapeutic Strategies for Ambiguous Thyrotoxicosis
Mijin Kim
The Korean Journal of Medicine.2025; 100(5): 241. CrossRef

Thyroid
Deep Learning Technology for Classification of Thyroid Nodules Using Multi-View Ultrasound Images: Potential Benefits and Challenges in Clinical Application: Jinyoung Kim, Min-Hee Kim, Dong-Jun Lim, Hankyeol Lee, Jae Jun Lee, Hyuk-Sang Kwon, Mee Kyoung Kim, Ki-Ho Song, Tae-Jung Kim, So Lyung Jung, Yong Oh Lee, Ki-Hyun Baek; Endocrinol Metab. 2025;40(2):216-224. Published online January 13, 2025; DOI: https://doi.org/10.3803/EnM.2024.2058

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Background
This study aimed to evaluate the applicability of deep learning technology to thyroid ultrasound images for classification of thyroid nodules.
Methods
This retrospective analysis included ultrasound images of patients with thyroid nodules investigated by fine-needle aspiration at the thyroid clinic of a single center from April 2010 to September 2012. Thyroid nodules with cytopathologic results of Bethesda category V (suspicious for malignancy) or VI (malignant) were defined as thyroid cancer. Multiple deep learning algorithms based on convolutional neural networks (CNNs) —ResNet, DenseNet, and EfficientNet—were utilized, and Siamese neural networks facilitated multi-view analysis of paired transverse and longitudinal ultrasound images.
Results
Among 1,048 analyzed thyroid nodules from 943 patients, 306 (29%) were identified as thyroid cancer. In a subgroup analysis of transverse and longitudinal images, longitudinal images showed superior prediction ability. Multi-view modeling, based on paired transverse and longitudinal images, significantly improved the model performance; with an accuracy of 0.82 (95% confidence intervals [CI], 0.80 to 0.86) with ResNet50, 0.83 (95% CI, 0.83 to 0.88) with DenseNet201, and 0.81 (95% CI, 0.79 to 0.84) with EfficientNetv2_ s. Training with high-resolution images obtained using the latest equipment tended to improve model performance in association with increased sensitivity.
Conclusion
CNN algorithms applied to ultrasound images demonstrated substantial accuracy in thyroid nodule classification, indicating their potential as valuable tools for diagnosing thyroid cancer. However, in real-world clinical settings, it is important to aware that model performance may vary depending on the quality of images acquired by different physicians and imaging devices.

Citations

Citations to this article as recorded by

Deep Learning for Ultrasound Classification to Identify Noninvasive Follicular Thyroid Neoplasms with Papillary–Like Nuclear Features
I-Hung Chien, Yi-Chiung Hsu, Shih-Ping Cheng
Journal of Imaging Informatics in Medicine.2026;[Epub] CrossRef
Knowledge-Prompted Trustworthy Disentangled Learning for Thyroid Ultrasound Segmentation With Limited Annotations
Wenxu Wang, Weizhen Wang, Qianjin Feng, Yu Zhang, Zhenyuan Ning
IEEE Transactions on Image Processing.2026; 35: 983. CrossRef
Integrating Robotic Bilateral Axillo-Breast Approach Thyroidectomy with Molecular Diagnostics and Artificial Intelligence in Thyroid Cancer Care
Qiang Deng, Xiaoping Men, Duo Jin, Yuzhuo Bai
Biomolecules & Therapeutics.2026; 34(1): 45. CrossRef
Deep Learning for the Diagnosis and Treatment of Thyroid Cancer: A Review
Rili Gao, Shangqing Mai, Song Wang, Wuqiang Hu, Zhangqi Chang, Guozhi Wu, Haixia Guan
Endocrine Practice.2025; 31(12): 1608. CrossRef
Artificial Intelligence for Thyroid Ultrasound: Clinical Performance, Pitfalls, and Practice Integration
Junseok Kang, Jihyun Ahn, Jeong Hun Hah
Clinical Ultrasound.2025; 10(2): 59. CrossRef
Molecular intelligence and immune reconnaissance in thyroid cancer: a new paradigm for diagnosis, risk stratification, and therapeutic precision
Marcio J. Concepción-Zavaleta, Jenyfer M. Fuentes-Mendoza, Alfredo Cruz-Quintá, Argelia V. Cadena-Guerrero, Ximena Barrón, Luis Concepción-Urteaga, Cristian D. Armas, José Paz-Ibarra, Juan Eduardo Quiroz-Aldave
Expert Review of Anticancer Therapy.2025; : 1. CrossRef

Thyroid
The Diagnostic Role of Repeated Biopsy of Thyroid Nodules with Atypia of Undetermined Significance with Architectural Atypia on Core-Needle Biopsy: Hye Hyeon Moon, Sae Rom Chung, Young Jun Choi, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee, Jung Hwan Baek; Endocrinol Metab. 2024;39(2):300-309. Published online January 3, 2024; DOI: https://doi.org/10.3803/EnM.2023.1818

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Abstract PDF Supplementary Material PubReader ePub: Background
We aimed to evaluate the utility of repeat biopsy of thyroid nodules classified as atypia of undetermined significance with architectural atypia (IIIB) on core-needle biopsy (CNB).
Methods
This retrospective study evaluated patients with thyroid nodules categorized as IIIB on CNB between 2013 and 2015. Demographic characteristics, subsequent biopsy results, and ultrasound (US) images were evaluated. The malignancy rates of nodules according to number of CNBs and the number of IIIB diagnoses was compared. Demographic and US features were evaluated to determine factors predictive of malignancy.
Results
Of 1,003 IIIB nodules on CNB, the final diagnosis was determined for 328 (32.7%) nodules, with 121 of them confirmed as malignant, resulting in a malignancy rate of 36.9% (95% confidence interval, 31.7% to 42.1%). Repeat CNB was performed in 248 nodules (24.7%), with 75 (30.2%), 131 (52.8%), 13 (5.2%), 26 (10.5%), one (0.4%), and two (0.8%) reclassified into categories II, IIIB, IIIA, IV, V, and VI, respectively. Malignancy rates were not significantly affected by the number of CNBs (P=0.291) or the number of IIIB diagnoses (P=0.473). None of the nodules confirmed as category II on repeat CNB was malignant. US features significantly associated with malignancy (P<0.003) included solid composition, irregular margins, microcalcifications, and high suspicion on the US risk stratification system.
Conclusion
Repeat biopsy of nodules diagnosed with IIIB on CNB did not increase the detection of malignancy but can potentially reduce unnecessary surgery. Repeat biopsy should be performed selectively, with US features guiding the choice between repeat biopsy and diagnostic surgery.

Thyroid Thyroid Cancer Screening
Diagnostic Performance of Ultrasound-Based Risk Stratification Systems for Thyroid Nodules: A Systematic Review and Meta-Analysis: Leehi Joo, Min Kyoung Lee, Ji Ye Lee, Eun Ju Ha, Dong Gyu Na; Endocrinol Metab. 2023;38(1):117-128. Published online February 27, 2023; DOI: https://doi.org/10.3803/EnM.2023.1670

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Background
This study investigated the diagnostic performance of biopsy criteria in four society ultrasonography risk stratification systems (RSSs) for thyroid nodules, including the 2021 Korean (K)-Thyroid Imaging Reporting and Data System (TIRADS).
Methods
The Ovid-MEDLINE, Embase, Cochrane, and KoreaMed databases were searched and a manual search was conducted to identify original articles investigating the diagnostic performance of biopsy criteria for thyroid nodules (≥1 cm) in four widely used society RSSs.
Results
Eleven articles were included. The pooled sensitivity and specificity were 82% (95% confidence interval [CI], 74% to 87%) and 60% (95% CI, 52% to 67%) for the American College of Radiology (ACR)-TIRADS, 89% (95% CI, 85% to 93%) and 34% (95% CI, 26% to 42%) for the American Thyroid Association (ATA) system, 88% (95% CI, 81% to 92%) and 42% (95% CI, 22% to 67%) for the European (EU)-TIRADS, and 96% (95% CI, 94% to 97%) and 21% (95% CI, 17% to 25%) for the 2016 K-TIRADS. The sensitivity and specificity were 76% (95% CI, 74% to 79%) and 50% (95% CI, 49% to 52%) for the 2021 K-TIRADS_1.5 (1.5-cm size cut-off for intermediate-suspicion nodules). The pooled unnecessary biopsy rates of the ACR-TIRADS, ATA system, EU-TIRADS, and 2016 K-TIRADS were 41% (95% CI, 32% to 49%), 65% (95% CI, 56% to 74%), 68% (95% CI, 60% to 75%), and 79% (95% CI, 74% to 83%), respectively. The unnecessary biopsy rate was 50% (95% CI, 47% to 53%) for the 2021 K-TIRADS_1.5.
Conclusion
The unnecessary biopsy rate of the 2021 K-TIRADS_1.5 was substantially lower than that of the 2016 K-TIRADS and comparable to that of the ACR-TIRADS. The 2021 K-TIRADS may help reduce potential harm due to unnecessary biopsies.

Citations

Citations to this article as recorded by

Enhancing diagnostic accuracy of thyroid nodules: integrating self-learning and artificial intelligence in clinical training
Daham Kim, Yoon-a Hwang, Youngsook Kim, Hye Sun Lee, Eunjung Lee, Hyunju Lee, Jung Hyun Yoon, Vivian Youngjean Park, Miribi Rho, Jiyoung Yoon, Si Eun Lee, Jin Young Kwak
Endocrine.2025; 88(3): 766. CrossRef
Interobserver agreement between artificial intelligence models in the thyroid imaging and reporting data system (TIRADS) assessment of thyroid nodules
Andrea Leoncini, Pierpaolo Trimboli
Endocrine.2025; 89(1): 197. CrossRef
A comparative study of Chinese and ACR-TIRADS diagnostic accuracy in small thyroid nodule risk evaluation
Rasha Nadeem Ahmed, Maysaloon Shaman Saeed, Nazar M. T. Jawhar, Mohamed Tarek El-Diasty, Noha Yahia Ebaid, Mostafa Mohamad Assy
Egyptian Journal of Radiology and Nuclear Medicine.2025;[Epub] CrossRef
Risk Stratification of Thyroid Nodules 10 mm in Diameter or Less: Strength and Pitfalls of the Ultrasonographic Assessment From a Cross‐Sectional Study
Giuseppe Lisco, Anna De Tullio, Vito Angelo Giagulli, Giuseppina Renzulli, Vincenzo Triggiani, Suraiya Saleem
International Journal of Endocrinology.2025;[Epub] CrossRef
Ultrasound Risk Stratification of Autonomously Functioning Thyroid Nodules: Cine Loop Video Sequences Versus Static Image Captures
Larissa Rosenbaum, Martin Freesmeyer, Tabea Nikola Schmidt, Christian Kühnel, Falk Gühne, Philipp Seifert
Diagnostics.2025; 15(19): 2525. CrossRef
Interobserver Agreement Among Thyroid Ultrasound Operators in Defining Thyroid Nodules as Subcapsular
Pierpaolo Trimboli, Enrico Papini, Jörg Bojunga, Chiara Camponovo, Maurilio Deandrea, Antonio Giangregorio, Lauro Gianola, Giorgio Grani, Rinaldo Guglielmi, Andrea Frasoldati, Fabian Pitoia, Gilles Russ, Cosimo Durante, Andrea Leoncini
Thyroid®.2025; 35(10): 1198. CrossRef
Accuracy of ultrasound in predicting thyroid malignancy: a comparative analysis of the ACR TI-RADS and ATA risk stratification systems
Shaza Samargandy, Aliaa H. Ghoneim
Archives of Endocrinology and Metabolism.2024;[Epub] CrossRef
Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules 2024
Young Joo Park, Eun Kyung Lee, Young Shin Song, Su Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung,
International Journal of Thyroidology.2024; 17(1): 208. CrossRef
Individual Ultrasonographic Characteristics of Thyroid Nodules and Their Cytopathological Correlation to Determine Malignancy Risk
Miguel Ángel Castilla Villanueva, Dania Guadalupe Solis Cano, Ana Amador Martínez, Marco Antonio Téliz Meneses, Jesús Baquera-Heredia, Cesar Eduardo Vallin Orozco, Mónica Loya Ceballos
Cureus.2024;[Epub] CrossRef
Improving the diagnostic performance of inexperienced readers for thyroid nodules through digital self-learning and artificial intelligence assistance
Si Eun Lee, Hye Jung Kim, Hae Kyoung Jung, Jin Hyang Jung, Jae-Han Jeon, Jin Hee Lee, Hanpyo Hong, Eun Jung Lee, Daham Kim, Jin Young Kwak
Frontiers in Endocrinology.2024;[Epub] CrossRef
Systemic therapy for differentiated thyroid cancer with distant metastasis
Eun Kyung Lee
Journal of the Korean Medical Association.2024; 67(7): 484. CrossRef
To Screen or Not to Screen?
Do Joon Park
Endocrinology and Metabolism.2023; 38(1): 69. CrossRef
The 2017 United States Preventive Services Task Force Recommendation for Thyroid Cancer Screening Is No Longer the Gold Standard
Ka Hee Yi
Endocrinology and Metabolism.2023; 38(1): 72. CrossRef
Thyroid Cancer Screening: How to Maximize Its Benefits and Minimize Its Harms
Jung Hwan Baek
Endocrinology and Metabolism.2023; 38(1): 75. CrossRef
2023 Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules
Young Joo Park, Eun Kyung Lee, Young Shin Song, Soo Hwan Kang, Bon Seok Koo, Sun Wook Kim, Dong Gyu Na, Seung-Kuk Baek, So Won Oh, Min Kyoung Lee, Sang-Woo Lee, Young Ah Lee, Yong Sang Lee, Ji Ye Lee, Dong-Jun Lim, Leehi Joo, Yuh-Seog Jung, Chan Kwon Jung
International Journal of Thyroidology.2023; 16(1): 1. CrossRef
Evaluation of the Appropriateness of Thyroid Fine-Needle Aspiration
Lairce Cristina Ribeiro Brito, Iara Beatriz De Carvalho Botêlho, Lanna Matos Silva Fernandes, Nayze Lucena Sangreman Aldeman, Uziel Nunes Silva
International Journal for Innovation Education and Research.2023; 11(6): 8. CrossRef

Thyroid Thyroid Cancer Screening
Survival Comparison of Incidentally Found versus Clinically Detected Thyroid Cancers: An Analysis of a Nationwide Cohort Study: Shinje Moon, Eun Kyung Lee, Hoonsung Choi, Sue K. Park, Young Joo Park; Endocrinol Metab. 2023;38(1):81-92. Published online February 27, 2023; DOI: https://doi.org/10.3803/EnM.2023.1668

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Background
The true benefit of thyroid cancer screening is incompletely understood. This study investigated the impact of ultrasound screening on thyroid cancer outcomes through a comparison with symptomatic thyroid cancer using data from a nationwide cohort study in Korea.
Methods
Cox regression analysis was performed to assess the hazard ratios (HRs) for all-cause and thyroid cancer-specific mortality. Considering the possible bias arising from age, sex, year of thyroid cancer registration, and confounding factors for mortality (including smoking/drinking status, diabetes, and hypertension), all analyses were conducted with stabilized inverse probability of treatment weighting (IPTW) according to the route of detection.
Results
Of 5,796 patients with thyroid cancer, 4,145 were included and 1,651 were excluded due to insufficient data. In comparison with the screening group, the clinical suspicion group was associated with large tumors (17.2±14.6 mm vs. 10.4±7.9 mm), advanced T stage (3–4) (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.09 to 1.41), extrathyroidal extension (OR, 1.16; 95% CI, 1.02 to 1.32), and advanced stage (III–IV) (OR, 1.16; 95% CI, 1.00 to 1.35). In IPTW-adjusted Cox regression analysis, the clinical suspicion group had significantly higher risks of all-cause mortality (HR, 1.43; 95% CI, 1.14 to 1.80) and thyroid cancer-specific mortality (HR, 3.07; 95% CI, 1.77 to 5.29). Mediation analysis showed that the presence of thyroid-specific symptoms was directly associated with a higher risk of cancer-specific mortality. Thyroid-specific symptoms also indirectly affected thyroid cancer-specific mortality, mediated by tumor size and advanced clinicopathologic status.
Conclusion
Our findings provide important evidence for the survival benefit of early detection of thyroid cancer compared to symptomatic thyroid cancer.

Citations

Citations to this article as recorded by

Thyroid cancer in Asia: incidence, mortality in 2022, and future projections to 2050
Mengxia Fu, Zhiming Peng, Min Wu
European Journal of Cancer Prevention.2026; 35(2): 126. CrossRef
Clinical Characteristics and Outcomes of Clinically Detected versus Imaging-Detected Incidental Thyroid Cancer
Po-Sheng Lee, Chi-Lung Tseng, Jui-Yu Chen, Harn-Shen Chen, Chun-Jui Huang
Endocrine Practice.2026;[Epub] CrossRef
Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and Survival
Ji Hyun Yoo, Da Eun Leem, Bo Ram Kim, Tae Hyuk Kim, Sun Wook Kim, Jae Hoon Chung
Endocrinology and Metabolism.2025; 40(3): 414. CrossRef
A One-Year Cross-Sectional Study on the Impact of the Thyroid Imaging Reporting and Data System (TIRADS) on Fine-Needle Aspiration Cytology (FNAC) Decision-Making in a Secondary Care Hospital
Srinivasa Swamy Bandaru, Qahtan A Al Dulaimi
Cureus.2025;[Epub] CrossRef
Cost-Utility Analysis of Early Detection with Ultrasonography of Differentiated Thyroid Cancer: A Retrospective Study on a Korean Population
Han-Sang Baek, Jeonghoon Ha, Kwangsoon Kim, Ja Seong Bae, Jeong Soo Kim, Sungju Kim, Dong-Jun Lim, Chul-Min Kim
Endocrinology and Metabolism.2024; 39(2): 310. CrossRef
Thyroid cancer-specific mortality during 2005–2018 in Korea, aftermath of the overdiagnosis issue: a nationwide population-based cohort study
Kyeong Jin Kim, Jimi Choi, Sue K. Park, Young Joo Park, Sin Gon Kim
International Journal of Surgery.2024; 110(9): 5489. CrossRef
Distinct Impacts of Clinicopathological and Mutational Profiles on Long-Term Survival and Recurrence in Medullary Thyroid Carcinoma
Moon Young Oh, Kyong Yeun Jung, Hoonsung Choi, Young Jun Chai, Sun Wook Cho, Su-jin Kim, Kyu Eun Lee, Eun-Jae Chung, Do Joon Park, Young Joo Park, Han-Kwang Yang
Endocrinology and Metabolism.2024; 39(6): 877. CrossRef
Clinical Characteristics, Diagnostic Approach and Outcome of Thyroid Incidental Findings vs. Clinically Overt Thyroid Nodules: An Observational Single-Centre Study
Tom Jansen, Nike Stikkelbroeck, Annenienke van de Ven, Ilse van Engen-van Grunsven, Marcel Janssen, Han Bonenkamp, Martin Gotthardt, Romana T. Netea-Maier
Cancers.2023; 15(8): 2350. CrossRef
Lower Thyroid Cancer Mortality in Patients Detected by Screening: A Meta-Analysis
Shinje Moon, Young Shin Song, Kyong Yeun Jung, Eun Kyung Lee, Young Joo Park
Endocrinology and Metabolism.2023; 38(1): 93. CrossRef
To Screen or Not to Screen?
Do Joon Park
Endocrinology and Metabolism.2023; 38(1): 69. CrossRef
The 2017 United States Preventive Services Task Force Recommendation for Thyroid Cancer Screening Is No Longer the Gold Standard
Ka Hee Yi
Endocrinology and Metabolism.2023; 38(1): 72. CrossRef
Thyroid Cancer Screening: How to Maximize Its Benefits and Minimize Its Harms
Jung Hwan Baek
Endocrinology and Metabolism.2023; 38(1): 75. CrossRef

Thyroid Thyroid Cancer Screening
Lower Thyroid Cancer Mortality in Patients Detected by Screening: A Meta-Analysis: Shinje Moon, Young Shin Song, Kyong Yeun Jung, Eun Kyung Lee, Young Joo Park; Endocrinol Metab. 2023;38(1):93-103. Published online February 27, 2023; DOI: https://doi.org/10.3803/EnM.2023.1667

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Background
Thyroid cancer screening has contributed to the skyrocketing prevalence of thyroid cancer. However, the true benefit of thyroid cancer screening is not fully understood. This study aimed to evaluate the impact of screening on the clinical outcomes of thyroid cancer by comparing incidental thyroid cancer (ITC) with non-incidental thyroid cancer (NITC) through a meta-analysis.
Methods
PubMed and Embase were searched from inception to September 2022. We estimated and compared the prevalence of high-risk features (aggressive histology of thyroid cancer, extrathyroidal extension, metastasis to regional lymph nodes or distant organs, and advanced tumor-node-metastasis [TNM] stage), thyroid cancer-specific death, and recurrence in the ITC and NITC groups. We also calculated pooled risks and 95% confidence intervals (CIs) of the outcomes derived from these two groups.
Results
From 1,078 studies screened, 14 were included. In comparison to NITC, the ITC group had a lower incidence of aggressive histology (odds ratio [OR], 0.46; 95% CI, 0.31 to 0.7), smaller tumors (mean difference, −7.9 mm; 95% CI, −10.2 to −5.6), lymph node metastasis (OR, 0.64; 95% CI, 0.48 to 0.86), and distant metastasis (OR, 0.42; 95% CI, 0.23 to 0.77). The risks of recurrence and thyroid cancer-specific mortality were also lower in the ITC group (OR, 0.42; 95% CI, 0.25 to 0.71 and OR, 0.46; 95% CI, 0.28 to 0.74) than in the NITC group.
Conclusion
Our findings provide important evidence of a survival benefit from the early detection of thyroid cancer compared to symptomatic thyroid cancer.

Citations

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Overdiagnosis of thyroid cancer in the United States: Improved estimates based on the SEER registries during 2000–2019
Minlu Zhang, Dongchen Xie, Yi Hu, Guoyou Qin, Wanghong Xu
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A guide to cancer screening
Stephen W. Duffy, Judith Offman
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Radioactive Iodine in Differentiated Thyroid Cancer: Effect on Detection of Distant Metastases Comparing 4 Guidelines
Merel T Stegenga, W Edward Visser, Robin P Peeters, Folkert J van Kemenade, Marco Medici, Tessa M van Ginhoven, Frederik A Verburg, Evert F S van Velsen
Journal of the Endocrine Society.2025;[Epub] CrossRef
Ultrasonography of Incidental Thyroid Nodules: A Systematic Review and Meta-analysis of Prevalence
Li-Jen Liao, Shun-Fa Hung, Ping-Chia Cheng, Wan-Lun Hsu
Journal of Medical Ultrasound.2025; 33(4): 365. CrossRef
Cost-Utility Analysis of Early Detection with Ultrasonography of Differentiated Thyroid Cancer: A Retrospective Study on a Korean Population
Han-Sang Baek, Jeonghoon Ha, Kwangsoon Kim, Ja Seong Bae, Jeong Soo Kim, Sungju Kim, Dong-Jun Lim, Chul-Min Kim
Endocrinology and Metabolism.2024; 39(2): 310. CrossRef
Thyroid nodules: diagnosis and management
Giorgio Grani, Marialuisa Sponziello, Sebastiano Filetti, Cosimo Durante
Nature Reviews Endocrinology.2024; 20(12): 715. CrossRef
Thyroid cancer-specific mortality during 2005–2018 in Korea, aftermath of the overdiagnosis issue: a nationwide population-based cohort study
Kyeong Jin Kim, Jimi Choi, Sue K. Park, Young Joo Park, Sin Gon Kim
International Journal of Surgery.2024; 110(9): 5489. CrossRef
To Screen or Not to Screen?
Do Joon Park
Endocrinology and Metabolism.2023; 38(1): 69. CrossRef
The 2017 United States Preventive Services Task Force Recommendation for Thyroid Cancer Screening Is No Longer the Gold Standard
Ka Hee Yi
Endocrinology and Metabolism.2023; 38(1): 72. CrossRef
Thyroid Cancer Screening: How to Maximize Its Benefits and Minimize Its Harms
Jung Hwan Baek
Endocrinology and Metabolism.2023; 38(1): 75. CrossRef
Delayed Surgery for and Outcomes of Papillary Thyroid Cancer: Is the Pendulum Still Swinging?
Giorgio Grani
Clinical Thyroidology.2023; 35(5): 192. CrossRef

Review Article

Mineral, Bone & Muscle
Update on Preoperative Parathyroid Localization in Primary Hyperparathyroidism: Hye-Sun Park, Namki Hong, Jong Ju Jeong, Mijin Yun, Yumie Rhee; Endocrinol Metab. 2022;37(5):744-755. Published online October 25, 2022; DOI: https://doi.org/10.3803/EnM.2022.1589

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Parathyroidectomy is the treatment of choice for primary hyperparathyroidism when the clinical criteria are met. Although bilateral neck exploration is traditionally the standard method for surgery, minimally invasive parathyroidectomy (MIP), or focused parathyroidectomy, has been widely accepted with comparable curative outcomes. For successful MIP, accurate preoperative localization of parathyroid lesions is essential. However, no consensus exists on the optimal approach for localization. Currently, ultrasonography and technetium-99m-sestamibi–single photon emission computed tomography/computed tomography are widely accepted in most cases. However, exact localization cannot always be achieved, especially in cases with multiglandular disease, ectopic glands, recurrent disease, and normocalcemic primary hyperparathyroidism. Therefore, new modalities for preoperative localization have been developed and evaluated. Positron emission tomography/computed tomography and parathyroid venous sampling have demonstrated improvements in sensitivity and accuracy. Both anatomical and functional information can be obtained by combining these methods. As each approach has its advantages and disadvantages, the localization study should be deliberately chosen based on each patient’s clinical profile, costs, radiation exposure, and the availability of experienced experts. In this review, we summarize various methods for the localization of hyperfunctioning parathyroid tissues in primary hyperparathyroidism.

Citations

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Ectopic parathyroid adenomas in primary hyperparathyroidism: anatomical classifications, localization strategies, and case series
Ruiying Zhu, Ning Yue, Yurong Hong, Qin Ye, Zhenyi Han, Zhiyan Luo, Chaoran Xie, Haichao Yan, Xing Yu
International Journal of Surgery.2026;[Epub] CrossRef
Algorithmic Surgical Management of Primary Hyperparathyroidism and Its Variants: A Scoping Review
Fleur Kabala, Todd Falcone, Kourosh Parham
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Original Articles

Thyroid
Usefulness of Real-Time Quantitative Microvascular Ultrasonography for Differentiation of Graves’ Disease from Destructive Thyroiditis in Thyrotoxic Patients: Han-Sang Baek, Ji-Yeon Park, Chai-Ho Jeong, Jeonghoon Ha, Moo Il Kang, Dong-Jun Lim; Endocrinol Metab. 2022;37(2):323-332. Published online April 13, 2022; DOI: https://doi.org/10.3803/EnM.2022.1413

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Background
Microvascular ultrasonography (MVUS) is a third-generation Doppler technique that was developed to increase sensitivity compared to conventional Doppler. The purpose of this study was to compare MVUS with conventional color Doppler (CD) and power Doppler (PD) imaging to distinguish Graves’ disease (GD) from destructive thyroiditis (DT).
Methods
This prospective study included 101 subjects (46 GDs, 47 DTs, and eight normal controls) from October 2020 to November 2021. All ultrasonography examinations were performed using microvascular flow technology (MV-Flow). The CD, PD, and MVUS images were semi-quantitatively graded according to blood flow patterns. On the MVUS images, vascularity indices (VIs), which were the ratio (%) of color pixels in the total grayscale pixels in a defined region of interest, were obtained automatically. Receiver operating characteristic curve analysis was performed to verify the diagnostic performance of MVUS. The interclass correlation coefficient and Cohen’s kappa analysis were used to analyze the reliability of MVUS (ClinicalTrials.gov:NCT04879173).
Results
The area under the curve (AUC) for CD, PD, MVUS, and MVUS-VI was 0.822, 0.844, 0.808, and 0.852 respectively. The optimal cutoff value of the MVUS-VI was 24.95% for distinguishing GD and DT with 87% sensitivity and 80.9% specificity. We found a significant positive correlation of MVUS-VI with thyrotropin receptor antibody (r=0.554) and with thyroid stimulating immunoglobulin bioassay (r=0.841). MVUS showed high intra- and inter-observer reliability from various statistical method.
Conclusion
In a real time and quantitative manner, MVUS-VI could be helpful to differentiate GD from thyroiditis in thyrotoxic patients, with less inter-observer variability.

Citations

Citations to this article as recorded by

Microvascular Ultrasonography Vascularity Index as a Rapid and Simplified Assessment Tool for Differentiating Graves’ Disease from Destructive Thyroiditis and Managing Thyrotoxicosis
Han-Sang Baek, Chaiho Jeong, Jeonghoon Ha, Dong-Jun Lim
Endocrinology and Metabolism.2025; 40(3): 394. CrossRef
Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management
Jin Wang, Ke Wan, Xin Chang, Rui-Feng Mao
World Journal of Diabetes.2024; 15(3): 348. CrossRef
Deep Learning Analysis With Gray Scale and Doppler Ultrasonography Images to Differentiate Graves’ Disease
Han-Sang Baek, Jinyoung Kim, Chaiho Jeong, Jeongmin Lee, Jeonghoon Ha, Kwanhoon Jo, Min-Hee Kim, Tae Seo Sohn, Ihn Suk Lee, Jong Min Lee, Dong-Jun Lim
The Journal of Clinical Endocrinology & Metabolism.2024; 109(11): 2872. CrossRef
Evaluation of normal and abnormal fetal renal microvascular flow characteristics of three-dimensional MV-flow imaging
Caixin Huang, Lihe Zhang, Yuting Jiang, Qiao Zheng, Ting Lei, Liu Du, Hongning Xie
Early Human Development.2024; 199: 106149. CrossRef
The Early Changes in Thyroid-Stimulating Immunoglobulin Bioassay over Anti-Thyroid Drug Treatment Could Predict Prognosis of Graves’ Disease
Jin Yu, Han-Sang Baek, Chaiho Jeong, Kwanhoon Jo, Jeongmin Lee, Jeonghoon Ha, Min Hee Kim, Jungmin Lee, Dong-Jun Lim
Endocrinology and Metabolism.2023; 38(3): 338. CrossRef
Duplex Hemodynamic Parameters of Both Superior and Inferior Thyroid Arteries in Evaluation of Thyroid Hyperfunction Disorders
Maha Assem Hussein, Alaa Abdel Hamid, Rasha M Abdel Samie, Elshaymaa Hussein, Shereen Sadik Elsawy
International Journal of General Medicine.2022; Volume 15: 7131. CrossRef
Case 5: A 41-Year-Old Woman With Palpitation
Jiwon Yang, Kabsoo Shin, Jeongmin Lee, Jeonghoon Ha, Dong-Jun Lim, Han-Sang Baek
Journal of Korean Medical Science.2022;[Epub] CrossRef
Microvascular assessment of fascio-cutaneous flaps by ultrasound: A large animal study
Guillaume Goudot, Yanis Berkane, Eloi de Clermont-Tonnerre, Claire Guinier, Irina Filz von Reiterdank, Antonia van Kampen, Korkut Uygun, Curtis L. Cetrulo, Basak E. Uygun, Anahita Dua, Alexandre G. Lellouch
Frontiers in Physiology.2022;[Epub] CrossRef

Thyroid
Clinicopathological Characteristics and Disease-Free Survival in Patients with Hürthle Cell Carcinoma: A Multicenter Cohort Study in South Korea: Meihua Jin, Eun Sook Kim, Bo Hyun Kim, Hee Kyung Kim, Yea Eun Kang, Min Ji Jeon, Tae Yong Kim, Ho-Cheol Kang, Won Bae Kim, Young Kee Shong, Mijin Kim, Won Gu Kim; Endocrinol Metab. 2021;36(5):1078-1085. Published online October 28, 2021; DOI: https://doi.org/10.3803/EnM.2021.1151

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Background
Hürthle cell carcinoma (HCC), a type of thyroid carcinoma, is rare in South Korea, and few studies have investigated its prognosis.
Methods
This long-term multicenter retrospective cohort study evaluated the clinicopathological features and clinical outcomes in patients with HCC who underwent thyroid surgery between 1996 and 2009.
Results
The mean age of the 97 patients included in the study was 50.3 years, and 26.8% were male. The mean size of the primary tumor was 3.2±1.8 cm, and three (3.1%) patients had distant metastasis at initial diagnosis. Ultrasonographic findings were available for 73 patients; the number of nodules with low-, intermediate-, and high suspicion was 28 (38.4%), 27 (37.0%), and 18 (24.7%), respectively, based on the Korean-Thyroid Imaging Reporting and Data System. Preoperatively, follicular neoplasm (FN) or suspicion for FN accounted for 65.2% of the cases according to the Bethesda category, and 13% had malignancy or suspicious for malignancy. During a median follow-up of 8.5 years, eight (8.2%) patients had persistent/recurrent disease, and none died of HCC. Older age, gross extrathyroidal extension (ETE), and widely invasive types of tumors were significantly associated with distant metastasis (all P<0.01). Gross ETE (hazard ratio [HR], 27.7; 95% confidence interval [CI], 2.2 to 346.4; P=0.01) and widely invasive classification (HR, 6.5; 95% CI, 1.1 to 39.4; P=0.04) were independent risk factors for poor disease-free survival (DFS).
Conclusion
The long-term prognosis of HCC is relatively favorable in South Korea from this study, although this is not a nation-wide data, and gross ETE and widely invasive cancer are significant prognostic factors for DFS. The diagnosis of HCC by ultrasonography and cytopathology remains challenging.

Citations

Citations to this article as recorded by

Epidemiology and prognostic factors of Hürthle-oncocytic cell carcinoma of the thyroid
Omar Hamdy, Hedaa Atwa, Ekbal Elkhouli, Ahmed H. Ata, Radwa M. Abdelsattar, Maryam Dawood, Shadi Awny, Mohamed Ezat
Discover Oncology.2026;[Epub] CrossRef
Hürthle-cell carcinoma of the thyroid: Clinicopathologic features and surgical outcomes at a single institution
Munir Memon
Sanamed.2026; (00): 22. CrossRef
Prognostic impact of fibrosclerotic changes in non-papillary, non-anaplastic, follicular cell-derived thyroid carcinomas
Giulia Orlando, Giulia Capella, Giulia Vocino Trucco, Elena Vissio, Jasna Metovic, Francesca Maletta, Marco Volante, Mauro Papotti
Virchows Archiv.2025; 487(3): 701. CrossRef
Differentiating oncocytic carcinoma from oncocytic adenoma: a comprehensive evaluation of preoperative characteristics and diagnostic approaches in a retrospective cohort study
Eunji Kim, Jun Hyun Park, Ji-Young Park, Sang-Woo Lee, Jin Hyang Jung
Annals of Surgical Treatment and Research.2025; 109(2): 105. CrossRef
2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer
Matthew D. Ringel, Julie Ann Sosa, Zubair Baloch, Lindsay Bischoff, Gary Bloom, Gregory A. Brent, Pamela L. Brock, Roger Chou, Robert R. Flavell, Whitney Goldner, Elizabeth G. Grubbs, Megan Haymart, Steven M. Larson, Angela M. Leung, Joseph Osborne, John
Thyroid®.2025; 35(8): 841. CrossRef
Molecular Alterations and Comprehensive Clinical Management of Oncocytic Thyroid Carcinoma
Lindsay A. Bischoff, Ian Ganly, Laura Fugazzola, Erin Buczek, William C. Faquin, Bryan R. Haugen, Bryan McIver, Caitlin P. McMullen, Kate Newbold, Daniel J. Rocke, Marika D. Russell, Mabel Ryder, Peter M. Sadow, Eric Sherman, Maisie Shindo, David C. Shonk
JAMA Otolaryngology–Head & Neck Surgery.2024; 150(3): 265. CrossRef
Oncocytic carcinoma of the thyroid: Conclusions from a 20‐year patient cohort
Nelson R. Gruszczynski, Shahzeb S. Hasan, Ana G. Brennan, Julian De La Chapa, Adithya S. Reddy, David N. Martin, Prem P. Batchala, Edward B. Stelow, Eric M. Dowling, Katherine L. Fedder, Jonathan C. Garneau, David C. Shonka
Head & Neck.2024; 46(8): 2042. CrossRef
Oncocytic cell carcinoma of the thyroid with TERT promoter mutation presenting as asphyxia in an elderly: a case report
Xiqian Wang, Yingao Liu, Lijie Chen, Jie Zhang, Ruoyu Jiang, Lei Zhang, Han Yan, Jie Zhang
Frontiers in Endocrinology.2024;[Epub] CrossRef
Clinical Considerations of Oncocytic Thyroid Cancer: A Review
Soo Young Kim
Journal of Endocrine Surgery.2024; 24(3): 49. CrossRef
Mitochondrial Proteome Defined Molecular Pathological Characteristics of Oncocytic Thyroid Tumors
Lu Li, Likun Zhang, Wenhao Jiang, Zhiqiang Gui, Zhihong Wang, Hao Zhang, Yi He, Yi Zhu, Tiannan Guo, Haixia Guan, Zhiyan Liu, Yaoting Sun, Jianqing Gao
Endocrine Pathology.2024; 35(4): 442. CrossRef
Hurthle cell carcinoma: a rare variant of thyroid malignancy – a case report
Yuvraj Adhikari, Anupama Marasini, Nawaraj Adhikari, Laxman D. Paneru, Binit Upadhaya Regmi, Manita Raut
Annals of Medicine & Surgery.2023; 85(5): 1940. CrossRef
Hürthle Cell Carcinoma: Single Center Analysis and Considerations for Surgical Management Based on the Recent Literature
Costanza Chiapponi, Milan J.M. Hartmann, Matthias Schmidt, Michael Faust, Christiane J. Bruns, Anne M. Schultheis, Hakan Alakus
Frontiers in Endocrinology.2022;[Epub] CrossRef

Clinical Study
Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation: Min Kyoung Lee, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Yu-Mi Lee, Tae Yong Kim, Jeong Hyun Lee; Endocrinol Metab. 2020;35(2):407-415. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.407

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Background
Although radiofrequency ablation (RFA) is a safe treatment for thyroid tumors, nerve damage is a frequent complication. A previous retrospective study suggested that an injection of cold 5% dextrose in water (5% DW) can reduce nerve damage during RFA. This study validated the efficacy of injecting cold 5% DW for management of nerve damage during RFA.
Methods
Between November 2017 and December 2018, 242 patients underwent 291 RFA sessions for treatment of benign thyroid nodules or recurrent thyroid cancers. Using a standardized technique, cold (0°C to 4°C) 5% DW was immediately injected around the damaged nerve into patients with any symptoms suggesting nerve damage. The incidence of nerve damage, the volume of 5% DW injected, symptom recovery time and the incidence of permanent nerve damage were evaluated.
Results
Nineteen patients experienced nerve damage symptoms related to 21 RFA sessions, including 17 patients during 19 sessions and two patients on the day after two sessions. Patients with nerve damage symptoms detected during RFA were treated by injection of a mean 41 mL (range, 3 to 260) cold 5% DW, but the two patients who experienced symptoms the next day did not receive cold 5% DW injections. Immediate recovery was observed after 15 RFA sessions in 14 patients. No patient experienced permanent nerve damage.
Conclusion
Injection of cold 5% DW is effective in managing nerve damage during RFA of thyroid lesions.

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Clinical Study
Revisiting Rupture of Benign Thyroid Nodules after Radiofrequency Ablation: Various Types and Imaging Features: Sae Rom Chung, Jung Hwan Baek, Jin Yong Sung, Ji Hwa Ryu, So Lyung Jung; Endocrinol Metab. 2019;34(4):415-421. Published online December 23, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.4.415

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Background

To evaluate the imaging features, clinical manifestations, and prognosis of patients with thyroid nodule rupture after radiofrequency ablation (RFA).

Methods

The records of 12 patients who experienced thyroid nodule rupture after RFA at four Korean thyroid centers between March 2010 and July 2017 were retrospectively reviewed. Clinical data evaluated included baseline patient characteristics, treatment methods, initial presenting symptoms, imaging features, treatment, and prognosis.

Results

The most common symptoms of post-RFA nodule rupture were sudden neck bulging and pain. Based on imaging features, the localization of nodule rupture was classified into three types: anterior, posterolateral, and medial types. The anterior type is the most often, followed by posterolateral and medial type. Eight patients recovered completely after conservative treatment. Four patients who did not improve with conservative management required invasive procedures, including incision and drainage or aspiration.

Conclusion

Thyroid nodule rupture after RFA can be classified into three types based on its localization: anterior, posterolateral, and medial types. Because majority of thyroid nodule ruptures after RFA can be managed conservatively, familiarity with these imaging features is essential in avoiding unnecessary imaging workup or invasive procedures.

Citations

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Clinical Study
Does Radiofrequency Ablation Induce Neoplastic Changes in Benign Thyroid Nodules: A Preliminary Study: Su Min Ha, Jun Young Shin, Jung Hwan Baek, Dong Eun Song, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee; Endocrinol Metab. 2019;34(2):169-178. Published online May 15, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.2.169

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Background

To evaluate the clinical feasibility of radiofrequency ablation (RFA) of benign thyroid nodules along with cytomorphological alteration, and any malignant transformation through biopsy.

Methods

The data were retrospectively collected between April 2008 and June 2013 and core needle biopsy (CNB) was performed on 16 benign thyroid nodules previously treated using RFA. The parameters of the patients were compared, between the time of enrollment and the last follow-up examination, using linear mixed model statistical analysis.

Results

No atypical cells or neoplastic transformation were detected in the undertreated peripheral portion of treated benign nodules on the CNB specimen. RFA altered neither the thyroid capsule nor the thyroid tissue adjacent to the treated area. On histopathological examinations, we observed 81.2% acellular hyalinization, which was the most common finding. After a mean follow-up period of over 5 years, the mean volume of thyroid nodule had decreased to 6.4±4.2 mL, with a reduction rate of 81.3%±5.8% (P<0.0001).

Conclusion

RFA is a technically feasible treatment method for benign thyroid nodules, with no carcinogenic effect or tissue damage of the normal thyroid tissue adjacent to the RFA-treated zone.

Citations

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Thyroid
The Validity of Ultrasonography-Guided Fine Needle Aspiration Biopsy in Thyroid Nodules 4 cm or Larger Depends on Ultrasonography Characteristics: Jin Hwa Kim, Na Kyung Kim, Young Lyun Oh, Hye Jeong Kim, Sang Yong Kim, Jae Hoon Chung, Sun Wook Kim; Endocrinol Metab. 2014;29(4):545-552. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.545

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Background

The objective of this study was to evaluate the validity of fine needle aspiration biopsy (FNAB) according to ultrasonography (US) characteristics in thyroid nodules 4 cm and larger.

Methods

We retrospectively reviewed the cases of 263 patients who underwent thyroid surgery for thyroid nodules larger than 4 cm between January 2001 and December 2010.

Results

The sensitivity of US-FNAB was significantly higher in nodules with calcifications (micro- or macro-) than those without (97.9% vs. 87.% P<0.05). The accuracy of US-FNAB was higher in large thyroid nodules with US features suspicious of malignancy, such as a solid component, ill-defined margin, hypoechogenicity or marked hypoechogenicity, or any calcifications (micro- or macro-) compared to thyroid nodules with none of these features. Furthermore, the accuracy improved as the number of these features increased. The overall false negative rate (FNR) was 11.9%. The FNR of thyroid nodules that appeared benign on US, such as mixed nodules (7.7%) or nodules without calcification (9.8%), trended toward being lower than that of solid nodules (17.9%) or nodules with any microcalcification or macrocalcification (33.3%). In nodules without suspicious features of malignancy, the FNR of US-FNAB was 0% (0/15).

Conclusion

We suggest individualized strategies for large thyroid nodules according to US features. Patients with benign FNAB can be followed in the absence of any malignant features in US. However, if patients exhibit any suspicious features, potential false negative results of FNAB should be kept in mind and surgery may be considered.

Citations

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Thyroid
Clinicopathological, Biochemical, and Sonographic Features of Thyroid Nodule Predictive of Malignancy among Adult Filipino Patients in a Tertiary Hospital in the Philippines: Edwin Jadulco Cañete, Cherrie Mae Sison-Peña, Cecilia Alegado Jimeno; Endocrinol Metab. 2014;29(4):489-497. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.489

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Background

Thyroid nodules may harbor cancer in 5% to 15% of cases. Specific clinical and sonographic features predictive of malignancy have been investigated in various populations, but due to differences in epidemiology, risk factors and iodine nutrition status, these predictors may not be valid in the Philippines. This study determined the clinicopathological, biochemical, and sonographic features of thyroid nodules predictive of malignancy among adult Filipino patients at the University of the Philippines-Philippine General Hospital (UP-PGH).

Methods

We reviewed the medical records of Filipino patients ≥19 years of age who underwent thyroid surgery in UP-PGH from 2008 to 2011.

Results

A total of 837 of 1,670 patients (50.1%) were enrolled in the study, which included 417 benign and 420 malignant tumors. The mean age at diagnosis was 38±11 years, with female predominance. Multiple logistic regression analysis showed that the presence of a hard or firm nodule (odds ratio [OR], 58.8, P<0.001; OR, 12.8, P<0.001), presence of microcalcifications (OR, 11.1; P<0.001), irregular margins on ultrasound (OR, 4.5; P<0.001), and absence of associated symptoms (OR, 2.3; P<0.002) increased significantly the likelihood of thyroid malignancy.

Conclusion

Similar to international data, the absence of associated symptoms, firm to hard thyroid nodules, and the presence of microcalcifications and irregular margins were significant predictors of thyroid malignancy.

Citations

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Detection of Thyroid Nodule Prevalence and Associated Risk Factors in Southwest China: A Study of 45,023 Individuals Undergoing Physical Examinations
Yi Liang, Xiaohong Li, Fang Wang, Zongting Yan, Yuhuan Sang, Yuan Yuan, Yun Qin, Xuefei Zhang, Mei Ju
Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 1697. CrossRef
Diagnostic performance of the EU TI‐RADS and ACR TI‐RADS scoring systems in predicting thyroid malignancy
Hiba‐Allah Chatti, Ibtissem Oueslati, Aymen Azaiez, Jihen Marrakchi, Seif Boukriba, Habiba Mizouni, Slim Haouet, Ghazi Besbes, Meriem Yazidi, Melika Chihaoui
Endocrinology, Diabetes & Metabolism.2023;[Epub] CrossRef
Behaviour and epidemiology of differentiated thyroid cancer among filipinos in and outside the Philippines: Comparison between Qatar, Canada and Philippines
Mohamed Said Ghali, Walid El Ansari, Abdelrahman Abdelaal, Mohamed S. Al Hassan
Annals of Medicine and Surgery.2022; 81: 104202. CrossRef
Association Between Thyroid Nodules and Volume and Metabolic Syndrome in an Iodine-Adequate Area: A Large Community-Based Population Study
Yue Su, Yan-ling Zhang, Meng Zhao, Hai-qing Zhang, Xu Zhang, Qing-bo Guan, Chun-xiao Yu, Shan-shan Shao, Jin Xu
Metabolic Syndrome and Related Disorders.2019; 17(4): 217. CrossRef
Accuracy of ultrasonography-guided fine needle aspiration cytology and significance of non-diagnostic cytology in the preoperative detection of thyroid malignancy
JSL Chieng, CH Lee, AA Karandikar , JPN Goh, SSS Tan
Singapore Medical Journal.2019; 60(4): 193. CrossRef
Thyroid Fine-Needle Aspiration Practice in the Philippines
Agustina D. Abelardo
Journal of Pathology and Translational Medicine.2017; 51(6): 555. CrossRef
RETRACTED: An Epidemiological Study of Risk Factors of Thyroid Nodule and Goiter in Chinese Women
Lei Zheng, Wenhua Yan, Yue Kong, Ping Liang, Yiming Mu
International Journal of Environmental Research and Public Health.2015; 12(9): 11608. CrossRef
Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee
Endocrinology and Metabolism.2015; 30(1): 47. CrossRef

Preoperative Localization and Intraoperative Parathyroid Hormone Assay in Korean Patients with Primary Hyperparathyroidism: Eirie Cho, Jung Mi Chang, Seok Young Yoon, Gil Tae Lee, Yun Hyi Ku, Hong Il Kim, Myung-Chul Lee, Guk Haeng Lee, Min Joo Kim; Endocrinol Metab. 2014;29(4):464-469. Published online December 29, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.4.464

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Background

The intraoperative parathyroid hormone (IOPTH) assay is widely used in patients with primary hyperparathyroidism (PHPT). We investigated the usefulness of the IOPTH assay in Korean patients with PHPT.

Methods

We retrospectively reviewed the data of 33 patients with PHPT who underwent parathyroidectomy. Neck ultrasonography (US) and ^99mTc-sestamibi scintigraphy (MIBI scan) were performed preoperatively and IOPTH assays were conducted.

Results

The sensitivity of neck US and MIBI scans were 91% and 94%, respectively. A 50% decrease in parathyroid hormone (PTH) levels 10 minutes after excision of the parathyroid gland was obtained in 91% (30/33) of patients and operative success was achieved in 97% (32/33) of patients. The IOPTH assay was 91% true-positive, 3% true-negative, 0% false-positive, and 6% false-negative. The overall accuracy of the IOPTH assay was 94%. In five cases with discordant neck US and MIBI scan results, a sufficient decrease in IOPTH levels helped the surgeon confirm the complete excision of the parathyroid gland with no additional neck exploration.

Conclusion

The IOPTH assay is an accurate tool for localizing hyperfunctioning parathyroid glands and is helpful for evaluating cases with discordant neck US and MIBI scan results.

Citations

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Intraoperative Parathyroid Hormone Monitoring Criteria in Primary Hyperparathyroidism
Phillip Staibano, Michael Au, Han Zhang, Sheila Yu, Winnie Liu, Jesse D. Pasternak, Xing Xing, Carolyn D. Seib, Lisa Orloff, Nhu-Tram Nguyen, Michael K. Gupta, Eric Monteiro, Sameer Parpia, Tyler McKechnie, Alex Thabane, J. E. M. (Ted) Young, Mohit Bhanda
JAMA Otolaryngology–Head & Neck Surgery.2025; 151(3): 190. CrossRef
Single-Center Experience of Parathyroidectomy Using Intraoperative Parathyroid Hormone Monitoring
Seong Hoon Kim, Si Yeon Lee, Eun Ah Min, Young Mi Hwang, Yun Suk Choi, Jin Wook Yi
Medicina.2022; 58(10): 1464. CrossRef
The natural history and hip geometric changes of primary hyperparathyroidism without parathyroid surgery
Kyong Yeun Jung, A. Ram Hong, Dong Hwa Lee, Jung Hee Kim, Kyoung Min Kim, Chan Soo Shin, Seong Yeon Kim, Sang Wan Kim
Journal of Bone and Mineral Metabolism.2017; 35(3): 278. CrossRef
The utility of the radionuclide probe in parathyroidectomy for primary hyperparathyroidism
MS Lim, M Jinih, CH Ngai, NM Foley, HP Redmond
The Annals of The Royal College of Surgeons of England.2017; 99(5): 369. CrossRef
Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee
Endocrinology and Metabolism.2015; 30(1): 47. CrossRef

Obesity and Metabolism
Association of Serum Adipocyte-Specific Fatty Acid Binding Protein with Fatty Liver Index as a Predictive Indicator of Nonalcoholic Fatty Liver Disease: Won Seon Jeon, Se Eun Park, Eun-Jung Rhee, Cheol-Young Park, Ki-Won Oh, Sung-Woo Park, Won-Young Lee; Endocrinol Metab. 2013;28(4):283-287. Published online December 12, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.4.283

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Background

Adipocyte-specific fatty acid-binding protein (A-FABP) is a cytoplasmic protein expressed in macrophages and adipocytes and it plays a role in insulin resistance and metabolic syndrome. Recently, the fatty liver index (FLI) was introduced as an indicator of nonalcoholic fatty liver disease (NAFLD). In this study, we aimed to investigate the relationship between baseline serum A-FABP levels and FLI after 4 years in apparently healthy subjects.

Methods

A total of 238 subjects without a past history of alcoholism or hepatitis were recruited from a medical check-up program. The NAFLD state was evaluated 4 years later in the same subjects using FLI. Fatty liver disease was diagnosed as diffusely increased echogenicity of the hepatic parenchyma compared to the kidneys, vascular blurring, and deep-echo attenuation. NAFLD was defined as subjects with fatty liver and no history of alcohol consumption (>20 g/day).

Results

Baseline serum A-FABP levels were significantly associated with FLI after adjustment for age and sex (P<0.001). The subjects with higher A-FABP levels had a higher mean FLI (P for trend=0.006). After adjusting for age and sex, serum A-FABP levels at baseline were shown to be significantly associated with FLI as a marker of development of NAFLD after 4 years (odds ratio, 2.68; 95% confidence interval, 1.24 to 5.80 for highest tertile vs. lowest tertile; P=0.012).

Conclusion

This study demonstrated that higher baseline serum A-FABP levels were associated with FLI as a predictive indicator of NAFLD after 4 years of follow-up in healthy Korean adults.

Citations

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Insulin Resistance, Non-Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: Clinical and Experimental Perspective
Inha Jung, Dae-Jeong Koo, Won-Young Lee
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Óscar Osorio-Conles, Ainitze Ibarzabal, José María Balibrea, Josep Vidal, Emilio Ortega, Ana de Hollanda
Journal of Clinical Medicine.2023; 12(3): 1013. CrossRef
Unveiling the Role of the Fatty Acid Binding Protein 4 in the Metabolic-Associated Fatty Liver Disease
Juan Moreno-Vedia, Josefa Girona, Daiana Ibarretxe, Lluís Masana, Ricardo Rodríguez-Calvo
Biomedicines.2022; 10(1): 197. CrossRef
Circulating level of fatty acid‐binding protein 4 is an independent predictor of metabolic dysfunction‐associated fatty liver disease in middle‐aged and elderly individuals
Marenao Tanaka, Satoko Takahashi, Yukimura Higashiura, Akiko Sakai, Masayuki Koyama, Shigeyuki Saitoh, Kazuaki Shimamoto, Hirofumi Ohnishi, Masato Furuhashi
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Georgiana-Diana Cazac, Cristina-Mihaela Lăcătușu, Cătălina Mihai, Elena-Daniela Grigorescu, Alina Onofriescu, Bogdan-Mircea Mihai
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Relationship Between Fatty Acid Binding Protein 4 and Liver Fat in Individuals at Increased Cardiometabolic Risk
Ricardo Rodríguez-Calvo, Juan Moreno-Vedia, Josefa Girona, Daiana Ibarretxe, Neus Martínez-Micaelo, Jordi Merino, Nuria Plana, Lluis Masana
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Yiting Xu, Xiaojing Ma, Xiaoping Pan, Xingxing He, Yufei Wang, Yuqian Bao
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Liver fatty acid-binding protein as a diagnostic marker for non-alcoholic fatty liver disease
Erdem Akbal, Erdem Koçak, Ömer Akyürek, Seyfettin Köklü, Hikmetullah Batgi, Mehmet Şenes
Wiener klinische Wochenschrift.2016; 128(1-2): 48. CrossRef
High‐methionine diets accelerate atherosclerosis by HHcy‐mediated FABP4 gene demethylation pathway via DNMT1 in ApoE−/− mice
An-Ning Yang, Hui-Ping Zhang, Yue Sun, Xiao-Ling Yang, Nan Wang, Guangrong Zhu, Hui Zhang, Hua Xu, Sheng-Chao Ma, Yue Zhang, Gui-Zhong Li, Yue-Xia Jia, Jun Cao, Yi-Deng Jiang
FEBS Letters.2015; 589(24PartB): 3998. CrossRef
Metabolic Health Is More Important than Obesity in the Development of Nonalcoholic Fatty Liver Disease: A 4-Year Retrospective Study
Min-Kyung Lee, Eun-Jung Rhee, Min Chul Kim, Byung Sub Moon, Jeong In Lee, Young Seok Song, Eun Na Han, Hyo Sun Lee, Yoonjeong Son, Se Eun Park, Cheol-Young Park, Ki-Won Oh, Sung-Woo Park, Won-Young Lee
Endocrinology and Metabolism.2015; 30(4): 522. CrossRef
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Noninvasive Markers for the Diagnosis of Nonalcoholic Fatty Liver Disease
Sang Yong Kim
Endocrinology and Metabolism.2013; 28(4): 280. CrossRef

Case Report

Thyroid
Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation: Ho-Su Kim, Bong Hoi Choi, Jung Rang Park, Jong Ryeal Hahm, Jung Hwa Jung, Soo Kyoung Kim, Sungsu Kim, Kyong-Young Kim, Soon Il Chung, Tae Sik Jung; Endocrinol Metab. 2013;28(3):231-235. Published online September 13, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.3.231

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Primary hyperparathyroidism occurs as a result of isolated parathyroid adenoma in 80% to 85% of all cases. A ^99mtechnetium (^99mTc) sestamibi scan or neck ultrasonography is used to localize the neoplasm prior to surgical intervention. A 53-year-old female was referred for the exclusion of metabolic bone disease. She presented with low back pain that had persisted for the past 6 months and elevated serum alkaline phosphatase (1,253 IU/L). Four years previously, she had been diagnosed at a local hospital with a 2.3-cm thyroid nodule, which was determined to be pathologically benign. Radiofrequency ablation was performed at the same hospital because the nodule was still growing during the follow-up period 2 years before the visit to our hospital, and the procedure was unsuccessful in reducing the size of the nodule. The results of the laboratory tests in our hospital were as follows: serum calcium, 14.6 mg/dL; phosphorus, 3.5 mg/dL; and intact parathyroid hormone (iPTH), 1,911 pg/mL. Neck ultrasonography and ^99mTc sestamibi scan detected a 5-cm parathyroid neoplasm in the left lower lobe of the patient's thyroid; left parathyroidectomy was performed. This case indicated that thyroid ultrasonographers and pathologists need to be experienced enough to differentiate a parathyroid neoplasm from a thyroid nodule; ^99mTc sestamibi scan, serum calcium, and iPTH levels can help to establish the diagnosis of parathyroid neoplasm.

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Hanifa Akhtar, Ruuzeno Kuotsu, Sankappa P. Sinhasan, Md Jamil, Neizekhotuo Brian Shunyu, Pakesh Baishya, DebKumar Boruah, Nisha Kumari
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Risk factors influencing cure of ultrasound-guided microwave ablation for primary hyperparathyroidism
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Efficacy and safety of radiofrequency ablation versus parathyroidectomy for secondary hyperparathyroidism in dialysis patients: a single-center retrospective study
Mian Ren, Danna Zheng, Juan Wu, Yueming Liu, Chengzhong Peng, Wei Shen, Bo Lin
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Iram Hussain, Shahzad Ahmad, Jules Aljammal
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Efficacy of Ultrasound-guided Radiofrequency Ablation of Parathyroid Hyperplasia: Single Session vs. Two-Session for Effect on Hypocalcemia
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Li Zhuo, Li-li Peng, Yu-mei Zhang, Zhi-hong Xu, Gu-ming Zou, Xin Wang, Wen-ge Li, Ming-de Lu, Ming-an Yu
Radiology.2017; 282(2): 576. CrossRef
Safety and efficiency of microwave ablation for recurrent and persistent secondary hyperparathyroidism after parathyroidectomy: A retrospective pilot study
Ming-An Yu, Li Yao, Ling Zhang, Lili Peng, Li Zhuo, Yumei Zhang, Wenge Li, Ming-De Lv
International Journal of Hyperthermia.2016; 32(2): 180. CrossRef
A nonfunctioning parathyroid carcinoma misdiagnosed as a follicular thyroid nodule
Filomena Cetani, Gianluca Frustaci, Liborio Torregrossa, Silvia Magno, Fulvio Basolo, Alberto Campomori, Paolo Miccoli, Claudio Marcocci
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Review Article

Thyroid
Indications for Fine Needle Aspiration in Thyroid Nodules: Jin Young Kwak; Endocrinol Metab. 2013;28(2):81-85. Published online June 18, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.2.81

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Thyroid nodules are a common clinical problem with the widespread use of ultrasonography. Fine needle aspiration (FNA) is the mainstay for diagnosing a thyroid malignancy. There have been several guidelines on when to perform FNA in thyroid nodules. This review is based on several published recommendations and helps physicians easily understand the factors favoring FNA.

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Case Report

Thyroid
Benign Teratoma of the Thyroid Gland: Chan Young Oak, Hee Kyung Kim, Tae Mi Yoon, Sang Chul Lim, Hyun Bum Park, Hyung Chul Park, Min Gui Han, Ho-Cheol Kang; Endocrinol Metab. 2013;28(2):144-148. Published online June 18, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.2.144

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Although pathology reports of thyroid tissue in ovarian teratomas are abundant, benign teratomas of the thyroid are extremely rare in adolescents and adults. Therefore, their clinical characteristics are still not well characterized. We report a case of a 54-year-old woman with a growing mass in her neck. Left lobectomy of the thyroid revealed it to be a benign thyroid teratoma composed of tissues from all three germ layers. Preoperative evaluations included thyroid ultrasonography (US), ultrasound-guided fine needle aspiration cytology (FNAC), and computed tomography (CT) of the neck. A 4.7-cm, well defined, predominantly hypoechoic mass intermingled with hyperechoic internal lesions, was observed in the inferior portion of the left thyroid lobe with substernal extension on US. The posterior extent of the nodule was not visualized due to deep attenuation of the echo. US-guided FNAC failed to reveal any thyroid follicular cells, but suggested a benign cystic tumor. Neck CT hinted at the diagnosis of teratoma because the mass contained large amounts of fat, and the margin was well defined. Extrathyroidal extension and cervical lymphadenopathy were not seen. She underwent left thyroid lobectomy, and histologic examination confirmed benign thyroid teratoma. To the best of our knowledge, this is the first case report of benign thyroid teratoma in Korea.

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Original Articles

Thyroid
Natural Course of Cytologically Benign Thyroid Nodules: Observation of Ultrasonographic Changes: Dong Jun Lim, Jee Young Kim, Ki Hyun Baek, Mee Kyoung Kim, Woo Chan Park, Jong Min Lee, Moo Il Kang, Bong Yun Cha; Endocrinol Metab. 2013;28(2):110-118. Published online June 18, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.2.110

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Background

The natural course of cytologically benign thyroid nodules remains unclear. The aim of this study was to evaluate whether ultrasonographic (US) changes are associated with changes in nodule volume during follow-up.

Methods

We retrospectively reviewed over 4 years of clinical records of patients with benign thyroid nodules as confirmed by fine needle aspiration (FNA). In total, 186 patients with 202 benign thyroid nodules were included for study. We assessed for changes in nodule volume and examined the cystic portion of the nodule as well as four US features (echogenicity, margin, calcification pattern, and shape).

Results

During follow-up (mean, 21.7±10.7 months) and using 50% as a cutoff value, nodule volumes increased in 11.8%, exhibited no change in 79.9%, and decreased in 8.3% of patients. Proportion of nodules demonstrating at least one US change was 20.8% (42/202). The most common US changes (in descending order of frequency) were cystic change, margin change, and calcification pattern change. Nodule shape and echogenicity rarely changed. Increased nodule volume was not significantly associated with any US features or with the number of FNAs but was associated with younger age at time of diagnosis.

Conclusion

Although a portion of thyroid nodules confirmed as benign showed US changes or volume changes during the follow-up period, these findings may only represent the natural course of benign nodules. Frequent follow-up with US might be needed for only a small number of cases with suspicious US findings.

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Letter: Natural Course of Cytologically Benign Thyroid Nodules: Observation of Ultrasonographic Changes (Endocrinol Metab 2013;28:110-8, Dong Jun Lim et al.)
Sun Wook Cho
Endocrinology and Metabolism.2013; 28(3): 241. CrossRef
Natural Course of Benign Thyroid Nodules
Kyung Won Kim
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Response: Natural Course of Cytologically Benign Thyroid Nodules: Observation of Ultrasonographic Changes (Endocrinol Metab 2013;28:110-8, Dong Jun Lim et al.)
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Endocrinology and Metabolism.2013; 28(3): 243. CrossRef

Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-Ups and Analysis of Fine Needle Aspiration Cytology.: Won Jun Kim, Joo Hyong Kim, Dong Won Park, Chang Beom Lee, Yong Soo Park, Dong Sum Kim, Woong Hwan Choi, Tae Wha Kim, You Hern Ahn; J Korean Endocr Soc. 2008;23(6):413-419. Published online December 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.6.413

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Abstract PDF

BACKGROUND
The purpose of this study was to assess the prevalence of thyroid nodules in healthy adults without a history of thyroid disease and the results of fine needle aspiration cytology (FNAC). METHODS: We retrospectively studied 4,832 adults (2,427 women, 2,405 men) over the age of 20 who had visited our health care center from January, 2005, to March, 2008. Subjects with previous thyroid disease were excluded. All were screened by thyroid ultrasonography and FNAC was performed on large or potentially malignant nodules. RESULTS: Thyroid nodules were present in 686 women (28.3%) and 396 men (16.5%), with a female predominance (odds ratio = 1.47, 95% CI = 1.35~1.60). The prevalence of a thyroid nodule was significantly correlated with age in both women and men (P < 0.001). Multinodularity also increased according to age in both groups. Ninety patients were tested with conventional FNAC and 195 underwent ultrasonography-guided FNAC. The rate of inadequate cytology by ultrasonographic guidance was lower than by freehand methods, and the total rate of malignant cytology per patient was 17.9%. Ultrasonographic characteristics that significantly correlated with histologically-confirmed papillary carcinoma included a solid component, hypoechogenecity, irregular margin, and the presence of microcalcification or macrocalcification. CONCLUSION: The prevalence of thyroid nodules detected by ultrasonography was 28.3% in healthy women and 16.5% in healthy men population. The prevalence and multinodularity was significantly correlated with age in both groups. It's useful to examine thyroid by ultrasonography because of detecting more nodules, providing guidance of FNAC, achieving more adequate sampling and not missing small malignant nodules.

Citations

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The Prevalence of Thyroid Nodules and the Morphological Analysis of Malignant Nodules on Ultrasonography
An Hyun, Ji Tae-jeong, Lee Hyo-young, Im In-chul
Journal of Radiological Science and Technology.2019; 42(3): 201. CrossRef
Ultrasonographic Characteristics of the Hyperfunctioning Thyroid Nodule and Predictive Factors for Thyroid Stimulating Hormone Suppression
Won Sang Yoo, Hoon Sung Choi
International Journal of Thyroidology.2019; 12(1): 35. CrossRef
Prevalence and Annual Incidence of Thyroid Disease in Korea from 2006 to 2015: A Nationwide Population-Based Cohort Study
Hyemi Kwon, Jin-hyung Jung, Kyung-Do Han, Yong-Gyu Park, Jung-Hwan Cho, Da Young Lee, Ji Min Han, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
Endocrinology and Metabolism.2018; 33(2): 260. CrossRef
Prevalence of thyroid nodules and their associated clinical parameters: a large-scale, multicenter-based health checkup study
Jae Hoon Moon, Min Kyung Hyun, Ja Youn Lee, Jung Im Shim, Tae Hyuk Kim, Hoon Sung Choi, Hwa Young Ahn, Kyung Won Kim, Do Joon Park, Young Joo Park, Ka Hee Yi
The Korean Journal of Internal Medicine.2018; 33(4): 753. CrossRef
Analysis of Fine Needle Aspiration Results of Thyroid Nodules in Ultrasonography
Jong-Gil Kwak, Jae-Bok Han, Jong-Nam Song, Il-Bong Moon, Nam-Gil Choi
The Journal of the Korea Contents Association.2016; 16(5): 290. CrossRef
Clinical Characteristics and Incidence of Thyroid Nodule in the Male Population for Health Check-up
Yeon Jin Jeon, Young Teag Koh, Seung Jong Oh, Min Young Koo
Korean Journal of Endocrine Surgery.2015; 15(4): 93. CrossRef
Clinical Characteristics and Incidence of Thyroid Nodule in the Male Population for Health Check-up
Yeon Jin Jeon, Young Teag Koh, Seung Jong Oh, Min Young Koo
Korean Journal of Endocrine Surgery.2015; 15(4): 93. CrossRef
Management of Thyroid Nodules and Cancers Arising in the Elderly
Eunyoung Kim, June Young Choi, Kyu Eun Lee
Journal of Korean Thyroid Association.2012; 5(2): 99. CrossRef
Screening of Thyroid Cancer and Management of Thyroid Incidentaloma
Jung Jin Cho
Korean Journal of Family Medicine.2010; 31(2): 87. CrossRef

Prevalence of Thyroid Nodules Detected by Ultrasonography in Adult Men Attending Health Check-ups.: Jung Hyun Kim, Sang Jun Park, Sang Eok Kim, Kwang Hee Lee, Il Kwon Cho, Sun Ik Jang, Jin Kwan Lee, Keum Soo Seo, Hyuck Po Kwon, Sung Chang Chung; J Korean Endocr Soc. 2007;22(2):112-117. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.112

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Abstract PDF

BACKGROUND
Thyroid nodules are a common disease in clinical practice. The prevalence of thyroid nodules has recently been increased by according to the development of thyroid ultrasonography. Thyroid nodules are more commonly found in women, but the potential for malignant nodules is much higher in men. So, we aimed to focus on the prevalence of thyroid nodules in the adult male population. METHODS: We studied men over the age of 30 who visited our health care center for routine health check-ups from January, 2005 to December, 2005. After excluding the patients with previous thyroid disorders, 1081 men were selected to undergo thyroid ultrasonography for detecting the presence of thyroid nodules. If nodules were found, then their size and numbers were recorded. These data were then correlated with the age of the patients. If needed, ultrasound-guided fine needle aspiration was performed. RESULTS: Among the 1,081 subjects, thyroid nodules were detected in 152 (14.1%) with its prevalence increasing with the increasing age of the patients (age 30 to 49: 12.3%, over 50: 17.2%, P = 0.026). Among these study subjects, nodules larger than 5 mm in size were detected in 99 patients and fine needle aspirations were performed on 53 of these patients. Six patients were diagnosed with papillary carcinoma. CONCLUSION: The prevalence of thyroid nodules in the male population was 14.1%, with an increasing prevalence in the over 50 age group.

Citations

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The Prevalence of Thyroid Nodules and the Morphological Analysis of Malignant Nodules on Ultrasonography
An Hyun, Ji Tae-jeong, Lee Hyo-young, Im In-chul
Journal of Radiological Science and Technology.2019; 42(3): 201. CrossRef
Prevalence of thyroid nodules and their associated clinical parameters: a large-scale, multicenter-based health checkup study
Jae Hoon Moon, Min Kyung Hyun, Ja Youn Lee, Jung Im Shim, Tae Hyuk Kim, Hoon Sung Choi, Hwa Young Ahn, Kyung Won Kim, Do Joon Park, Young Joo Park, Ka Hee Yi
The Korean Journal of Internal Medicine.2018; 33(4): 753. CrossRef
Prevalence and Annual Incidence of Thyroid Disease in Korea from 2006 to 2015: A Nationwide Population-Based Cohort Study
Hyemi Kwon, Jin-hyung Jung, Kyung-Do Han, Yong-Gyu Park, Jung-Hwan Cho, Da Young Lee, Ji Min Han, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
Endocrinology and Metabolism.2018; 33(2): 260. CrossRef
Clinical Characteristics and Incidence of Thyroid Nodule in the Male Population for Health Check-up
Yeon Jin Jeon, Young Teag Koh, Seung Jong Oh, Min Young Koo
Korean Journal of Endocrine Surgery.2015; 15(4): 93. CrossRef
An Iodine Database for Common Korean Foods and the Association between Iodine Intake and Thyroid Disease in Korean Adults
Mi-Rhan Han, Dal Lae Ju, Young Joo Park, Hee-Young Paik, YoonJu Song
International Journal of Thyroidology.2015; 8(2): 170. CrossRef
Clinical Characteristics and Incidence of Thyroid Nodule in the Male Population for Health Check-up
Yeon Jin Jeon, Young Teag Koh, Seung Jong Oh, Min Young Koo
Korean Journal of Endocrine Surgery.2015; 15(4): 93. CrossRef
Screening of Thyroid Cancer and Management of Thyroid Incidentaloma
Jung Jin Cho
Korean Journal of Family Medicine.2010; 31(2): 87. CrossRef
Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-Ups and Analysis of Fine Needle Aspiration Cytology
Won Jun Kim, Joo Hyong Kim, Dong Won Park, Chang Beom Lee, Yong Soo Park, Dong Sum Kim, Woong Hwan Choi, Tae Wha Kim, You Hern Ahn
Journal of Korean Endocrine Society.2008; 23(6): 413. CrossRef
Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-up and Analysis of Fine Needle Aspiration Cytology
Jae Hoon Chung
Journal of Korean Endocrine Society.2008; 23(6): 391. CrossRef

Prevalence of Ultrasonographically-Detected Thyroid Nodules in Adults without Previous History of Thyroid Disease.: Ji Hye Suk, Tae Yong Kim, Mi Kyung Kim, Won Bae Kim, Hong Kyu Kim, Seong Hoon Jeon, Young Kee Shong; J Korean Endocr Soc. 2006;21(5):389-393. Published online October 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.5.389

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Abstract PDF

BACKGROUND
The prevalence of palpable thyroid nodules in the general population is about 5%, and is 3~5 times higher in women than in men. However, much higher prevalence, up to 50%, was reported from autopsy data. Recently, the use of high resolution ultrasonography for routine check-up has resulted in much more detection of non-palpable thyroid nodules. We studied the prevalence of thyroid nodules in healthy adults without history of thyroid disease, and compared the prevalence in relation to palpability, age and gender. METHODS: The prevalence of thyroid nodules was studied in adults aged from 20 to 79 years who had visited the health promotion center at Asan Medical Center, Seoul, Korea, from Jan 2002 to Dec 2003. Subjects with previous thyroid disease were excluded. 7,440 subjects (6,168 female, 1,272 men) were included in this study. Thyroid palpation was performed and followed by ultrasonography using a 12-MHz real-time scanner. RESULTS: Thyroid nodules were detected in 3,040 of the 7,440 subjects (41%). Palpable nodules were present in 213 (3%), and non-palpable, but ultrasonographically detected thyroid nodules were present in 2,827 (38%). Thyroid nodules were present in 2,602 women (42.2%) and 370 men (29%). Among them, 159 women (2.6%) and 54 men (4.2%) had palpable thyroid nodules and 2,443 women (39.6%) and 316 men (24.8%) had non-palpable but ultrasonographically detected nodules. A significant linear trend was found between age and the prevalence of thyroid nodules. CONCLUSIONS: The prevalence of ultrasonographically detected thyroid nodules in adults with no previous history of thyroid disease was 41%. The prevalence of palpable nodules and non-palpable, but ultrasonographically detected nodules were 3% and 38%, respectively. Thyroid nodules were detected in 42.2% of women and 29% of men, showing that thyroid nodules are very common in healthy adults, even in men.

Citations

Citations to this article as recorded by

The Prevalence of Thyroid Nodules and the Morphological Analysis of Malignant Nodules on Ultrasonography
An Hyun, Ji Tae-jeong, Lee Hyo-young, Im In-chul
Journal of Radiological Science and Technology.2019; 42(3): 201. CrossRef
Prevalence of thyroid nodules and their associated clinical parameters: a large-scale, multicenter-based health checkup study
Jae Hoon Moon, Min Kyung Hyun, Ja Youn Lee, Jung Im Shim, Tae Hyuk Kim, Hoon Sung Choi, Hwa Young Ahn, Kyung Won Kim, Do Joon Park, Young Joo Park, Ka Hee Yi
The Korean Journal of Internal Medicine.2018; 33(4): 753. CrossRef
Prevalence and Annual Incidence of Thyroid Disease in Korea from 2006 to 2015: A Nationwide Population-Based Cohort Study
Hyemi Kwon, Jin-hyung Jung, Kyung-Do Han, Yong-Gyu Park, Jung-Hwan Cho, Da Young Lee, Ji Min Han, Se Eun Park, Eun-Jung Rhee, Won-Young Lee
Endocrinology and Metabolism.2018; 33(2): 260. CrossRef
An Iodine Database for Common Korean Foods and the Association between Iodine Intake and Thyroid Disease in Korean Adults
Mi-Rhan Han, Dal Lae Ju, Young Joo Park, Hee-Young Paik, YoonJu Song
International Journal of Thyroidology.2015; 8(2): 170. CrossRef
Management of Thyroid Nodules and Cancers Arising in the Elderly
Eunyoung Kim, June Young Choi, Kyu Eun Lee
Journal of Korean Thyroid Association.2012; 5(2): 99. CrossRef
Screening of Thyroid Cancer and Management of Thyroid Incidentaloma
Jung Jin Cho
Korean Journal of Family Medicine.2010; 31(2): 87. CrossRef
Postoperative Findings of the Cytological Diagnosis of Follicular Neoplasm or Hürthle Cell Neoplasm and the Risk of Malignancy
Ji Hye Yim, Eui Young Kim, Won Gu Kim, Tae Yong Kim, Gyungyup Gong, Suck Joon Hong, Won Bae Kim, Young Kee Shong
Endocrinology and Metabolism.2010; 25(4): 316. CrossRef
Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-up and Analysis of Fine Needle Aspiration Cytology
Jae Hoon Chung
Journal of Korean Endocrine Society.2008; 23(6): 391. CrossRef
Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-Ups and Analysis of Fine Needle Aspiration Cytology
Won Jun Kim, Joo Hyong Kim, Dong Won Park, Chang Beom Lee, Yong Soo Park, Dong Sum Kim, Woong Hwan Choi, Tae Wha Kim, You Hern Ahn
Journal of Korean Endocrine Society.2008; 23(6): 413. CrossRef
Trends Analysis of Characteristics of Thyroid Cancer Patients in One Medical Center
Seung Hun Lee, Tae Yong Kim, Jin-Sook Ryu, Gyungyub Gong, Won Bae Kim, Seong Chul Kim, Suck Joon Hong, Young Kee Shong
Journal of Korean Endocrine Society.2008; 23(1): 35. CrossRef
Prevalence of Thyroid Nodules Detected by Ultrasonography in Adult Men Attending Health Check-ups
Jung Hyun Kim, Sang Jun Park, Sang Eok Kim, Kwang Hee Lee, Il Kwon Cho, Sun Ik Jang, Jin Kwan Lee, Keum Soo Seo, Hyuck Po Kwon, Sung Chang Chung
Journal of Korean Endocrine Society.2007; 22(2): 112. CrossRef

The Usefulness of High Resolution Ultrasonography in the Differentiation of Thyroid Nodule.: Hyun Dae Yoon, Ho Sang Shon; J Korean Endocr Soc. 2005;20(3):242-251. Published online June 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.3.242

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Abstract PDF

BACKGROUND
Fine needle aspiration(FNA) is regarded as the best procedure in the diagnosis of thyroid malignancies. However, the rate of false negative and indeterminate results are between 5~10 and 10~30%, respectively. Therefore, a new diagnostic tool to assist FNA is required. Recently, high resolution ultrasonography(US) has become a useful tool in the detection of malignant thyroid nodules. Therefore, the sonographic characteristics differentiating malignant from benign nodules were analyzed, and the usefulness of US in the diagnosis of thyroid malignancy assessed. METHODS: Of the 212 patients that underwent surgery due to a thyroid nodule, at the Daegu Catholic University Hospital between January 2002 and June 2004, and 181 patients(199 nodules) who underwent high resolution US examination before surgery, were included in this study. The characteristics of the sonographic parameters, such as depth/width ratio, shape, margin, structure, sponge sign, calcification and halo, and the homogeneity and echogenicity of the solid component and invasion, were observed. RESULTS: In a univariate analysis of the nonfollicular neoplasms, the depth/width ratio, shape, margin, structure, calcification and halo, and the homogeneity and echogenicity of the solid component were found to be significant parameters. The "sponge sign", a new parameter suggested by us, was found only in benign nodules. In a multiple logistic regression analysis, only the depth/width ratio, shape, presence of calcification and echogenicity of the solid component were significant parameters. According to the results of the multiple logistic regression analysis, the point and estimate of each characteristic of the significant parameters were found, and a formula for calculating a score for the prediction of malignancy computed. At a score of 0.44, the sensitivity and specificity of US were 85.9 and 88.7%, respectively. In a univariate analysis of follicular neop-lasms, the shape, calcification and echogenicity were found to be significant parameters. CONCLUSION: It was conclude that high resolution US is a very useful tool in the differentiation of benign and malignant nodules, especially in nonfollicular neoplasms. It is also suggested that the "sponge sign" might be used as a strong indicator for the confirmation of benign nodules

Citations

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Effectiveness of Suppressive Therapy with Levothyroxine in Benign Thyroid Nodules
Yun Jeong Kim, Kyung Tae, Seok Young Kang, Yong Seop Lee, Dong Sun Kim, Tae Hwa Kim, You Hern Ahn
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2009; 52(8): 674. CrossRef

Prevalence of Thyroid Nodules detected by Ultrasonography in Womens Attending Health Check-Ups.: Chang Hoon Yim, Han Jin Oh, Ho Yeon Chung, Ki Ok Han, Hak Chul Jang, Hyun Ku Yoon, In Kwon Han, Byoung Hee Han, Kyung Sang Lee, Byung Jae Cho; J Korean Endocr Soc. 2002;17(2):183-188. Published online April 1, 2002

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Abstract PDF: BACKGROUND
Thyroid nodules are commonly found in clinical practice, and the recent development of thyroid ultrasonography has allowed for the detection of small nodules previously undetectable by routine palpations. Since previous studies on thyroid ultrasonography have been focused on patients with known thyroid disorders, we aimed to determine the prevalence of thyroid nodules in a female population. METHODS: We studied women in the age range 30 to 70 years visiting the health promotion center at Samsung Cheil Hospital for routine health check-ups. After excluding patients with previous thyroid disorders, 1300 women where selected to undergo thyroid ultrasonography for the detection of the presence of thyroid nodules. If nodules were found, their size and numbers were recorded, and these data correlated with the patients age. RESULTS: Of the 1300 subjects, thyroid nodules were detected in 490 (37.7%) with their prevalence (p=0.009), and that of multinodularity of thyroid nodules (p=0.001), increasing with the increasing age of the patients (Age 30 to 39: 30.8%, 40 to 49: 37.0%, 50 to 59: 41.5% and 60 to 69: 65.2%). Among these study subjects, nodules larger than 15 mm in size were detected in 29 and after performing fine needle aspirations on 18 nodules, 17 were found to be benign, with 1 papillary carcinoma, which required a total thyroidectomy. CONCLUSION: The prevalence of thyroid nodules in our female study population was 37.7%, with their prevalence, and that of multinodularity of thyroid nodules, increasing with increased age.

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