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Wilmington, NC, United States

Azizi G.,Wilmington Endocrinology | Malchoff C.D.,University of Connecticut Health Center
Endocrine Practice | Year: 2011

Objective: To examine the relationship between clinical markers of autoimmune thyroid disease and the risk of thyroid cancer in patients with thyroid nodules.Methods: A retrospective cohort analysis was performed in a single clinical practice. In 2,500 consecutive patients, fine-needle aspiration biopsy (FNAB) was performed on all 3,658 ultrasonography-positive thyroid nodules that were ≥1.0 cm in diameter or ≥0.5 cm in diameter with ultrasound features suspicious for thyroid cancer. Serum concentrations of thyroglobulin antibodies (TgAb), thyroid peroxidase antibodies, and thyroid-stimulating hormone were measured before FNAB. Diagnosis of thyroid cancer was based on pathologic analysis of thyroidectomy tissue. Associations of thyroid cancer with the independent variables were determined by multivariate logistic regression analysis and reported as the adjusted odds ratio (OR) with the 95% confidence interval (CI).Results: There were 202 patients with malignant thyroid nodules, 51 patients with microscopic unsuspected thyroid cancer distal to the nodule under investigation (found at thyroidectomy), and 2,247 patients with benign thyroid nodules. To evaluate the association of clinical markers for autoimmune thyroid disease with thyroid cancer, we included all 253 patients with thyroid cancer in the malignant cohort. Thyroid cancer was associated with elevated levels of TgAb (OR = 1.57; CI = 1.11 to 2.23) and age <55 years (OR = 2.01; CI = 1.45 to 2.78), and a strong trend was demonstrated for association with male sex (OR = 1.45; CI = 0.99 to 2.12). Thyroid cancer was not associated with elevated levels of thyroid peroxidase antibodies.Conclusion: In patients who have thyroid nodules with indications for FNAB, elevated levels of TgAb are associated with thyroid cancer. Copyright © 2011 AACE. Source

Wilmington Endocrinology | Date: 2014-10-22

Computer software used to analyze thyroid nodules to predict the risk of thyroid malignancy.

Wilmington Endocrinology | Date: 2013-05-29

software for predicting the risk of thyroid malignancy of a thyroid nodule.

Azizi G.,Wilmington Endocrinology | Keller J.M.,Wilmington Pathology Associates | Mayo M.L.,Wilmington Endocrinology | Piper K.,Research Compliance | And 3 more authors.
Ultrasound in Medicine and Biology | Year: 2016

This prospective study evaluates the accuracy of virtual touch imaging quantification (VTIQ), a non-invasive shear wave elastography method for measuring cervical lymph nodes (LN) stiffness in differentiating benign from malignant LN. The study evaluated 270 LN in 236 patients with both conventional B-mode ultrasound and VTIQ shear wave elastography before fine-needle aspiration biopsy (FNAB). LN stiffness was measured as shear wave velocity (SWV) in m/s. Surgical resection was advised for FNAB results that were not clearly benign. Surgical pathology confirmed 54 malignant LN. The receiver operating curve (ROC) identified a single cut-off value of 2.93 m/s as the maximum SWV for predicting a malignant cervical LN. The sensitivity and specificity were 92.59% and 75.46%, respectively. Positive predictive value (PPV) was 48.54% and negative predictive value (NPV) was 97.60%. LN stiffness measured by VTIQ-generated shear wave elastography is an independent predictor of malignancy. © 2016 The Authors. Source

Azizi G.,Wilmington Endocrinology | Piper K.,Beth Israel Deaconess Medical Center | Keller J.M.,NC Associates | Mayo M.L.,Wilmington Endocrinology | And 3 more authors.
European Journal of Radiology | Year: 2016

Objectives This study prospectively determines the shear wave elastography characteristics of parathyroid adenomas using virtual touch imaging quantification, a non-invasive ultrasound based shear wave elastography method. Methods This prospective study examined 57 consecutive patients with biochemically proven primary hyperparathyroidism and solitary parathyroid adenoma identified by ultrasound and confirmed by at least one of the following: surgical resection, positive Technetium–99 m Sestamibi Scintigraphy (MIBI) scan, or fine needle aspiration biopsy with positive PTH washout (performed only in MIBI negative patients). Vascularity and shear wave elastography were performed for all patients. Parathyroid adenoma stiffness was measured as shear wave velocity in meters per second. Results The median (range) pre-surgical value for PTH and calcium were 58 pg/mL (19, 427) and 10.8 mg/dL (9.5, 12.1), respectively. 37 patients had positive MIBI scan. 20 patients had negative MIBI scan but diagnosis was confirmed with positive PTH washout. 42 patients underwent parathyroidectomy, and an adenoma was confirmed in all. The median (range) shear wave velocity for all parathyroid adenomas enrolled in this study was 2.02 m/s (1.53, 2.50). The median (range) shear wave velocity for thyroid tissue was 2.77 m/s (1.89, 3.70). The shear wave velocity of the adenomas was independent of adenoma size, serum parathyroid hormone concentration, or plasma parathyroid hormone concentration. Conclusions Tissue elasticity of parathyroid adenoma is significantly lower than thyroid tissue. B-mode features and distinct vascularity pattern are helpful tools in diagnosing parathyroid adenoma with ultrasound. Shear wave elastography may provide valuable information in diagnosing parathyroid adenoma. © 2016 The Author(s) Source

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