Background Acromegaly is a rare disease that is frequently associated with thyroid diseases. The exact prevalence of goiter and thyroid dysfunction remains uncertain. Objectives This study aims to provide a comprehensive description of the clinical, morphological, and biochemical features of thyroid disorder in Saudi patients with acromegaly and to establish its correlation with the activity and duration of the disease. Methods This retrospective study involved patients who were diagnosed with acromegaly during the period 2006-2023 in an outpatient endocrine clinic at a tertiary hospital. Results A total of 40 patients with acromegaly (27 males and 13 females) were identified and included in the analysis, with a mean age of 46.78 ± 13.76 years and an estimated duration of disease of 8.08 ± 6.43 years. Goiter was diagnosed in 28 patients (70.0%), including multinodular goiter (MNG) (70.0%), solitary thyroid nodules (14.2%), and thyroid cysts (14.2%). Primary hypothyroidism was present at 40.0%. Goiter was not correlated with estimated insulin-like growth factor 1 (IGF-1) levels or disease duration. In 40 patients with nodular goiter, fine needle biopsies were performed in six cases; five nodules were benign, and one nodule was a follicular lesion of unknown significance (Bethesda III). Conclusions The patients with acromegaly have a high prevalence of nodular thyroid disorders and thyroid dysfunction. No cases of thyroid cancer were found in our study. The periodic ultrasonography assessment of the thyroid is needed for evaluating patients with acromegaly.

Gray-scale ultrasound (US) is the standard-of-care for evaluating thyroid nodules (TNs). However, the performance is better for the identification of hypoechoic malignant TNs (such as classic papillary thyroid cancer) than isoechoic malignant TNs. Quantitative ultrasound (QUS) utilizes information from raw ultrasonic radiofrequency (RF) echo signal to assess properties of tissue microarchitecture. The purpose of this study is to determine if QUS can improve the cancer risk stratification of isoechoic TNs.
Patients scheduled for TN fine needle biopsy (FNB) were recruited from the Thyroid Health Clinic at Boston Medical Center. B-mode US and RF data (to generate QUS parameters) were collected in 274 TNs (163 isoechoic, 111 hypoechoic). A linear combination of QUS parameters (CQP) was trained and tested for isoechoic [CQP(i)] and hypoechoic [CQP(h)] TNs separately and compared with the performance of conventional B-mode US risk stratification systems.
CQP(i) produced an ROC AUC value of 0.937+/- 0.043 compared to a value of 0.717 +/- 0.145 (p >0.05) for the American College of Radiology Thyroid Imaging, Reporting and Data System (ACR TI-RADS) and 0.589 +/- 0.173 (p >0.05) for the American Thyroid Association (ATA) risk stratification system. In this study, CQP(i) avoids unnecessary FNBs in 73% of TNs compared to 55.8% and 11.8% when using ACR TI-RADS and ATA classification system.
This data supports that a unique QUS-based classifier may be superior to conventional US stratification systems to evaluate isoechoic TNs for cancer and should be explored further in larger studies.

OBJECTIVE: The study explores various factors, including coronavirus disease 2019 (COVID-19) history and vaccination status, that influence the classification value of ultrasonography-guided thyroid fine needle aspiration biopsy (TFNAB) by comparing non-diagnostic (Bethesda-I) and diagnostic (Bethesda II-VI) results.
METHODS: We conducted a retrospective observational study in a high-volume tertiary care center involving patients who underwent TFNAB from November 2022 to April 2023. The study retrospectively analyzed the cytopathology of 482 thyroid nodules. Patients were categorized into non-diagnostic (n = 136) and Diagnostic groups (n = 346) based on TFNAB. A comprehensive set of parameters was examined, including demographic, anthropometric and clinical data, thyroid ultrasonography findings, COVID-19 history and immunization status.
RESULTS: The mean age was 55.1 ± 12.1 years in the non-diagnostic group and 53.5 ± 13 years in the Diagnostic group (p = .223). 75.7% (n = 103) of the non-Diagnostic group and 82.9% (n = 287) of the Diagnostic group were male (p = .070). The mean nodule longitudinal diameter of the Diagnostic group was significantly higher than that of the non-diagnostic group (p = .015). The TIRADS score of the nodules showed a statistical difference between the groups (p = .048). The groups had no significant differences regarding other ultrasonographic parameters and COVID-19-related variables.
CONCLUSIONS: It can be assumed that when the longitudinal diameter of the thyroid nodule is small and in TIRADS categories other than the TIRADS3 category, TFNAB is less likely to be diagnostic. However, future research may be needed to confirm these findings and uncover any long-term effects of COVID-19 or vaccines on thyroid nodule diagnostics.

UNASSIGNED: Thyroid pathologies are very common diseases. The most common thyroid pathologies are goiter and thyroid nodules. Thyroid ultrasonography is the most widely used examination method in the evaluation of thyroid pathologies. The aim of this field study is to determine the frequency of thyroid pathologies in the province of Tokat and to evaluate its relationship with some factors such as gender and dietary habits.
UNASSIGNED: In this population-based prospective study, thyroid US examination was performed on a total of 822 patients. The examination procedure was carried out by one radiologist with at least 10 years of experience. During the examination, thyroid dimensions, parenchyma echo, presence of nodule, echo if any, number, size, and localization were evaluated. The relationships between thyroid pathologies and age, gender, body mass index (BMI), and chronic diseases in the participants were evaluated.
UNASSIGNED: Up to 45.2% (n = 372) of the participants were male and 54.8% (n = 417) were female. The ages of the participants ranged from 20 to 87 years. The mean age of the participants was 47.2. Up to 9.8% of the participants had an increase in thyroid size, defined as goiter. Parenchyma was homogeneous in 72.1% of the participants and heterogeneous in 27.9%. Thyroid nodules were present in the thyroid gland in 40.8% of the participants. There was a statistically significant relationship between thyroid pathologies and female gender, age, and obesity.
UNASSIGNED: Thyroid diseases show regional differences. Older age, female gender, and obesity increase the frequency of thyroid pathologies.

Newborn screening for congenital hypothyroidism (CH) has been highly effective in preventing devastating neurodevelopmental and physical sequelae in affected infants. We report a case of an ectopic thyroid gland located in the submandibular area detected at the age of 3 months, which was missed by congenital hypothyroidism screening test based on twice-repeated TSH measurement in dried blood spots. The diagnosis of subclinical hypothyroidism was confirmed on the basis of blood test performed in the endocrine clinic: TSH 26.3 µIU/ml (N: < 10 µIU/ml), with FT4 14.7 pmol/l (N: 10-25 pmol/l) and fT3 6.9 pmol/l (N: 3-8 pmol/l). Ultrasonography and scintigraphy revealed ectopically located thyroid tissue in the sublingual area. In the case of doubtful results of a neonatal screening test or in any case of suspected congenital hypothyroidism, the diagnosis should be supplemented with ultrasound examination of the neonate\'s neck and followed by scintigraphy if necessary.
Badania przesiewowe noworodków w kierunku wrodzonej niedoczynności tarczycy (CH) charakteryzują się dużą skutecznością w zapobieganiu groźnym zaburzeniom neurorozwojowym dzieci dotkniętych tą chorobą. W pracy przedstawiono przypadek dziewczynki z wrodzoną niedoczynnością tarczycy w przebiegu ektopii gruczołu, u której na podstawie wyniku badania przesiewowego (dwukrotnie powtórzone oznaczenie TSH w suchej kropli krwi) wykluczono CH. Wyniki badań wykonanych w wieku 3 miesięcy pozwoliły na rozpoznanie subklinicznej niedoczynności tarczycy (TSH 26,3 µIU/ml; N: < 10 µIU/ml, przy FT4 14,7 pmol/l; N: 10–25 pmol/l i fT3 6,9 pmol/l; N: 3–8 pmol/l). Badaniami ultransonografii i scyntygrafii stwierdzono ektopowo zlokalizowaną tkankę tarczycy w okolicy podjęzykowej. Podsumowanie: w przypadku wątpliwych wyników badania przesiewowego noworodka lub podejrzenia wrodzonej niedoczynności tarczycy diagnozę należy uzupełnić o badanie ultrasonograficzne szyi noworodka, a następnie scyntygrafię, jeśli to konieczne.

OBJECTIVE: This study aimed to investigate the long-term effect of radioiodine (RAI) treatment on thyroid functions and ultrasonographic changes in the thyroid gland and toxic nodules.
METHODS: Thyroid function tests and ultrasonography reports of patients diagnosed with toxic adenoma (TA) or toxic multinodular goitre (TMNG) between 2000 and 2021 were retrospectively analysed.
RESULTS: We included 100 patients whom thyroid function and ultrasonography results were obtained from our outpatient clinic before and at least 36 months post-RAI. At the end of the follow-up period, the mean thyroid volume reduction in patients with TA and TMNG was 56.6% ± 3.1% and 51.1% ± 6.7%, respectively; the mean volume decrease of all toxic nodules was 80.5% ± 1.9%. The volume of the thyroid and toxic nodules was significantly reduced up to 12 years (p < 0.01). Between 3 and 10 years after RAI therapy, the annual incidence of hypothyroidism was 2.0% and 1.5% in the TA and TMNG groups, respectively. Toxic nodules were more frequently solid and hypoechoic in post-RAI ultrasounds (p < 0.01).
CONCLUSIONS: The volume of thyroid gland and toxic nodules continuously decreases, as the risk of hypothyroidism increases up to 10 years after RAI treatment. After RAI treatment, patients should be followed up to check their thyroid functions. In post-RAI examinations, toxic nodules may show ultrasonographic features suspicious for malignancy. History taking should include previous RAI therapies and old scintigraphy scans should be evaluated to avoid unnecessary procedures and non-diagnostic biopsy results.

UNASSIGNED: We aim to leverage deep learning to develop a computer aided diagnosis (CAD) system toward helping radiologists in the diagnosis of follicular thyroid carcinoma (FTC) on thyroid ultrasonography.
UNASSIGNED: A dataset of 1159 images, consisting of 351 images from 138 FTC patients and 808 images from 274 benign follicular-pattern nodule patients, was divided into a balanced and unbalanced dataset, and used to train and test the CAD system based on a transfer learning of a residual network. Six radiologists participated in the experiments to verify whether and how much the proposed CAD system helps to improve their performance.
UNASSIGNED: On the balanced dataset, the CAD system achieved 0.892 of area under the ROC (AUC). The accuracy, recall, precision, and F1-score of the CAD method were 84.66%, 84.66%, 84.77%, 84.65%, while those of the junior and senior radiologists were 56.82%, 56.82%, 56.95%, 56.62% and 64.20%, 64.20%, 64.35%, 64.11% respectively. With the help of CAD, the metrics of the junior and senior radiologists improved to 62.81%, 62.81%, 62.85%, 62.79% and 73.86%, 73.86%, 74.00%, 73.83%. The results almost repeated on the unbalanced dataset. The results show the proposed CAD approach can not only achieve better performance than radiologists, but also significantly improve the radiologists\' diagnosis of FTC.
UNASSIGNED: The performances of the CAD system indicate it is a reliable reference for preoperative diagnosis of FTC, and might assist the development of a fast, accessible screening method for FTC.

OBJECTIVE: Despite the value of ultrasonography in the detection of chronic thyroiditis (CT) as well as in nodular goitre, it is often only indicated in patients with hypothyroidism if a palpable goitre or a thyroid mass is identified. The objective of the study is to evaluate the clinical usefulness of thyroid ultrasonography in patients with primary hypothyroidism without clinical suspicion of nodular goitre. And more specifically, to analyse its value in the aetiological diagnosis of hypothyroidism, and to evaluate its contribution in the detection and characterisation of coexisting subclinical thyroid nodular disease.
METHODS: Prospective cross-sectional observational study of 114 patients with primary hypothyroidism of CT or idiopathic aetiology, without symptoms or cervical palpation suspected of nodular goitre, who underwent a thyroid function test, a serological study of antithyroid antibodies, a thyroid ultrasonound and, when appropriate, a cytological study of the nodules found.
RESULTS: Ultrasonound allowed CT to be recognised as the cause of hypothyroidism in 19% of patients who had a negative serological study, and detected nodules larger than 9mm in 22 patients (16 with antithyroid antibodies). A cytological study was performed in 18 of the cases. Five patients underwent surgery, with carcinoma found in two of them.
CONCLUSIONS: Thyroid ultrasound is useful in the aetiological diagnosis of primary hypothyroidism as well as in the detection of a coexisting, unsuspected, but clinically relevant nodular goitre, so this examination should be indicated in the initial study of patients with primary hypothyroidism.

暂无摘要。

Langerhans cell histiocytosis (LCH) is a rare disease caused by the clonal expansion of CD1a+/CD207+ LCH cells. The thyroid involvement in LCH has mostly been described in case reports.
We retrospectively evaluated the clinical characteristics, diagnosis, and treatment of 27 children and adult patients with thyroid LCH in our center between 2010 and 2021.
The incidence of thyroid LCH was 14.00% (7/50) in children and 10.10% (20/198) in adults, respectively. Among patients with thyroid involvement, 81.5% presented with diabetes insipidus (DI) as the first symptom, and 51.9% complained of neck swelling or mass. Children and adults with thyroid LCH had higher frequencies of the hypothalamic-pituitary axis (HPA) (children: 100% vs. 62.8%, P=0.05; adult: 95% vs. 42.1%, P<0.001), the lung (children: 85.7% vs. 25.6%, P=0.004; adult: 70% vs. 50.6%, P=0.099), and a lower frequency of bone (children: 14.3% vs. 55.8%, P=0.049; adult: 45% vs. 73.6%, P=0.008) involvement than patients without thyroid involvement. Patients with thyroid LCH had a higher frequency of primary hypothyroidism and a lower frequency of euthyroidism than patients without it. The two major types of ultrasound imaging were diffuse (55%) and nodular type (45%). The standardized uptake value of thyroid on 18-F-fluorodeoxyglucose positron emission tomography/computed tomography was 5.3-12.8. The diagnoses were confirmed using thyroid aspiration (54.5%) or surgery (45.5%). In addition, thyroid LCH combined with papillary thyroid carcinoma was not rare (2/27).
Thyroid involvement in LCH is not rare. Furthermore, identifying thyroid involvement can facilitate the pathological diagnosis of LCH. Therefore, the possibility of thyroid LCH should be fully investigated in patients with DI, primary hypothyroidism, abnormal thyroid ultrasound results, and multi-system disease. In addition, thyroid aspiration can confirm suspected thyroid LCH. Finally, special attention should be paid to evaluating HPA and pulmonary involvement in thyroid LCH.