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Background: Noise, an unwanted variability in judgement, is ubiquitous in medicine, including in the prescription of radioactive iodine (RAI). Building upon our recently developed predictive risk model, we created an online clinical support tool to facilitate the translation of our model into clinical practice. The aim of this study is to assess the utility of an online clinical support tool to reduce noise in the treatment for patients with DTC.
Methods: The tool was accessible via weblink or a QR code. Activity recommendations were applied to the calculators four risk catgeories: 0GBq for very low risk, 1GBq for low risk; 4GBq for intermediate risk, and 6GBq for high risk. The tool was applied prospectively to 103 patients who received RAI at Royal North Shore Hospital between 2021-2022, and retrospectively to 393 patients treated with RAI between 2017-2021.
Results: A significant difference was observed in administered activity between the 2021-2022 vs 2017-2021cohorts in patients stratified as intermediate (median activity 3.95GBq, IQR 2.03-4.04 vs 4GBq, 4-4), and high risk (4.07GBq, 3.95-5.7 vs 6GBq, 6-6) with p-values of 0.01 and <0.01 respectively. No difference was seen in low risk patients (2.01GBq, 1.03-3.98 vs 1GBq, 1-4,p = 0.30). Additionally, no clinically significant recurrence was observed between the two cohorts (6.6% vs 4.5%,p = 0.628).
Conclusion: Optimal risk classification and activity recommendation continues to be established; our data suggests providing risk stratification and activity recommendation in an easy to access online tool can reduce noise and variability in activity prescription for patients with DTC.
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Next-generation sequencing (NGS) is of great benefit to clinical practice in terms of identifying genetic alterations. This study aims to clarify the gene background and its influence on thyroid tumor in Chinese population. NGS data and corresponding clinicopathological features (sex, age, tumor size, extrathyroidal invasion, metastasis, multifocality and TNM stage) were collected and analyzed retrospectively from 2844 individual thyroid tumor samples during July 2021 to August 2022. 2337 (82%) of the cohort possess genetic alterations including BRAF (71%), RAS (4%), RET/PTC (4%), TERT (3%), RET (2.2%) and TP53 (1.4%). Diagnostic sensitivity before surgery can be significantly increased from 0.76 to 0.91 when cytology is supplemented by NGS. Our results show that BRAF positive papillary thyroid cancer (PTC) patients tend to have elder age, smaller tumor size, less vascular invasion, more frequent tumor multifocality and significantly higher cervical lymph node metastatic rate. Mutation at RET gene codon 918 and 634 is strongly correlated with medullary thyroid cancer (MTC), However it did not display more invasive clinical characteristics. TERT positive patients are more likely to have elder age, larger tumor size, more tumor invasiveness, and more advanced TNM stage, indicating poor prognosis. Patients with TERT, RET/PTC1 and CHEK2 mutation are more susceptible to lateral lymph node metastasis. In conclusion. NGS can be a useful tool which provides practical gene evidence in the process of diagnosis and treatment in thyroid tumors.
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Purpose:
This study aimed to investigate the relation of magnetic resonance image (MRI) features and immunohistochemistrical subtypes of pituitary microadenomas (PMAs) characterized by location and growth pattern.
Materials and methods:
A double-center, retrospective review of MRI characteristics was conducted in 57 PMA cases recorded from February 2014 to September 2023 and identified on the basis of 2017 WHO classification of pituitary gland tumors. The geometric center of the tumor was defined, and the possibility of PMA vertical or lateral growth pattern was evaluated according to ratio of maximum diameter between the X and Y axes.
Results:
Among the PMAs, somatotroph adenomas (STAs) significantly frequented the lateral–anteroinferior portion of pituitary gland (P=0.036). Lactotroph adenomas (LTAs) showed significant locational preference for the lateral–posteroinferior portion (P=0.037), and gonadotroph adenomas (GTAs) were predominately located in the central–anteroinferior portion (P=0.022). Furthermore, the PMAs in the suprasellar portion exhibited vertical extension with statistical significance (P=0.0).
Conclusion:
In our cohort, the micro-STAs were predominately located in the lateral–anteroinferior portion of pituitary gland, the micro-LTAs in the lateral–posteroinferior portion, and the micro-GTAs in the central–anteroinferior portion. The growth pattern of the PMAs was highly correlated with their vertical position instead of their immunohistochemistrical subtypes. Therefore, MRI shows potential in differentiating partial PMA subgroups, especially the cases in silent groups.
Department of Emergency Medicine, Landspitali – The National University Hospital of Iceland, Reykjavik, Iceland
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Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland
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School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
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Department of Medicine, Landspitali – The National University Hospital of Iceland, Reykjavik, Iceland
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the study. Furthermore, follow-up with the same endocrinologist was offered to all women who were diagnosed with PD. It is a limiting factor that the study is retrospective as mTBI tends to be underreported ( 55 , 71 , 72 , 73 ). Results from part
Division of Epidemiology and Biometry, Carl von Ossietzky Universität, Oldenburg, Germany
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were not available for analyses. Usually, the rareness of the disease results in certain limitations due to low cohort size. However, in our analyses the cohort size of 292 patients with this rare disease should be pointed out as a strength of our study
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INSERM, UMRS 1166, Nutriomic Group 6, Paris, France
Sorbonne Université, UMRS1166, Paris, France
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study. The cohort was divided into two groups. The first group, named the ‘transition group’ ( n = 31), included patients who had received specialized and multidisciplinary pediatric care including endocrine follow-up in one of six children hospitals
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neuroendocrine outcomes of iGCT patients with sellar involvement. Finally, as a retrospective design, this study did not mention the final height, puberty development, and the quality of life. All these long-term outcomes are valuable for survivors and require
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). However, warfarin and direct oral anticoagulants (DOACs) did not prevent stroke in two retrospective cohort studies ( 6 , 15 ). There are no systematic reviews or Cochrane reviews on this topic. Materials and methods The primary objective is the
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diversity and complicacy of the treatments limited further subgroup analysis. There are several limitations in the present study. First, the validation cohort was from a retrospective study in a single institution, and the number was limited due to the
Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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Department of Respiratory, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China
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downloaded the full texts of 29 records, and 8 studies were ultimately included in our analysis following the eligibility criteria, involving a total of 108,054 participants. Among them, seven were retrospective cohort studies, and one was randomized
