Nodule Volume Research Articles

Thyroid Embolization for Nonsurgical Treatment of Nodular Goiter: A Single-Center Experience in 56 Consecutive Patients

PurposeTo investigate the safety and efficacy of thyroid artery embolization (TAE) in the treatment of nodular goiter (NG). MethodsDuring a 5.5-year period, 56 consecutive patients with a NG underwent TAE. In Group A, there were 20 patients with a solitary/dominant 5–11-cm nodule, and in Group B, there were 36 patients with numerous nodules. Of the 56 patients, 47 (84%) had a retrosternal goiter and 25 had hyperthyroidism. In all patients, clinical and radiological evaluations were made at baseline and 6 months after TAE, and these parameters were statistically compared. ResultsIn 56 patients, 145 of the 146 thyroid arteries were successfully embolized. The 30-day mortality rate was 1.8%. Minor and major complications occurred in 25 and 2 patients, respectively. Six months after the TAE, the mean nodule volume was reduced from 80.2 mL to 25.0 mL, the mean thyroid volume was reduced from 147.0 mL to 62.6 mL, and the mean intrathoracic extension was reduced from 31.7 mm to 15.9 mm (P < .001). Of the 22 patients with non–Graves hyperthyroidism, 19 (86%) became euthyroid. The mean thyroid-related patient-reported outcome scores improved from 155.4 to 70.4 (P < .001). Of the 51 patients, 50 (98%) declared that they would recommend TAE to other patients with NG. ConclusionsTAE is safe and effective for the treatment of NG, with a significant volume reduction of the nodule(s) and thyroid gland.

The role of ultrasound measurements and cosmetic scoring in evaluating the effectiveness of ethanol ablation in cystic thyroid nodules.

A minimally invasive approach has been adopted to treat benign cystic nodules in recent years, with ethanol ablation (EA) being used as a more common method in routine treatment. For this study, we aimed to investigate the change of nodule volumes and cosmetic scores before and after EA in benign thyroid nodules and the effectiveness of treatment. Therefore, ultrasound data and cosmetic scores of pure cystic, mixed-type and spongy-type benign thyroid nodules undergoing EA in the last two years were reviewed retrospectively. Archive scanning was performed for all cases that were proven benign by fine-needle aspiration biopsy (FNAB) and who underwent EA. In all 46 patients included in the study, thyroid FNAB was performed. Ultrasound images were available to assess the size and volumes at pretreatment and 3 and 6months after EA. The cosmetic scores obtained before the procedure and at 6months after EA were compared. There was a statistically significant difference when the sizes and volumes of the nodules were compared at pretreatment, 3 and 6months follow-up (P<.001). The mean pretreatment cosmetic score was 3.09, and at 6months, it was 1.20, with a statistically significant difference (P<.001). Recently, a minimally invasive approach has been adopted in the treatment of benign cystic nodules, with ethanol ablation becoming more common in routine treatment. Therefore, ethanol ablation is very valuable in minimising complications that may arise from surgery.

Assessment of thyroid-specific quality of life in patients with benign symptomatic thyroid nodules treated with radiofrequency or ethanol ablation: a prospective multicenter study

PurposeRadiofrequency ablation (RFA) and ethanol ablation (EA) are effective and safe for benign symptomatic thyroid nodules (BSTNs). However, relatively little is known about the effects of these procedures on patients’ quality of life (QoL). This prospective, multicenter study evaluated the effects of RFA and EA on changes in thyroid-specific QoL in patients with BSTNs and assessed the volume reduction and safety of these procedures.MethodsEighty-six consecutive patients with 86 BSTNs were prospectively included from two medical centers. RFA was performed for 55 BSTNs with solidity ≥50% and EA was performed for 31 BSTNs with solidity <50%. QoL was evaluated using an 11-scale, multiple-choice thyroid-specific QoL questionnaire. Nodule characteristics and QoL were evaluated at diagnosis and 1, 6, and 12 months after treatment. Overall QoL was rated from 0 (good) to 4 (poor).ResultsThe mean longest size and volume of the index nodule were 4.2±1.5 cm and 21.6±22.1 mL, respectively. Patients received 1.1 treatments on average (range, 1 to 2). Significant post-treatment volume reductions were noted; however, the EA group showed a higher volume reduction than the RFA group at 1 (78.7%-16.1% vs. 49.1%-15.8%), 6 (86.3%-21.7% vs. 73.0%-14.5%), and 12 (90.9%-14.9% vs. 80.3%-12.4%) months. The score for each scale of the QoL questionnaire improved significantly during follow-up (all P<0.001). Overall QoL improved significantly, from 1.7±0.9 at diagnosis to 0.6±0.7 at the 12-month follow-up (P<0.001). There were no major complications.ConclusionBoth RFA and EA are safe and effective in reducing nodule volume and improving thyroid-specific QoL in patients with BSTNs.

The impact of lung parenchyma attenuation on nodule volumetry in lung cancer screening

BackgroundRecent recommendations for lung nodule management include volumetric analysis using tools that present intrinsic measurement variability, with possible impacts on clinical decisions and patient safety. This study was conducted to evaluate whether changes in the attenuation of the lung parenchyma adjacent to a nodule affect the performance of nodule segmentation using computed tomography (CT) studies and volumetric tools.MethodsTwo radiologists retrospectively applied two commercially available volumetric tools for the assessment of lung nodules with diameters of 5–8 mm detected by low-dose chest CT during a lung cancer screening program. The radiologists recorded the success and adequacy of nodule segmentation, nodule volume, manually and automatically (or semi-automatically) obtained long- and short-axis measurements, mean attenuation of adjacent lung parenchyma, and presence of interstitial lung abnormalities or disease, emphysema, pleural plaques, and linear atelectasis. Regression analysis was performed to identify predictors of good nodule segmentation using the volumetric tools. Interobserver and intersoftware agreement on good nodule segmentation was assessed using the intraclass correlation coefficient.ResultsIn total, data on 1265 nodules (mean patient age, 68.3 ± 5.1 years; 70.2% male) were included in the study. In the regression model, attenuation of the adjacent lung parenchyma was highly significant (odds ratio 0.987, p < 0.001), with a large effect size. Interobserver and intersoftware agreement on good segmentation was good, although one software package performed better and measurements differed consistently between software packages.ConclusionFor lung nodules with diameters of 5–8 mm, the likelihood of good segmentation declines with increasing attenuation of the adjacent parenchyma.

The anticancer activity of ethanol extract of Chromolaena odorata leaves in 7,12-Dimethylbenz[a]anthracene in (DMBA) induced breast cancer Wistar rats (Rattus novergicus)

Background: Breast cancer chemotherapy with standard drugs such as doxorubicin will induce cardiotoxicity. Therefore, this study aims to evaluate the anticancer activity ofC. odorataleaves extract in DMBA induced breast cancer on rats.Methods: Seven groups ofRattus novergicuswere used: Four treatment groups ofC. odorataextract (500, 1000, 2000, and 4000 mg/kg BW), normal control, breast cancer control, and doxorubicin treatment group. The number, volume, and weight of the nodule and the rats’ body weight were compared among groups. Data was analyzed using paired t-test or one-way ANOVA with post hoc analysis as appropriate.Results: Significant decline of the number, volume, and weight of cancer nodules was observed in the treatment group (p&amp;lt; 0.001). The weight of the cancer nodule at week 16thwas also significantly reduced in GCo2000compared to Gdoxo(p&amp;lt; 0.0001). A significant increase in body weight was also dose-dependent, especially at week 11th(p&amp;lt; 0.05 in all comparisons) and week 16th(p&amp;lt; 0.001 in all comparisons).Conclusion: This study suggested that the ethanol extract ofC. odorataleaves has anticancer and antiproliferative activity.

Long-term efficacy and safety of percutaneous ethanol injection (PEI) in cystic thyroid nodules: A systematic review and meta-analysis.

Percutaneous ethanol injection (PEI) is used for the treatment of benign cystic thyroid nodules. This systematic review and meta-analysis aimed to obtain strong evidence of its long-term efficacy and safety. PubMed, CENTRAL, Scopus and Web of Science databases were searched until November 2020 for studies reporting data on volume reduction rate (VRR), compressive symptoms and cosmetic concerns. Associated complications were assessed. A random-effects model was designed to pool the data. Out of 385 papers, nine studies evaluating 1667 nodules were finally included. Overall, VRR at 6, 12, 24, 36, 60 and 120months was 77%, 81%, 72%, 68%, 74% and 69%, respectively. Significant reductions in the compressive symptoms and cosmetic concerns were observed. No permanent complications were observed. The present meta-analysis showed that PEI could significantly reduce the volume of benign cystic thyroid nodules. This reduction was already effective at 6months post-treatment, and the effect was stable over time.

Evaluation of solid pulmonary nodules in patients with bladder cancer with computed tomography based texture analysis method: Is it possible to differentiate metastatic - non-metastatic nodules?

Solid Pulmonary Nodule (SPN) is defined as parenchymal radiopacity smaller than 3 cm in diameter. Evaluating the metastatic nature of the SPNs detected in the thorax computed tomography (TCT) examination for staging purposes in cancer patients becomes a fundamental problem for the physician. Invasive procedures, additional imaging or follow-up imaging, are often used to differentiate metastatic and non-metastatic nodules. In this study, we aimed to distinguish SPNs detected in patients diagnosed with bladder cancer (BC) as metastatic and non-metastatic nodules by texture analysis. TCT images of patients diagnosed with BC in our hospital from January 2007 until December 2017 were retrospectively evaluated. A total of 46 patients with SPN, including metastatic (n= 19) and non-metastatic (n= 27), were included in the study. Short axis diameter, long-axis diameter, nodule volume and volume histogram values of the nodules were obtained. Chisquare test was used to evaluate dependent variables, and the Mann-Whitney U test was used to evaluate independent variables. ROC curves of the obtained data were plotted. Statistically, the significant p-value was determined as less than 0.05. A significant difference was found between SPN long axis, short axis and volume values. In the volumetric histogram analysis, the maximum density value and the mean density value were found to be statistically significant. When the average of the highest densities in the volume histogram data was evaluated, the area under the curve value was 0.702 (95% CI, 519-854). The metastatic nodule could be distinguished with a sensitivity of 88% and a specificity of 70% when the volume histogram has the maximum density threshold of 50 HU. In this study, we concluded that SPN detected on CT images can be distinguished as metastatic and non-metastatic nodules using texture analysis method without invasive procedures.

Safety and Efficacy of Radiofrequency Ablation of Thyroid Nodules-Expanding Treatment Options in the United States.

ContextRadiofrequency ablation (RFA) has only recently gained popularity in the United States for treatment of thyroid nodules (TNs), with a limited number of patients having undergone the procedure in this country.ObjectiveTo evaluate the safety and efficacy of RFA of TNs performed in an outpatient setting in the United States.MethodsThis is a retrospective, single-center study of 53 patients who underwent RFA of 58 TNs between November 2018 and January 2021. The reduction in volume of nodule, cosmetic and symptomatic improvement, effect on thyroid function, and complications following RFA were assessed.ResultsEleven out of 53 patients were excluded from the analysis. A total of 47 benign TNs (23 nonfunctioning thyroid nodules [NFTNs] and 24 autonomously functioning thyroid nodules [AFTNs]), were assessed after RFA. The median reduction in volume was 70.8% after a median follow-up period of 109 days, with symptomatic and cosmetic improvement (P < 0.0001). Compared with larger nodules, smaller nodules had greater volume reduction (P = 0.0266). RFA improved thyrotropin (TSH) in AFTNs (P value = 0.0015) and did not affect TSH in NFTNs (P value = 0.23). There were no major complications; however, 1 patient had self-limited local bleeding and another had transient voice change that recovered in 6 months.ConclusionRFA is a safe and efficacious treatment for symptomatic NFTNs and AFTNs in our population and is especially effective for smaller nodules. RFA should be considered an alternative for TNs in patients who cannot or do not want to undergo surgery.

Current Status and Challenges of US-Guided Radiofrequency Ablation of Thyroid Nodules in the Long Term: A Systematic Review.

Simple SummaryUltrasound (US)-guided minimally-invasive techniques, such as radiofrequency ablation (RFA) have emerged as an alternative treatment to surgery for benign and malignant thyroid nodules. Based on a systematic literature search, here we report the long-term outcomes of thyroid RFA. Available data show that US-guided RFA significantly reduced benign thyroid nodules and destroyed most PTMC, and this was generally maintained for at least 5 years after the initial treatment. Further studies addressing the risk of regrowth in patients with benign thyroid nodules, as well as the risk of recurrence in patients with PTMC are needed.Background: US-guided minimally-invasive techniques, such as radiofrequency ablation (RFA) have emerged as an alternative treatment for benign and malignant thyroid nodules. This systematic review aims to provide an overview on the long-term outcomes of US-guided RFA in patients with benign and malignant thyroid nodules. Methods: We systematically searched PubMed/MEDLINE, EMBASE, and Scopus to identify articles reporting the outcomes of thyroid RFA after a follow-up of at least 3 years. Results: A total of 20 studies met the inclusion criteria and were included in the review. In patients with benign thyroid nodules, RFA significantly reduced nodule volume and this was generally maintained for the following 5 years. However, a small but not negligible proportion of nodules regrew and some of them required further treatments over time. In patients with malignant nodules, RFA has been used not only to treat differentiated thyroid cancer (DTC) neck recurrences, but also to treat papillary thyroid microcarcinoma (PTMC). In most patients with PTMC, RFA led to complete disappearance of the tumor. When it was compared to surgery, RFA was not inferior in terms of oncologic efficacy but it had a lower complication rate. However, RFA did not allow for final pathology, disease staging and accurate risk stratification. Conclusions: US-guided RFA significantly reduces benign thyroid nodules and destroys most PTMC, and this is generally maintained for at least 5 years after the initial treatment. Further studies addressing the risk of regrowths in patients with benign thyroid nodules, as well as the risk of recurrence in patients with PTMC are needed.

Fast fully automatic detection, classification and 3D reconstruction of pulmonary nodules in CT images by local image feature analysis

This study develops a computer-aided diagnosis (CAD) system for automatic detection and classification of pulmonary nodules in lung computed tomography (CT) images, which can simultaneously detect and classify ground-glass opacity (GGO), part-solid, and solid nodules. From the morphological feature and local image features of pulmonary nodules, a total of ten features were selected for artificial neural network (ANN) training and testing, to ensure the system can detect and classify pulmonary nodules. Then, the cross-sectional area of each slice of pulmonary nodule was extracted. The response evaluation criteria in solid tumor (RECIST) value was obtained using the Euclidean distance formula, and the number of pixels of the maximum cross-sectional area was counted for area computation. The nodule volume and 3D reconstruction was obtained using the marching cube algorithm and Riemann integral formula. The sensitivity of system detection and classification were 93.13% and 92.70%, respectively. The proposed system can detect GGO, part-solid, and solid nodules, and takes only 0.1 s to process a single image. This study used the clay model imitating pulmonary nodule morphology as physical samples. Each physical sample underwent three CT. The average difference between the physical volume and the volume derived from this study was 0.37%. The detection and classification results of the system enhanced the clinical detection of missing nodules. 3D reconstruction and volume information of the nodules can give their volume doubling time and growth rate when the patient undergoes CT for the second time, thus enhancing the effect of diagnosis and treatment.

Modeling an effectual multi‐section You Only Look Once for enhancing lung cancer prediction

AbstractThe shape and size of nodules are significant pointers of malignancy in cancer diagnosis. Moreover, considerable capture of nodules' structural data attained from computed tomography (CT) scans in computer‐aided design is a confronting task. Various investigations deal with computationally deep ensemble approaches/convolutional neural network (CNN) models; however, sampling tumors based on multi‐section‐You Only Look Once (MS‐YOLO) architecture, this anticipated model acquires nodules' multi‐sections from various views and encodes nodule's information to data aggregation from diverse cross‐sections through pooling layers. Subsequently, the features are utilized for the nodule classification task. This MS YOLO does not need any nodules' spatial annotation. However, it works directly over the cross‐section acquired from enclosed nodule volume. This work has been analyzed using LUNA R16 dataset. It attains adequate performance with a mean value of 90.8% classification accuracy. Anticipated architecture is cast‐off to choose cross‐section determination of malignancy that helps in output interpretation. The proposed model shows better trade‐off among previous methodologies. Simulation was carried out in MATLAB environment.

Percutaneous Ultrasound-Guided Laser Ablation of Benign Thyroid Nodules: Results of 10-Year Follow-Up in 171 Patients.

ContextPercutaneous, ultrasound-guided laser ablation is effective in nodular thyroid disease.ObjectiveThe aim of this study was to evaluate the long-term (10-year) efficacy and safety of laser ablation in the treatment of benign thyroid nodules.MethodsFrom 2009 to 2010, 171 patients received a single session of laser ablation. Evaluation of nodule volume was performed before treatment, at 6 months, and every year.ResultsTechnique efficacy was achieved in 92% of patients at 1 year. Median nodule volume significantly decreased from 16.7 mL (range, 11.0-97.0 mL) at baseline to 5.0 mL (range, 4.1-32.0 mL) at 1 year, a volume reduction ratio (VRR) of 68%. The benefit of the treatment was durable (P < 0.001 vs baseline at all timepoints), with a VRR of 59% after 10 years. No cases of nodule regrowth > 50% were observed at 1 year, although such cases did occur after 4 years (n = 3; 1.7% of the overall cohort) and 7 years (n = 8; 4.7%). There were no further cases of regrowth beyond 7 years. When patients were stratified according to baseline nodule volume (< 15 mL, 15-25 mL, or > 25 mL), durable results were observed across all 3 categories, with the largest, most prolonged effect observed in patients with nodules < 15 mL. Treatment was well tolerated, with only minor, transient complications of fever and local pain, and 98% of patients willing to recommend the treatment.ConclusionPercutaneous, ultrasound-guided laser ablation of benign thyroid nodules provides long-term benefits and the treatment is well tolerated.

Relative Observer and Technical Error in the Ultrasonic Monitoring of Thyroid Nodular Growth Using Nodular Volume (VOL), vs. Longest Dimension (LD), vs. the Sum of the 3 Nodular Dimensions (SUM3D)

Abstract Though not a reliable indicator of malignancy, ultrasonic monitoring of nodule growth still has a role in the evaluation of nodules, e.g. indicating when a nodule may require biopsy or re-biopsy. Observer and technical limitations, however, limit the precision of ultrasonic determination of simple growth, vs. stability or shrinkage. Ultrasonic parameters used for this purpose all have their own limitations. Monitoring nodule growth by VOL frequently exhibits wide and conflicting swings in apparent size compared to the penultimate size, doubtlessly reflecting measurement limitations. As a growth parameter, LD typically exhibits a smoother time course but does not address growth in the other two dimensions. SUM3D includes changes in all dimensions but, like LD, is not a true measure of nodule mass or volume. This study was to determine the relative error of these three growth parameters and how it relates to their relative efficacy for nodular growth monitoring. The anterior-posterior (AP), left-right (LR) and superior-inferior (SI) dimensions of 34 benign nodules were determined ultrasonographically by four pairs of trained observers. One observer of a pair was regarded as a Time-1 observer and the other as a Time-2 observer, simulating the process for determining growth change over time. All observers measured the same image of each of the 34 nodules but were unaware of the measurements obtained by any other observer. For each image for each pair of observers, the dimensions were used to calculate the VOL, LD and SUM3D and the perceived changes thereof from Time-1 to Time-2. Since only one image for each nodule was distributed, differences between the Time-1 vs Time-2 measurements for each nodule could only reflect observer-based differences. “S”-curves plotting the nominal %-change in a parameter reported by the Time-2 observer compared to that reported by the Time-1 observer (x-axis) were rank-ordered from negative to positive changes (y-axis). The %-change in each parameter due to observer/technical error ranging from the highest over-estimate to the lowest were, in order from Top 10%, Middle 40%, and Bottom 10%, respectively: LD: 19-36%, -4 to 6%, -15 to -42%; SUM3D: 15 to 28%, -4 to 4%, -11 to -43%; VOL: 48 to 105%, -13 to 15%, -33 to -81%. The magnitude of %-change from Time-1 to Time-2 for the VOL parameter were 2 to 3 times greater than that of the LD or SUM3D parameters for the top 10% of values, the middle 40% of values, and the bottom 10% of values. These degrees of difference coincide with the wide variability seen in nodular growth curves [not illustrated here] when nodular VOL (y-axis) is plotted as a function of length of observation (x-axis). This study helps explain why monitoring nodular growth by LD or by the SUM3D usually provides a clearer, less fluctuant illustration of thyroid nodule growth over time than does VOL.

Ultrasound Guided Percutaneous Ethanol Ablation of Benign Thyroid Nodule: A Study From a Tertiary Hospital in Eastern India

Abstract Introduction: Ultrasound guided percutaneous ethanol injection (PEI) of benign thyroid nodule is an easy and effective procedure particularly in cystic and predominantly cystic nodule. Aims: To evaluate efficacy and safety of PEI in managing purely cystic and mixed cystic and solid thyroid nodules. Materials and Methods: Patients of either sex presented with solitary purely cystic benign thyroid nodule, solitary benign mixed with predominantly cystic (&amp;gt;50% of total volume) thyroid nodule, solitary benign mixed with predominantly solid (&amp;gt;50% of total volume) thyroid nodule, solitary solid thyroid nodule were included in this study. Patients who had a nodule BETHESDA 3 and above, pregnancy, patients with critical or terminal illness, patients with other malignancies, multinodular lesions of thyroid, patients with raised T3, T4 and/ or suppressed TSH level were excluded from the study. One hundred sixty patients presenting with thyroid nodule were initially evaluated with thyroid function test and USG. Only those patients with euthyroid solitary thyroid nodules are subjected for fine needle aspiration (FNA). Nodules under BETHESDA 2 are considered for US guided percutaneous ethanol injection (PEI). One hundred twenty-three patients were excluded because of various reasons. Finally ethanol ablation was done in 37 patients. Benign, purely cystic and mixed thyroid nodules were aspirated under ultrasonography guidance. Sterile absolute alcohol (99.99%) (50% of volume aspirated/ maximum 10 ml) was injected and reviewed after 2, 5and 7 months. In case of solid nodule alcohol (50% of nodule volume) was injected. A reduction in volume is calculated at each follow up visit. An adequate response is considered as ≥50 percent reduction in size from baseline after 7 months. If the reduction is &amp;lt;50%, then a second session of absolute ethanol injection is given. Again, patients were similarly followed up after 2, 5 and 7 months. Results: Thirty seven patients underwent PEI. Thirty three patients were considered for final analysis (4 lost to follow up). Response rate of PEI for purely cystic nodule was 100.0% and the overall response rate for mixed nodule was 53.57%. None of the solid nodule responded to PEI even after second session. Among the responder in the mixed nodules, 93.33% responded after first session of PEI. Minor complications like headache occurred in 54.1% patients in the first session. Transient pain at injection site were complained by 86.5% and 37.8% patients in the first and second session respectively. Nausea and vomiting were complained by 18.9% and 16.2% patients in the first and second session respectively. Conclusions: PEI is an effective and safe for purely cystic and mixed thyroid nodules. It is a relatively safe and less invasive procedure from management of benign solitary cystic and mixed thyroid nodules.

Microwave ablation of autonomously functioning thyroid nodules: a comparative study with radioactive iodine therapy on the functional treatment success.

The objective of this study was to compare the efficiency of microwave ablation (MWA) and radioactive iodine (RAI) in the treatment of toxic adenoma (TA), and to investigate the functional treatment success of the used modalities for its remission. Treatment outcomes- thyroid hormone levels and nodule characteristics- of 30 patients (23:7 F:M; 52.77 ± 11.13 years) treated by MWA were compared with the those of 35 patients (24:11 F:M; 61.43 ± 12.60 years) treated by RAI. The baseline characteristics of TAs, which are gender and pre volume, were analogous and did not show any statistical significance (p > 0.05). Thyroid hormone levels of patients treated with two different methods were measured after 9 months, and the obtained results were compared. Although there was no statistically significant difference in the nodule volume (p > 0.05), there was a greater volume reduction rate (VRR%) in the group treated with MWA rather than RAI (p < 0.05) at the end of the follow-up. In the MWA group, there was a higher increase in FT3 than in the RAI group (p < 0.05). Furthermore, no statistically significant difference in TSH (p = 0.124) and FT4 (p = 0.144) levels of the patients as treatment outcomes was observed. The therapeutic success was accomplished in 18/30 (60%) of the MWA group and in 24/35 (68.6%) of the RAI group. Therapeutic success of MWA and RAI did not show any statistically significant difference (p = 0.471). However, the development of hypothyroidism in 7 of 35 patients treated with RAI was observed. On the other hand, no case of post-treatment hypothyroidism was observed in patients treated with MWA. In this regard, MWA could be a great alternative to RAI due to its advantages in terms of non-exposure to radiation and lower risk of post-treatment hypothyroidism.

Mikrodalga Ablasyon ve Etanol Ablasyon Tedavisi Uygulanan Benign Tiroid Nodüllerinin Tedaviden Sonra Hacimsel ve Kozmetik Skorlama Değişikliklerinin Karşılaştırması

Aim: This study retrospectively evaluated the effects of treatment of benign mixed-type and spongy-type thyroid nodules with microwave ablation (MWA) and ethanol ablation (EA) therapies. The changes in volume obtained by ultrasonography and cosmetic scores were examined. The efficiency of both treatment methods was also compared by statistical analyses. Methods: Between July 2015 and July 2020, archive scanning was performed for patients who underwent MWA and EA in the radiology clinic. As a result, 57 MWA and 55 EA patients were included in the study. Nodule volumes from before the treatment, 3 months, and 6 months after ablation treatment were noted for each case. Cosmetic scores for all patients were also examined. Results: A statistically significant difference was found in the mean nodule volume at 6 months between MWA and EA, with MWA being more successful (p&amp;lt;0.05). The MWA technique also resulted in significantly higher mean cosmetic score reduction (p&amp;lt;0.05). Conclusion: Minimally invasive approaches are increasingly adopted in the treat¬ment of benign thyroid nodules, and both MWA and EA are effective and safe treat¬ments techniques. The results show that MWA treatment leads to better cosmetic scores and nodule volume changes in patients with benign mixed-type and spongy-type thyroid nodules.

Lung Cancer Screening: Evidence, Risks, and Opportunities forImplementation.

Lung cancer is the most common cause of cancer death worldwide. Several trials with different screening approaches have recognized the role of lung cancer screening with low-dose CT for reducing lung cancer mortality. The efficacy of lung cancer screening depends on many factors and implementation is still pending in most European countries. This review aims to portray current evidence on lung cancer screening with a focus on the potential for opportunities for implementation strategies. Pillars of lung cancer screening practice will be discussed according to the most updated literature (PubMed search until November 16, 2020). The NELSON trial showed reduction of lung cancer mortality, thus confirming previous results of independent European studies, notably by volume of lung nodules. Heterogeneity in patient recruitment could influence screening efficacy, hence the importance of risk models and community-based screening. Recruitment strategies develop and adapt continuously to address the specific needs of the heterogeneous population of potential participants, the most updated evidence comes from the UK. The future of lung cancer screening is a tailored approach with personalized continuous stratification of risk, aimed at reducing costs and risks. · Secondary prevention of lung cancer by low-dose computed tomography showed a reduction of lung cancer mortality.. · Semi-automated volume measurement and use of volume doubling time should be the reference method for optimization of risks, namely controlling measurement variability and the false-positive rate.. · A conservative approach with surveillance of subsolid nodules can be one of the strategies to reduce the risk of overdiagnosis and overtreatment.. · The goal of a tailored approach with personalized risk stratification aims to reduce costs and risks. A longer interval between rounds is one option for participants at lower risk.. · Tringali G, Milanese G, Ledda RE et al. Lung Cancer Screening: Evidence, Risks, and Opportunities for Implementation. Fortschr Röntgenstr 2021; 193: 1153 - 1161.

Optimum diameter threshold for lung nodules at baseline lung cancer screening with low-dose chest CT: exploration of results from the Korean Lung Cancer Screening Project.

To explore the optimum diameter threshold for solid nodules to define positive results at baseline screening low-dose CT (LDCT) and to compare two-dimensional and volumetric measurement of lung nodules for the diagnosis of lung cancers. We included consecutive participants from the Korean Lung Cancer Screening project between 2017 and 2018. The average transverse diameter and effective diameter (diameter of a sphere with the same volume) of lung nodules were measured by semi-automated segmentation. Diagnostic performances for lung cancers diagnosed within 1 year after LDCT were evaluated using area under receiver-operating characteristic curves (AUCs), sensitivities, and specificities, with diameter thresholds for solid nodules ranging from 6 to 10 mm. The reduction of unnecessary follow-up LDCTs and the diagnostic delay of lung cancers were estimated for each threshold. Fifty-two lung cancers were diagnosed among 10,424 (10,141 men; median age 62 years) participants within 1 year after LDCT. Average transverse (0.980) and effective diameters (0.981) showed similar AUCs (p = .739). Elevating the average transverse diameter threshold from 6 to 9 mm resulted in a significantly increased specificity (91.7 to 96.7%, p < .001), a modest reduction in sensitivity (96.2 to 94.2%, p = .317), a 60.2% estimated reduction of unnecessary follow-up LDCTs, and a diagnostic delay in 1.9% of lung cancers. Elevating the threshold to 10 mm led to a significant reduction in sensitivity (86.5%, p = .025). Elevating the diameter threshold for solid nodules from 6 to 9 mm may lead to a substantial reduction in unnecessary follow-up LDCTs with a small proportion of diagnostic delay of lung cancers. • Elevation of the diameter threshold for solid nodules from 6 to 9 mm can substantially reduce unnecessary follow-up LDCTs with a small proportion of diagnostic delay of lung cancers. • The average transverse and effective diameters of lung nodules showed similar performances for the prediction of a lung cancer diagnosis.

Rock-Solubilizing Microbial Inoculums Have Enormous Potential as Ecological Remediation Agents to Promote Plant Growth

Anthropogenic overexploitation poses significant threats to the ecosystems that surround mining sites, which also have tremendous negative impacts on human health and society safety. The technological capacity of the ecological restoration of mine sites is imminent, however, it remains a challenge to sustain the green restorative effects of ecological reconstruction. As a promising and environmentally friendly method, the use of microbial technologies to improve existing ecological restoration strategies have shown to be effective. Nonetheless, research into the mechanisms and influences of rock-solubilizing microbial inoculums on plant growth is negligible and the lack of this knowledge inhibits the broader application of this technology. We compared the effects of rock-solubilizing microbial inoculums on two plant species. The results revealed that rock-solubilizing microbial inoculums significantly increased the number of nodules and the total nodule volume of Robinia pseudoacacia L. but not of Lespedeza bicolor Turcz. The reason of the opposite reactions is possibly because the growth of R. pseudoacacia was significantly correlated with nodule formation, whereas L. bicolor’s growth index was more closely related to soil characteristics and if soil nitrogen content was sufficient to support its growth. Further, we found that soil sucrase activity contributed the most to the height of R. pseudoacacia, and the total volume of root nodules contributed most to its ground diameter and leaf area. Differently, we found a high contribution of total soil carbon to seedling height and ground diameter of L. bicolor, and the soil phosphatase activity contributed the most to the L. bicolor’ s leaf area. Our work suggests that the addition of rock-solubilizing microbial inoculums can enhance the supply capacity of soil nutrients and the ability of plants to take up nutrients for the promotion of plant growth. Altogether, our study provides technical support for the practical application of rock-solubilizing microbes on bare rock in the future.

Evaluation of biochar in the root nodulation of Acacia mangium Willd. in a nursery

Organic matter stabilized in the form of biochar has benefits in a nursery for the physico-chemical and biological properties of substrates derived from forest propagation. With biochars from Acacia mangium Willd. (BAM) residue increases for agricultural production in nurseries have been reported. In this research, we evaluated the effect of different levels of this biochar and its mixture with a synthetic fertilizer (SF) on the root nodulation of A. mangium seedlings. Nine treatments were established to assess the effects on volume and nodule count. Two analyses were performed on a volume using the Kruskal-Wallis test and on counting using the Chi-square test of homogeneity distribution. The results of a subsequent comparison between treatments highlighted higher nodule volumes in treatments with BAM and a mixture with SF compared to those of only SF. The distribution of the nodule count was not homogeneous among treatments. The treatment 80 ton·ha−1 of BAM and 50% of SF produced a greater number of nodules compared to the control. All treatments with higher nodule volumes contained BAM to some degree. Biochar seems likely to contribute to increased volume and nodule count, which could suggest greater potential in the population of microorganisms associated with the development of nodules in seedlings.