Subcategorization of intermediate suspicion thyroid nodules based on suspicious ultrasonographic findings

Purpose@#This study compared the malignancy risk of intermediate suspicion thyroid nodules according to the presence of suspicious ultrasonographic (US) findings. @*Methods@#From January 2014 to December 2014, 299 consecutive intermediate suspicion thyroid nodules in 281 patients (mean age, 50.6±12.5 years) with final diagnoses were included in this study. Two radiologists retrospectively reviewed the US findings and subcategorized the intermediate suspicion category into nodules without suspicious findings and nodules with suspicious findings, including punctate echogenic foci, nonparallel orientation, or irregular margins. The malignancy rates were compared between the two subcategory groups. @*Results@#Of the 299 intermediate suspicion thyroid nodules, 230 (76.9%) were subcategorized as nodules without suspicious findings and 69 (23.1%) as nodules with suspicious findings. The total malignancy rate was 33.4% (100/299) and the malignancy rate of nodules with suspicious findings was significantly higher than that of nodules without suspicious findings (47.8% vs. 29.1%, P=0.004). In nodules with suspicious findings, the most common suspicious finding was punctate echogenic foci (48/82, 58.5%) followed by nonparallel orientation (22/82, 26.8%) and irregular margins (12/82, 14.6%). Thirteen nodules had two suspicious findings simultaneously. A linearly increasing trend in the malignancy rate was observed according to the number of suspicious US findings (P for trend=0.001). @*Conclusion@#Intermediate suspicion thyroid nodules with suspicious findings showed a higher malignancy rate than those without suspicious findings. Further management guidelines for nodules with suspicious findings should differ from guidelines for nodules without suspicious findings, even in the same US category.

MRI Findings Suggestive of Metastatic Axillary Lymph Nodes in Patients with Invasive Breast Cancer

Purpose@#This study aimed to investigate the diagnostic performance of features suggestive of nodal metastasis on preoperative MRI in patients with invasive breast cancer. @*Materials and Methods@#We retrospectively reviewed the preoperative breast MRI of 192 consecutive patients with surgically proven invasive breast cancer. We analyzed MRI findings of axillary lymph nodes with regard to the size, long/short ratio, cortical thickness, shape and margin of the cortex, loss of hilum, asymmetry, signal intensity (SI) on T2-weighted images (T2WI), degree of enhancement in the early phase, and enhancement kinetics. Receiver operating characteristic (ROC) analysis, chi-square test, t test, and McNemar’s test were used for statistical analysis. @*Results@#Increased shorter diameter, uneven cortical shape, increased cortical thickness, loss of hilum, asymmetry, irregular cortical margin, and low SI on T2WI were significantly suggestive of metastasis. ROC analysis revealed the cutoff value for the shorter diameter and cortical thickness as 8.05 mm and 2.75 mm, respectively. Increased cortical thickness (> 2.75 mm) and uneven cortical shape showed significantly higher sensitivity than other findings in McNemar’s test. Irregular cortical margins showed the highest specificity (100%). @*Conclusion@#Cortical thickness > 2.75 mm and uneven cortical shape are more sensitive parameters than other findings, and an irregular cortical margin is the most specific parameter for predicting axillary metastasis in patients with invasive breast cancer.

Analysis of Some Online Questions with High Frequency about Dental Treatment in Korea / 치위생과학회지

BACKGROUND: The Internet has advantages in terms of accessibility and amount of information, and the search for health information over the Internet is increasing exponentially. The purpose of this study is to analyze the information generated about some dental treatment on the internet by year. METHODS: Naver Knowledge (JisikIn in Korean) which is an interactive search service was selected as the first search site in Korea. Scaling, wisdom tooth extraction, and endodontic treatment that can be paid by Korean health insurance were selected. Finally, 4,729 questions about scaling, 23,963 wisdom teeth extraction questions and 17,733 endodontic treatment questions were extracted. The question contents, the information about the questioner and the answerer, and an error of answers were investigated. Frequency analysis was used and chi-square test was used if necessary. RESULTS: The most frequently asked questions were discomfort and dissatisfaction after the treatment. The need for treatment was the second in questions of the wisdom tooth extraction and endodontic treatment, but the health insurance benefit was the second in dental scaling. Most of the questioners didn't disclose personal information. The public answered the most in 2013~2014, but the highest percentage of the respondents was experts in 2017. Responses were mostly personal experience, but showed a tendency to decrease with years, and professional knowledge showed an increasing tendency. The error of the answer has also gradually decreased. CONCLUSION: Questions about dental care over the Internet are increasing exponentially, experts are responding increasingly, and errors in answers are decreasing. Nevertheless, it is necessary to pay attention to the related expert group to prevent misinformation.