Age-related variation in malignant cytology rates of thyroid nodules: insights from a retrospective observational study assessing the ACR TI-RADS.

OBJECTIVE: The influence of age on the malignant cytology rate of thyroid nodules remains uncertain. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) is currently used to guide subsequent investigations of thyroid nodules, regardless of clinical variables. This study aimed to investigate the impact of age on the malignant cytology rates of thyroid nodules and the diagnostic performance of ACR TI-RADS across different age groups. DESIGN: A retrospective, single-center, observational study. METHODS: Patients aged ≥ 20 years with thyroid nodules, who underwent fine-needle aspiration biopsy between 2012 and 2019 were evaluated. Ultrasound images were used to obtain the TI-RADS data. Malignancy was determined based on suspicious for malignancy (Bethesda V) and malignant (Bethesda VI) cytology results or malignancy in cell block analysis. RESULTS: A total of 1023 nodules from 921 patients (88.2% female) were analyzed. The median age was 58.5 (interquartile range [IQR], 41.1-66.6) years, and the median nodule size was 2.4 (IQR, 1.7-3.6) cm. Stratification by age revealed a decreasing prevalence of malignant cytology across subgroups of 20-39, 40-59, and ≥60 years (10.7%, 8.5%, and 3.7%, respectively; P = .002). After adjusting for sex, multinodularity, nodule size, and ACR TI-RADS category, we observed that each year of age reduced the OR for malignant cytology by 3.0% (95% CI: 0.7%-5.3%; P = .011). When comparing the subgroups of 20-39 and ≥60 years, the malignant cytology rate decreased by half in TI-RADS 4 (from 21.4% to 10.4%) and two-thirds in TI-RADS 5 (from 64.7% to 22.6%). CONCLUSIONS: Our study demonstrated that as patient age increased, the rate of malignant cytology in thyroid nodules decreased. Moreover, age significantly influences the malignancy rates of thyroid nodules classified according to the ACR TI-RADS.

Classificação de Atlanta revisada das pancreatites agudas: a sistematização do diagnóstico radiológico da pancreatite / The revised Atlanta Classification of acute pancreatitis: a systematization of radiological diagnosis of pancreatitis

A pancreatite aguda (PA) tem uma prevalência elevada, sendo uma causa frequente de internação hospitalar. Revisaremos as diferentes formas de pancreatite aguda, bem como as coleções peripancreáticas. As nomenclaturas atualizadas pela Classificação de Atlanta padronizam a terminologia dos achados avaliados por tomografia computadorizada (TC) com contraste, o que é essencial para um diálogo uniforme entre todas as especialidades, facilitando o entendimento e o manejo desta patologia.

Acute pancreatitis (AP) has a high prevalence and is a frequent cause of hospitalization. We will review the different forms of acute pancreatitis, as well as Peripancreatic collections. Nomenclatures updated by Atlanta Classification standardize the terminology of the findings evaluated by computed tomography (CT) with contrast, which is essential for a uniform dialogue between all specialties, facilitating the understanding and management of this condition.