The sonographer’s and pathologist’s perspective of echogenic microfoci in papillary thyroid carcinoma
Objective: Punctate echogenic foci (PEF)/microcalcifications are thought to represent psammoma bodies (PB) in histopathology. However, there are few and contradictory data on this. Different types of sonographic echogenic microfoci (EMF) are seen in papillary thyroid carcinoma (PTC), and their histo...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2024-01-01
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| Series: | European Thyroid Journal |
| Subjects: | |
| Online Access: | https://etj.bioscientifica.com/view/journals/etj/12/6/ETJ-23-0108.xml |
| _version_ | 1797361905604493312 |
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| author | Adile Begüm Bahçecioğlu Alptekin Gürsoy Serpil Dizbay Sak Seyfettin Ilgan Banu Bilezikçi Murat Faik Erdoğan |
| author_facet | Adile Begüm Bahçecioğlu Alptekin Gürsoy Serpil Dizbay Sak Seyfettin Ilgan Banu Bilezikçi Murat Faik Erdoğan |
| author_sort | Adile Begüm Bahçecioğlu |
| collection | DOAJ |
| description | Objective: Punctate echogenic foci (PEF)/microcalcifications are thought to represent psammoma bodies (PB) in histopathology. However, there are few and contradictory data on this. Different types of sonographic echogenic microfoci (EMF) are seen in papillary thyroid carcinoma (PTC), and their histopathological equivalents are not clearly known. There is also conflicting data on the interobserver agreement between the sonographers on EMF.
Methods: We prospectively collected US video records of PTC nodules with and without EMF in two large thyroid centers. All video recordings were independently interpreted by three blinded, experienced sonographers. EMF were classified as true microcalcifications (punctate echogenic foci (PEF) ≤1 mm long), linear microechogenities (>1 mm long, posterior acoustic enhancement of the back wall of a microcystic area), comet-tail artifacts/reverberations or linear microechogenities with comet-tail artifacts/ reverberations, non-shadowing coarse echogenic foci (>1 mm nonlinear areas) and unclassifiable. Histopathological evaluation was performed by two blinded, qualified pathologists.
Results: A total of 114 malignant nodules were included. The average Cohen’s kappa (κ) of three sonographers for the EMF presence was 0.775, indicating substantial agreement. A substantial agreement for PEF with 0.658 κ, only fair agreement for other types of EMF with 0.052 to 0.296 κ were detected. EMF were significantly associated with PB and papillae. PEF had an evident relationship with PB in multivariate analysis. There was a strong positive correlation between the amount of PEF and PB (r = 0.634, P < 0.001).
Conclusions: PEF in PTC mainly correspond to PB on histopathology. Although observation of EMF varies among sonographers, this inconsistency can be reduced by classifying EMF into subgroups and keeping the term ‘PEF’ only for true microcalcifications. |
| first_indexed | 2024-03-08T15:59:51Z |
| format | Article |
| id | doaj.art-c00f6cb6ebb543dc996435acc0e289fe |
| institution | Directory Open Access Journal |
| issn | 2235-0802 |
| language | English |
| last_indexed | 2024-03-08T15:59:51Z |
| publishDate | 2024-01-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj.art-c00f6cb6ebb543dc996435acc0e289fe2024-01-08T10:39:26ZengBioscientificaEuropean Thyroid Journal2235-08022024-01-0112617https://doi.org/10.1530/ETJ-23-0108The sonographer’s and pathologist’s perspective of echogenic microfoci in papillary thyroid carcinomaAdile Begüm Bahçecioğlu0Alptekin Gürsoy1Serpil Dizbay Sak2Seyfettin Ilgan3Banu Bilezikçi4Murat Faik Erdoğan5Department of Endocrinology and Metabolism, Ankara University, School of Medicine, Ankara, TurkeyDepartment of Endocrinology and Metabolism, Ankara Guven Hospital, Ankara, TurkeyDepartment of Pathology, Ankara University, School of Medicine Ankara, TurkeyDepartment of Nuclear Medicine, Ankara Guven Hospital, Ankara, TurkeyDepartment of Pathology, Ankara Guven Hospital, Ankara, TurkeyDepartment of Endocrinology and Metabolism, Ankara University, School of Medicine, Ankara, TurkeyObjective: Punctate echogenic foci (PEF)/microcalcifications are thought to represent psammoma bodies (PB) in histopathology. However, there are few and contradictory data on this. Different types of sonographic echogenic microfoci (EMF) are seen in papillary thyroid carcinoma (PTC), and their histopathological equivalents are not clearly known. There is also conflicting data on the interobserver agreement between the sonographers on EMF. Methods: We prospectively collected US video records of PTC nodules with and without EMF in two large thyroid centers. All video recordings were independently interpreted by three blinded, experienced sonographers. EMF were classified as true microcalcifications (punctate echogenic foci (PEF) ≤1 mm long), linear microechogenities (>1 mm long, posterior acoustic enhancement of the back wall of a microcystic area), comet-tail artifacts/reverberations or linear microechogenities with comet-tail artifacts/ reverberations, non-shadowing coarse echogenic foci (>1 mm nonlinear areas) and unclassifiable. Histopathological evaluation was performed by two blinded, qualified pathologists. Results: A total of 114 malignant nodules were included. The average Cohen’s kappa (κ) of three sonographers for the EMF presence was 0.775, indicating substantial agreement. A substantial agreement for PEF with 0.658 κ, only fair agreement for other types of EMF with 0.052 to 0.296 κ were detected. EMF were significantly associated with PB and papillae. PEF had an evident relationship with PB in multivariate analysis. There was a strong positive correlation between the amount of PEF and PB (r = 0.634, P < 0.001). Conclusions: PEF in PTC mainly correspond to PB on histopathology. Although observation of EMF varies among sonographers, this inconsistency can be reduced by classifying EMF into subgroups and keeping the term ‘PEF’ only for true microcalcifications.https://etj.bioscientifica.com/view/journals/etj/12/6/ETJ-23-0108.xmlpapillary thyroid carcinomaultrasonographypunctate echogenic focipsammoma body |
| spellingShingle | Adile Begüm Bahçecioğlu Alptekin Gürsoy Serpil Dizbay Sak Seyfettin Ilgan Banu Bilezikçi Murat Faik Erdoğan The sonographer’s and pathologist’s perspective of echogenic microfoci in papillary thyroid carcinoma European Thyroid Journal papillary thyroid carcinoma ultrasonography punctate echogenic foci psammoma body |
| title | The sonographer’s and pathologist’s perspective of echogenic microfoci in papillary thyroid carcinoma |
| title_full | The sonographer’s and pathologist’s perspective of echogenic microfoci in papillary thyroid carcinoma |
| title_fullStr | The sonographer’s and pathologist’s perspective of echogenic microfoci in papillary thyroid carcinoma |
| title_full_unstemmed | The sonographer’s and pathologist’s perspective of echogenic microfoci in papillary thyroid carcinoma |
| title_short | The sonographer’s and pathologist’s perspective of echogenic microfoci in papillary thyroid carcinoma |
| title_sort | sonographer s and pathologist s perspective of echogenic microfoci in papillary thyroid carcinoma |
| topic | papillary thyroid carcinoma ultrasonography punctate echogenic foci psammoma body |
| url | https://etj.bioscientifica.com/view/journals/etj/12/6/ETJ-23-0108.xml |
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