Distribution of Functional Status of Thyroid Nodules and Malignancy Rates of Hyperfunctioning and Hypofunctioning Thyroid Nodules in Germany

Simone Agnes Schenke; Michael C Kreissl; Michael Grunert; Anja Hach; Sarvar Haghghi; Tatjana Kandror; Eckhard Peppert; Sandra Rosenbaum-Krumme; Verena Ruhlmann; Alexander Stahl; Dieter Wanjura; Konstantin Zaplatnikov; Michael Zimny; Elena Gilman; Ken Herrmann; Rainer Görges

doi:10.1055/a-1856-4052

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2022; 61(05): 376-384
DOI: 10.1055/a-1856-4052

Original Article

Distribution of Functional Status of Thyroid Nodules and Malignancy Rates of Hyperfunctioning and Hypofunctioning Thyroid Nodules in Germany

Verteilung der szintigraphischen Funktionalität von Schilddrüsenknoten und Malignitätsrate von hyperfunktionellen und hypofunktionellen Schilddrüsenknoten in Deutschland

Simone Agnes Schenke

¹Klinik und Institut für Nuklearmedizin, Klinikum Bayreuth GmbH, Bayreuth, Germany (Ringgold ID: RIN15019)

²Nuklearmedizin, Universitätsklinikum Magdeburg, Magdeburg, Germany (Ringgold ID: RIN39067)

,

Michael C Kreissl

²Nuklearmedizin, Universitätsklinikum Magdeburg, Magdeburg, Germany (Ringgold ID: RIN39067)

,

Michael Grunert

³Klinik für Nuklearmedizin, Bundeswehrkrankenhaus Ulm, Ulm, Germany (Ringgold ID: RIN39542)

,

Anja Hach

⁴Institut für Radiologie und Nuklearmedizin Bremerhaven, Bremerhaven, Germany

,

Sarvar Haghghi

²Nuklearmedizin, Universitätsklinikum Magdeburg, Magdeburg, Germany (Ringgold ID: RIN39067)

,

Tatjana Kandror

⁵Nuklearmedizin, MVZ Mainz, Mainz, Germany

,

Eckhard Peppert

⁶ANZW, Ambulant-Nuklearmedizinsches Zentrum Würzburg, Würzburg, Germany

,

Sandra Rosenbaum-Krumme

⁷Radiologie Institut Oberhausen, Oberhausen, Germany

,

Verena Ruhlmann

⁸Gemeinschaftspraxis Nuklearmedizin Duisburg, Duisburg, Standort Moers, Germany

,

Alexander Stahl

⁹Radiologie im Zentrum, Augsburg, Germany

,

Dieter Wanjura

¹⁰Radiologiezentrum Ulm, Ulm, Germany

,

Konstantin Zaplatnikov

¹¹MVZ Nuklearmedizin Mögeldorf, Nürnberg, Germany

,

Michael Zimny

¹²Standort Hanau, Überörtliche Berufsausübungsgemeinschaft für Nuklearmedizin Hanau, Hanau, Germany

,

Elena Gilman

¹³Gilman Biometrics, Köln, Germany

,

Ken Herrmann

¹⁴Klinik für Nuklearmedizin, Universitätsklinikum Essen, Essen, Germany (Ringgold ID: RIN39081)

,

Rainer Görges

¹⁵Gemeinschaftspraxis Nuklearmedizin Duisburg, Duisburg, Germany

¹⁴Klinik für Nuklearmedizin, Universitätsklinikum Essen, Essen, Germany (Ringgold ID: RIN39081)

› Author Affiliations

Abstract

Aim Thyroid scintigraphy enables the depiction of the functional status of thyroid nodules (TNs) with both, ^99mTc-pertechnetate and ¹²³Iodine. The functional status is relevant for diagnostic procedures for the differentiation of benign and malignant TNs. The aim of this study was to examine the current frequencies of hyper-, hypo- and isofunctioning TNs in Germany and to estimate the risk of malignancy with regard to functional status.

Methods In 11 study centers, a minimum of 100 nodules per center were consecutively enrolled between July 2019 and April 2020. Inclusion criteria were: newly diagnosed nodule, nodule’ size of 10 mm or more, thyroid scintigraphy. Exclusion criteria were: completely cystic TNs, patients with prior radioiodine therapy or thyroid surgery. The risk of malignancy was estimated for hyper- and hypofunctioning TNs.

Results Overall, 849 patients (72 % women) with 1262 TNs were included. Patients’ age ranged from 18 to 90 years. Most TNs were hypofunctioning (n=535, 42%) followed by isofunctioning TNs (n=488, 39%) and hyperfunctioning TNs (n=239, 19%). When only TNs with a maximum size of 2 cm or more were considered the rate of hyperfunctioning and hypofunctioning TNs increased (to 27% and 49%) while isofunctioning TNs decreased. Only one of all hyperfunctioning TNs was malignant. In hypofunctioning nodules, the malignancy rate was estimated at 10%.

Conclusion In Germany, the proportion of hyperfunctioning TNs is approximately 20% and increases in larger TNs to up to 27%. Due to the low risk of malignancy in hyperfunctioning TNs, no further procedures to rule out malignancy are necessary. The risk of malignancy of hypofunctioning TNs is significantly higher. Thus, a thyroid scintigraphy is a useful diagnostic tool in Germany.

Keywords

Hyperfunctioning thyroid nodules - Hypofunctioning thyroid nodules - Thyroid scintigraphy - Risk of malignancy

Full Text

References

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