ArticleEuropean journal of nuclear medicine and molecular imaging2014
Combined (99m)Tc-methoxyisobutylisonitrile scintigraphy and fine-needle aspiration cytology offers an accurate and potentially cost-effective investigative strategy for the assessment of solitary or dominant thyroid nodules.
Article in European journal of nuclear medicine and molecular imaging, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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22 citing papers in PubMed, 42 citations in OpenAlex.
- FDG-PET/CT in indeterminate thyroid nodules: cost-utility analysis alongside a randomised controlled trial.European journal of nuclear medicine and molecular imaging · 2022Trial
- Molecular imaging with (99m)Tc-MIBI and molecular testing for mutations in differentiating benign from malignant follicular neoplasm: a prospective comparison.European journal of nuclear medicine and molecular imaging · 2016Trial
- The management of cytologically indeterminate thyroid nodules in clinical practice: A contemporary perspective with focus on molecular imaging.Endocrine · 2025Review
- [Update on follicular thyroid cancer-What is relevant for surgeons?]Chirurgie (Heidelberg, Germany) · 2025Article
- A Comprehensive Diagnostic Assessment of Thyroid Nodules Utilizing Scintigraphy and Telomere Lengths (T/S ratios).Molecular imaging and radionuclide therapy · 2025Article
- BRAF Detection in FNAC Combined with Semi-QuantitativeDiagnostics (Basel, Switzerland) · 2024Article
- Integrated Diagnostics of Thyroid Nodules.Cancers · 2024Review
- Diagnostic Performance ofDiagnostics (Basel, Switzerland) · 2022Article
- Accessing the influence ofLangenbeck's archives of surgery · 2022Article
- The Role of Tc-99 m-MIBI Scan in the Assessment of the Cystic Thyroid Nodule.Nuclear medicine and molecular imaging · 2021Article
- Follicular thyroid cancer avid on C-11 Methionine PET/CT.Endocrinology, diabetes & metabolism case reports · 2018Article
- Diagnostic accuracy of [Oncotarget · 2017Article
- Systematic reviews of diagnostic tests in endocrinology: an audit of methods, reporting, and performance.Endocrine · 2017Article
- Increasing Importance.Deutsches Arzteblatt international · 2017Article
- Why the European Association of Nuclear Medicine has declined to endorse the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer.European journal of nuclear medicine and molecular imaging · 2016Article
- Comparison of F-18 FDG-PET/CT and Tc-99m MIBI in the preoperative evaluation of cold thyroid nodules in the same patient group.Endocrine · 2015Article
- Differentiated thyroid cancer-personalized therapies to prevent overtreatment.Nature reviews. Endocrinology · 2014Review
- Thyroid nodules with indeterminate cytology: molecular imaging with ⁹⁹mTc-methoxyisobutylisonitrile (MIBI) is more cost-effective than the Afirma gene expression classifier.European journal of nuclear medicine and molecular imaging · 2014Article
- Better diagnostics and treatment.Deutsches Arzteblatt international · 2014Article
- Comments on Wale et al. : Combined (99)mTc-methoxyisobutylisonitrile scintigraphy and fine-needle aspiration cytology offers an accurate and potentially cost-effective investigative strategy for the assessment of solitary or dominant thyroid nodules.European journal of nuclear medicine and molecular imaging · 2014Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFine-needle aspiration (FNA) has revolutionised the care of patients with thyroid nodules and is the initial investigation of choice. However, as a result of nondiagnostic (Thy1) and nonneoplastic (Thy2) specimens, it remains an imperfect sole solution with a range of sensitivities and a high inadequate ratio. Therefore the British Thyroid Association (BTA) guidelines recommend a second FNA immediately for Thy1 specimens and 3-6 months later for Thy2 specimens. Patients must be followed up to exclude malignancy. In this study we assessed the performance of MIBI scintigraphy for diagnosing thyroid malignancy and the cost-effectiveness of a combined FNA/MIBI investigative strategy for the management of thyroid nodules.
methodsThe diagnostic performance of MIBI scintigraphy was calculated from a retrospective review of local data combined with a meta-analysis of the published literature. Decision tree analysis was used to calculate the cost-effectiveness of a combined FNA/MIBI investigative strategy compared to the BTA guidelines.
resultsFrom 712 patients, the sensitivity, specificity, PPV and NPV of MIBI scintigraphy for the diagnosis of malignancy were 96 %, 46 %, 34 % and 97 %, respectively. MIBI-based strategies were more accurate and associated with lower cost per patient (£1,855/<euro>2,125 vs. £2,445/<euro>2,801) and lower cost per cancer diagnosed (£1,902/<euro>2,179 vs. £2,469/<euro>2,828) with negligible change in life expectancy.
conclusionDue to its high NPV, MIBI scintigraphy can usefully exclude malignancy for Thy1 and Thy2 lesions. Its low specificity means MIBI scintigraphy cannot be recommended as a first-line investigation, but as a second-line investigation MIBI scintigraphy may lead to a lower rate of unnecessary thyroidectomies. Combined FNA/MIBI strategies are potentially cost-effective in the management of solitary or dominant thyroid nodules.
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