Endocrinology and Metabolism

Young Jun Choi (Choi YJ)

6 Articles

Thyroid
The Diagnostic Role of Repeated Biopsy of Thyroid Nodules with Atypia of Undetermined Significance with Architectural Atypia on Core-Needle Biopsy: Hye Hyeon Moon, Sae Rom Chung, Young Jun Choi, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee, Jung Hwan Baek; Endocrinol Metab. 2024;39(2):300-309. Published online January 3, 2024; DOI: https://doi.org/10.3803/EnM.2023.1818

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Abstract PDF Supplementary Material PubReader ePub: Background
We aimed to evaluate the utility of repeat biopsy of thyroid nodules classified as atypia of undetermined significance with architectural atypia (IIIB) on core-needle biopsy (CNB).
Methods
This retrospective study evaluated patients with thyroid nodules categorized as IIIB on CNB between 2013 and 2015. Demographic characteristics, subsequent biopsy results, and ultrasound (US) images were evaluated. The malignancy rates of nodules according to number of CNBs and the number of IIIB diagnoses was compared. Demographic and US features were evaluated to determine factors predictive of malignancy.
Results
Of 1,003 IIIB nodules on CNB, the final diagnosis was determined for 328 (32.7%) nodules, with 121 of them confirmed as malignant, resulting in a malignancy rate of 36.9% (95% confidence interval, 31.7% to 42.1%). Repeat CNB was performed in 248 nodules (24.7%), with 75 (30.2%), 131 (52.8%), 13 (5.2%), 26 (10.5%), one (0.4%), and two (0.8%) reclassified into categories II, IIIB, IIIA, IV, V, and VI, respectively. Malignancy rates were not significantly affected by the number of CNBs (P=0.291) or the number of IIIB diagnoses (P=0.473). None of the nodules confirmed as category II on repeat CNB was malignant. US features significantly associated with malignancy (P<0.003) included solid composition, irregular margins, microcalcifications, and high suspicion on the US risk stratification system.
Conclusion
Repeat biopsy of nodules diagnosed with IIIB on CNB did not increase the detection of malignancy but can potentially reduce unnecessary surgery. Repeat biopsy should be performed selectively, with US features guiding the choice between repeat biopsy and diagnostic surgery.

Thyroid
Immunoglobulin G4-Related Thyroid Disease: A Single-Center Experience and Literature Review: Meihua Jin, Bictdeun Kim, Ahreum Jang, Min Ji Jeon, Young Jun Choi, Yu-Mi Lee, Dong Eun Song, Won Gu Kim; Endocrinol Metab. 2022;37(2):312-322. Published online April 25, 2022; DOI: https://doi.org/10.3803/EnM.2021.1318

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Background
Immunoglobulin G4 (IgG4)-related disease is an entity that can involve the thyroid gland. The spectrum of IgG4-related thyroid disease (IgG4-RTD) includes Hashimoto thyroiditis (HT) and its fibrotic variant, Riedel thyroiditis, as well as Graves’ disease. The early diagnosis of IgG4-RTD is important because it is a medically treatable disease, and a delay in the diagnosis might result in unnecessary surgery. We present a case series of IgG4-RTD with a review of the literature.
Methods
We retrospectively reviewed the clinical presentation and the radiological and pathological findings of patients diagnosed with IgG4-RTD between 2017 and 2021 at a tertiary medical center in Korea. We also conducted a literature review of IgG4-RTD.
Results
Five patients were diagnosed with IgG4-RTD during the study period. The patients’ age ranged from 31 to 76 years, and three patients were men. Most patients visited the clinic for a neck mass, and hypoechogenic nodular lesions were observed on neck ultrasonography. Three patients had IgG4 HT, and two patients had IgG4 Riedel thyroiditis. All patients developed hypothyroidism that necessitated L-thyroxine replacement. The diagnosis of IgG4-RTD was confirmed after a pathological examination of the surgical specimen in the first two cases. However, the early diagnosis was possible after a core needle biopsy in three clinically suspected patients.
Conclusion
The diagnosis of IgG4-RTD requires clinical suspicion combined with serology and histological analyses using IgG4 immunostaining. The early diagnosis of IgG4-RTD is difficult; thus, biopsy with IgG4 immunostaining and serum IgG4 measurements will help diagnose patients suspected of having IgG4-RTD.

Citations

Citations to this article as recorded by

Are sonographic characteristics of Hashimoto’s thyroiditis related with immunologic parameters? A cross-sectional study
K. Kenarlı, A. B. Bahçecioğlu, Ö. B. Aksu, S. Güllü
Journal of Endocrinological Investigation.2024; 47(7): 1701. CrossRef
A machine learning-based diagnosis modeling of IgG4 Hashimoto’s thyroiditis
Chenxu Zhao, Zhiming Sun, Yang Yu, Yiwei Lou, Liyuan Liu, Ge Li, Jumei Liu, Lei Chen, Sainan Zhu, Yu Huang, Yang Zhang, Ying Gao
Endocrine.2024;[Epub] CrossRef
Reshaping the Concept of Riedel’s Thyroiditis into the Larger Frame of IgG4-Related Disease (Spectrum of IgG4-Related Thyroid Disease)
Mara Carsote, Claudiu Nistor
Biomedicines.2023; 11(6): 1691. CrossRef

Clinical Study
Long-Term Results of Thermal Ablation of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis: Se Jin Cho, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee; Endocrinol Metab. 2020;35(2):339-350. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.339

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Background
Ultrasound-guided thermal ablations have become one of the main options for treating benign thyroid nodules. To determine efficacy of thermal ablation of benign thyroid nodules, we performed a meta-analysis of studies with long-term follow-up of more than 3 years.
Methods
Databases were searched for studies published up to August 25, 2019, reporting patients with benign thyroid nodules treated with thermal ablation and with follow-up data of more than 3 years. Data extraction and quality assessment were performed according to PRISMA guidelines. The analysis yielded serial volume reduction rates (VRRs) of ablated nodules for up to 3 years or more, and adverse effect of ablation during follow-up. Radiofrequency ablation (RFA) and laser ablation (LA) were compared in a subgroup analysis.
Results
The pooled VRRs for ablated nodules showed rapid volume reduction before 12 months, a plateau from 12 to 36 months, and more volume reduction appearing after 36 months, demonstrating long-term maintenance of treatment efficacy. Thermal ablation had an acceptable complication rate of 3.8%. Moreover, patients undergoing nodule ablation showed no unexpected delayed complications during the follow-up period. In the subgroup analysis, RFA was shown to be superior to LA in terms of the pooled VRR and the number of patients who underwent delayed surgery.
Conclusion
Thermal ablations are safe and effective methods for treating benign thyroid nodules, as shown by a long follow-up analysis of more than 3 years. In addition, RFA showed superior VRRs compared with LA for the treatment of benign thyroid nodules, with less regrowth and less delayed surgery.

Citations

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Iram Hussain
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Adjustable-tip needles versus fixed-tip needles in radiofrequency ablation of symptomatic benign thyroid nodules: a single-center Italian experience
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Gustavo Philippi de los Santos, Marco Aurélio Vamondes Kulcsar, Fabio de Aquino Capelli, Jose Higino Steck, Klecius Leite Fernandes, Cleo Otaviano Mesa, Joaquim Mauricio da Motta-Leal-Filho, Rafael Selbach Scheffel, Fernanda Vaisman, Guilherme Lopes Pinhe
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American Journal of Neuroradiology.2023; 44(6): 693. CrossRef
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Massive Hemorrhage and Mortality Following Thyroid Radiofrequency Ablation
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Das „heiße“ Schilddrüsenkarzinom mit einem kritischen Blick auf die Thermoablation
Joachim Jähne, Andreas Niesen, Joachim Bernhardts, Marija Hillemans
Der Chirurg.2021; 92(1): 34. CrossRef
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Haris Muhammad, Prasanna Santhanam, Jonathon O. Russell, Jennifer H. Kuo
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Erivelto Volpi
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Comparative efficacy of different ultrasound-guided ablation for the treatment of benign thyroid nodules: Systematic review and network meta-analysis of randomized controlled trials
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Unresolved Clinical Issues in Thermal Ablation of Benign Thyroid Nodules: Regrowth at Long-Term Follow-Up
Jung Suk Sim, Jung Hwan Baek
Korean Journal of Radiology.2021; 22(8): 1436. CrossRef
Current Status and Challenges of US-Guided Radiofrequency Ablation of Thyroid Nodules in the Long Term: A Systematic Review
Stella Bernardi, Andrea Palermo, Rosario Francesco Grasso, Bruno Fabris, Fulvio Stacul, Roberto Cesareo
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Update of Radiofrequency Ablation for Treating Benign and Malignant Thyroid Nodules. The Future Is Now
Ralph P. Tufano, Pia Pace-Asciak, Jonathon O. Russell, Carlos Suárez, Gregory W. Randolph, Fernando López, Ashok R. Shaha, Antti Mäkitie, Juan P. Rodrigo, Luiz Paulo Kowalski, Mark Zafereo, Peter Angelos, Alfio Ferlito
Frontiers in Endocrinology.2021;[Epub] CrossRef
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Huynh Q Khanh, Nguyen L Vuong, Tran Q Tien
World Journal of Endocrine Surgery.2021; 12(3): 117. CrossRef
Long-Term Outcomes of Thermal Ablation for Benign Thyroid Nodules: The Issue of Regrowth
Jung Suk Sim, Jung Hwan Baek, Rosaria Meccariello
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Matrix 3D ultrasound-assisted thyroid nodule volume estimation and radiofrequency ablation: a phantom study
T. Boers, S. J. Braak, M. Versluis, S. Manohar
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Chi-Yu Kuo, Chien-Liang Liu, Chung-Hsin Tsai, Shih-Ping Cheng
International Journal of Hyperthermia.2021; 38(1): 1536. CrossRef

Clinical Study
Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation: Min Kyoung Lee, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Yu-Mi Lee, Tae Yong Kim, Jeong Hyun Lee; Endocrinol Metab. 2020;35(2):407-415. Published online June 24, 2020; DOI: https://doi.org/10.3803/EnM.2020.35.2.407

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Abstract PDF PubReader ePub

Background
Although radiofrequency ablation (RFA) is a safe treatment for thyroid tumors, nerve damage is a frequent complication. A previous retrospective study suggested that an injection of cold 5% dextrose in water (5% DW) can reduce nerve damage during RFA. This study validated the efficacy of injecting cold 5% DW for management of nerve damage during RFA.
Methods
Between November 2017 and December 2018, 242 patients underwent 291 RFA sessions for treatment of benign thyroid nodules or recurrent thyroid cancers. Using a standardized technique, cold (0°C to 4°C) 5% DW was immediately injected around the damaged nerve into patients with any symptoms suggesting nerve damage. The incidence of nerve damage, the volume of 5% DW injected, symptom recovery time and the incidence of permanent nerve damage were evaluated.
Results
Nineteen patients experienced nerve damage symptoms related to 21 RFA sessions, including 17 patients during 19 sessions and two patients on the day after two sessions. Patients with nerve damage symptoms detected during RFA were treated by injection of a mean 41 mL (range, 3 to 260) cold 5% DW, but the two patients who experienced symptoms the next day did not receive cold 5% DW injections. Immediate recovery was observed after 15 RFA sessions in 14 patients. No patient experienced permanent nerve damage.
Conclusion
Injection of cold 5% DW is effective in managing nerve damage during RFA of thyroid lesions.

Citations

Citations to this article as recorded by

The Role of Radiofrequency Ablation in Benign and Malignant Thyroid Nodules
Meghal Shah, Catherine McManus
Surgical Clinics of North America.2024; 104(4): 779. CrossRef
Recurrent laryngeal nerve monitoring by flexible laryngoscopy during thyroid radiofrequency ablation in the awake patient
Marsida Teliti, Antonio Occhini, Rodolfo Fonte, Laura Croce, Benedetto Calì, Federica Antonella Ripepi, Andrea Carbone, Mario Rotondi, Spyridon Chytiris
Frontiers in Endocrinology.2024;[Epub] CrossRef
Clinical and Economic Evaluation of Ultrasound-Guided Radiofrequency Ablation vs. Parathyroidectomy for Patients with Primary Hyperparathyroidism: A Cohort Study
Hui-hui Chai, Zhan-jing Dai, Bai Xu, Qiao-hong Hu, Hong-feng He, Ying Xin, Wen-wen Yue, Cheng-zhong Peng
Academic Radiology.2023; 30(11): 2647. CrossRef
Efficacy of single-session radiofrequency ablation (RFA) in rendering euthyroidism for persistent/relapsed Graves’ disease, a pilot study
Man Him Matrix Fung, Brian Hung Hin Lang
European Radiology.2023; 33(9): 6534. CrossRef
Radiofrequency Ablation of Cervical Thyroid Cancer Metastases—Experience of Endocrinology Practices in the United States
Shahzad Ahmad, Jules Aljammal, Ian Orozco, Sheharyar Raashid, Fizza Zulfiqar, Sean P Nikravan, Iram Hussain
Journal of the Endocrine Society.2023;[Epub] CrossRef
Radiofrequency ablation of benign thyroid nodules: the value of anterolateral hydrodissection
So Yeong Jeong, Jung Hwan Baek, Sae Rom Chung, Young Jun Choi, Ki-Wook Chung, Tae Yong Kim, Jeong Hyun Lee
Ultrasonography.2023; 42(3): 432. CrossRef
Effective and Safe Application of Radiofrequency Ablation for Benign Thyroid Nodules
Jin Yong Sung
Journal of the Korean Society of Radiology.2023; 84(5): 985. CrossRef
Assessment of thyroid-specific quality of life in patients with benign symptomatic thyroid nodules treated with radiofrequency or ethanol ablation: a prospective multicenter study
So Yeong Jeong, Eun Ju Ha, Jung Hwan Baek, Tae Yong Kim, Yu-Mi Lee, Jeong Hyun Lee, Jeonghun Lee
Ultrasonography.2022; 41(1): 204. CrossRef
Management of Recurrent Laryngeal Nerve Injury During Radiofrequency Ablation of Thyroid Nodules
Jules Aljammal, Iram Hussain, Shahzad Ahmad
AACE Clinical Case Reports.2022; 8(2): 102. CrossRef
Thermal Ablation for the Management of Papillary Thyroid Microcarcinoma in the Era of Active Surveillance and Hemithyroidectomy
Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Jeong Hyun Lee
Current Oncology Reports.2022; 24(8): 1045. CrossRef
Improving Voice Outcomes after Thyroid Surgery and Ultrasound-Guided Ablation Procedures
Pia Pace-Asciak, Jon O. Russell, Ralph P. Tufano
Frontiers in Surgery.2022;[Epub] CrossRef
Using Intra‐Operative Laryngeal Ultrasonography as a Real‐Time Tool in Assessing Vocal Cord Function During Radiofrequency Ablation of the Thyroid Gland
Matrix Man Him Fung, Brian Hung Hin Lang
World Journal of Surgery.2022; 46(9): 2206. CrossRef
Long-term outcome of microwave ablation for benign thyroid nodules: Over 48-month follow-up study
Jia-Rui Du, Wen-Hui Li, Cheng-Hai Quan, Hui Wang, Deng-Ke Teng
Frontiers in Endocrinology.2022;[Epub] CrossRef
Continuous neuromonitoring during radiofrequency ablation of benign thyroid nodules provides objective evidence of laryngeal nerve safety
Catherine F. Sinclair, Maria J. Téllez, Roberto Peláez-Cruz, Alba Díaz-Baamonde, Sedat Ulkatan
The American Journal of Surgery.2021; 222(2): 354. CrossRef
Future Considerations and Directions for Thermal Ablative Technologies
Jonathon Russell, Catherine F. Sinclair
Current Otorhinolaryngology Reports.2021; 9(2): 210. CrossRef

Clinical Study
Does Radiofrequency Ablation Induce Neoplastic Changes in Benign Thyroid Nodules: A Preliminary Study: Su Min Ha, Jun Young Shin, Jung Hwan Baek, Dong Eun Song, Sae Rom Chung, Young Jun Choi, Jeong Hyun Lee; Endocrinol Metab. 2019;34(2):169-178. Published online May 15, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.2.169

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Background

To evaluate the clinical feasibility of radiofrequency ablation (RFA) of benign thyroid nodules along with cytomorphological alteration, and any malignant transformation through biopsy.

Methods

The data were retrospectively collected between April 2008 and June 2013 and core needle biopsy (CNB) was performed on 16 benign thyroid nodules previously treated using RFA. The parameters of the patients were compared, between the time of enrollment and the last follow-up examination, using linear mixed model statistical analysis.

Results

No atypical cells or neoplastic transformation were detected in the undertreated peripheral portion of treated benign nodules on the CNB specimen. RFA altered neither the thyroid capsule nor the thyroid tissue adjacent to the treated area. On histopathological examinations, we observed 81.2% acellular hyalinization, which was the most common finding. After a mean follow-up period of over 5 years, the mean volume of thyroid nodule had decreased to 6.4±4.2 mL, with a reduction rate of 81.3%±5.8% (P<0.0001).

Conclusion

RFA is a technically feasible treatment method for benign thyroid nodules, with no carcinogenic effect or tissue damage of the normal thyroid tissue adjacent to the RFA-treated zone.

Citations

Citations to this article as recorded by

Comparison of the Therapeutic Efficacy and Technical Outcomes between Conventional Fixed Electrodes and Adjustable Electrodes in the Radiofrequency Ablation of Benign Thyroid Nodules
Jae Ho Shin, Minkook Seo, Min Kyoung Lee, So Lyung Jung
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Thyroid
A Comparison of Ultrasound-Guided Fine Needle Aspiration versus Core Needle Biopsy for Thyroid Nodules: Pain, Tolerability, and Complications: Eun Ji Jeong, Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Jae Kyun Kim, Jeong Hyun Lee; Endocrinol Metab. 2018;33(1):114-120. Published online March 21, 2018; DOI: https://doi.org/10.3803/EnM.2018.33.1.114

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Background

To compare pain, tolerability, and complications associated with fine needle aspiration (FNA) versus core needle biopsy (CNB).

Methods

FNAs were performed using 23-gauge needles and CNBs were performed using 18-gauge double-action spring-activated needles in 100 patients for each procedure. Patients were asked to record a pain score using a 10-cm visual analog scale and procedure tolerability. Complications and number of biopsies were recorded.

Results

The median pain scores were similar for the FNA and CNB approaches during and 20 minutes after the biopsy procedures (3.7 vs. 3.6, P=0.454; 0.9 vs. 1.1, P=0.296, respectively). The procedure was tolerable in all 100 FNA patients and in 97 CNB patients (P=0.246). The mean number of biopsies was fewer in the CNB group (1.4 vs. 1.2, P=0.002). By subgroup analysis (staff vs. non-staff), no significant difference was detected in any parameter. There were no major complications in either group, but three patients who underwent CNB had minor complications (P=0.246).

Conclusion

FNA and CNB show no significant differences for diagnosing thyroid nodules in terms of pain, tolerability, or complications.

Citations

Citations to this article as recorded by

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