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Original Studies |
University of Illinois College of Medicine (A.B.S., B.C.) and Columbia-Michael Reese Hospital (A.B.S., C.B., J.L., J.R., H.H., E.S.-F., T.G.), Chicago, Illinois 60612
Address all correspondence and requests for reprints to: Arthur B. Schneider, M.D., Ph.D., Section of Endocrinology and Metabolism (MC 640), University of Illinois College of Medicine, 1819 West Polk Street, Chicago, Illinois 60612.
In 1974 we began a prospective study of a cohort of 4296 individuals
exposed to therapeutic head and neck irradiation during childhood for
benign conditions. To define the role of thyroid ultrasonography in
following irradiated individuals, we studied a subgroup of 54
individuals. They all had been screened between 1974–1976 and had
normal thyroid scans and no palpable nodules at that time. Thyroid
ultrasonography, thyroid scanning, physical examination, and serum
thyroglobulin measurements were performed. One or more discrete
ultrasound-detected nodules were present in 47 of 54 (87%) subjects.
There were a total of 157 nodules, 40 of which were 1.0 cm or larger in
largest dimension. These 40 nodules occurred in 28 (52%) of the
subjects. Thirty (75%) of these 1.0-cm or larger nodules matched
discrete areas of diminished uptake on corresponding thyroid scans. The
10 that did not match (false negative scans for 
1.0-cm nodules) were
the only nodules of this size in 7 subjects. Of 11 nodules 1.5 cm or
larger, only 5 were palpable. Serum thyroglobulin correlated to the
number (P = 0.04; r2 = 0.10), but not
the volume of the thyroid nodules (P = 0.07;
r2 = 0.08). We conclude that thyroid nodules are continuing
to occur and are exceedingly common in this irradiated cohort of
individuals. The results confirm that thyroid ultrasonography is more
sensitive than physical examination and scanning. However, thyroid
ultrasound is so sensitive and nodules so prevalent that great caution
is needed in interpreting the results.
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M. Imaizumi, T. Usa, T. Tominaga, M. Akahoshi, K. Ashizawa, S. Ichimaru, E. Nakashima, R. Ishii, E. Ejima, A. Hida, et al. Long-Term Prognosis of Thyroid Nodule Cases Compared with Nodule-Free Controls in Atomic Bomb Survivors J. Clin. Endocrinol. Metab., September 1, 2005; 90(9): 5009 - 5014. [Abstract] [Full Text] [PDF]
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M. S. Momani, E. Shore-Freedman, B. J. Collins, J. Lubin, E. Ron, and A. B. Schneider Familial Concordance of Thyroid and Other Head and Neck Tumors in an Irradiated Cohort: Analysis of Contributing Factors J. Clin. Endocrinol. Metab., May 1, 2004; 89(5): 2185 - 2191. [Abstract] [Full Text] [PDF]
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A. Bucci, E. Shore-Freedman, T. Gierlowski, D. Mihailescu, E. Ron, and A. B. Schneider Behavior of Small Thyroid Cancers Found by Screening Radiation-Exposed Individuals J. Clin. Endocrinol. Metab., August 1, 2001; 86(8): 3711 - 3716. [Abstract] [Full Text] [PDF]
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 E. Marqusee, C. B. Benson, M. C. Frates, P. M. Doubilet, P. R. Larsen, E. S. Cibas, and S. J. Mandel Usefulness of Ultrasonography in the Management of Nodular Thyroid Disease Ann Intern Med, November 7, 2000; 133(9): 696 - 700. [Abstract] [Full Text] [PDF]
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