Anna Crescenzi

Bio: Anna Crescenzi is an academic researcher from Università Campus Bio-Medico. The author has contributed to research in topics: Thyroid nodules & Thyroid. The author has an hindex of 33, co-authored 120 publications receiving 4937 citations. Previous affiliations of Anna Crescenzi include Sapienza University of Rome.

Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features.

Abstract: The aim of the study was to correlate the sonographic [ultrasound (US)] and color-Doppler (CFD) findings with the results of US-guided fine needle aspiration biopsy (FNA) and of pathologic staging of resected carcinomas to establish: 1) the relative importance of US features as risk factors of malignancy; and 2) a cost-effective management of nonpalpable thyroid nodules. Four hundred ninety-four consecutive patients with nonpalpable thyroid nodules (8–15 mm) were evaluated by US, CFD, and US-FNA. Ninety-two patients with inadequate cytology were excluded from the study. All patients with suspicious or malignant cytology underwent surgery, whereas subjects with benign cytology had clinical and US control 6 months later. Thyroid malignancies were observed in 18 of 195 (9.2%) solitary thyroid nodules and in 13 of 207 (6.3%) multinodular goiters. Cancer prevalence was similar in nodules greater or smaller than 10 mm (9.1 vs. 7.0%). Extracapsular growth (pT4) was present in 35.5%, and nodal involvement in 19.4...

Italian consensus for the classification and reporting of thyroid cytology

Abstract: IntroductionThyroid nodules are diagnosed with increasing frequencyin clinical practice. The first step in the management ofpatients presenting with thyroid nodules is an accuratetriage of those who should be referred to surgery [1–5]. Inspite of the advances in ultrasound (US) imaging [6–8] andthe promising results of molecular analysis [9–16], thisbasic step still strongly relies on cytology [3]. Among theacronyms used to indicate the sampling technique forthyroid cytology (FNA, FNAB, FNAC, FNC), fine-needleaspiration (FNA) is the most frequently adopted and it willbe employed in this document. When the cytologicspecimen is obtained without aspiration the term FNC(fine-needle cytology) may be used [2].In the recent years, a variety of four- to six-tieredreporting schemes for thyroid cytology have been proposedby different societies and institutions, with the aim ofimproving the communication between cytopathologistsand clinicians [17].With the aim to standardize the diagnostic terminologyin thyroid FNA, in 2007 the United States National CancerInstitute (NCI) has proposed a reporting system for thyroidcytology based on the NCI Thyroid FNA State-Of-ScienceConsensus Conference [18]. This system has gained widediffusion and the atlas ‘‘The Bethesda System for Report-ing Thyroid Cytology’’ (BSRTC) provided well-definedcriteria with exhaustive explanatory notes [19]. Followingthe recommendations of the 2009 European Federation ofCytology Societies (EFCS) symposium aiming at theworldwide unification of the reporting systems for thyroidcytology [20], a working group of the Royal College ofPathologists (RCPath) updated the reporting systemalready in use in UK since 2007 [21] using criteria that aresimilar to those used in BSRTC [22].In Italy, a 5-tiered classification, proposed in 2007 bythe Italian Society for Anatomic Pathology and Cytologyjoint with the Italian Division of the International Academyof Pathology (SIAPEC-IAP) [2], is currently used by mostinstitutions. In 2012 the Italian Societies of Endocrinology,i.e., the Italian Thyroid Association (AIT), the ItalianAssociation of Clinical Endocrinologists (AME), the Ital-ian Society of Endocrinology (SIE) and the SIAPEC-IAPappointed a working panel of experts to update the formerconsensus in line with the indications of the EFCS. Thepresent document provides a reporting scheme for thyroidcytology and the suggested clinical actions. This Consen-sus is not meant to address in detail all the morphological

Thyroid tissue: US-guided percutaneous interstitial laser ablation-a feasibility study.

Abstract: PURPOSE: To evaluate percutaneous interstitial laser photocoagulation (ILP) as a palliative treatment of recurrent thyroid carcinoma untreatable with surgery or radioiodine administration. MATERIALS AND METHODS: By using 18 resected thyroid glands, the volume and histologic pattern of ILP-induced thyroid damage were assessed. In vivo treatment feasibility was evaluated by using a low-energy laser in two volunteers before thyroidectomy for huge autonomously functioning nodules. With ultrasonographic (US) monitoring, a 21-gauge spinal needle was inserted into the thyroid nodules. A 300-μm quartz fiberoptic guide was inserted through the needle lumen, and the fiber tip was placed in direct contact with the tissue. Laser irradiation was performed with a 1.064-nm Nd:YAG laser in surgically resected glands, which were treated with 2, 3, 5, or 7 W. RESULTS: Tissue ablation was well-defined histologically, and its area was related to laser irradiation parameters (range, 0–26 mm). No correlation was found between ...

Thyroid tissue: US-guided percutaneous laser thermal ablation.

Abstract: PURPOSE: To evaluate in vivo the safety and effectiveness of percutaneous laser thermal ablation (LTA) in the debulking of thyroid lesions. MATERIALS AND METHODS: Twenty-five adult patients at poor surgical risk with cold nodules (n = 8), autonomously hyperfunctioning thyroid nodules (n = 16), or anaplastic carcinoma (n = 1) underwent LTA. One to four 21-gauge spinal needles were inserted with ultrasonographic (US) guidance into the thyroid lesions. A 300-μm-diameter quartz optical fiber was advanced through the sheath of the needle. Nd:YAG laser was used with output power of 3–5 W. Side effects, complications, and clinical and hormonal changes were evaluated at the end of LTA and during follow-up. Linear regression analysis was used to investigate the correlation between energy delivered and reduction in nodule volume. Volume of induced necrosis and reduction in nodule volume were assessed with US or computed tomography. RESULTS: LTA was performed without difficulties in 76 LTA sessions. After treatment ...

2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

Abstract: Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer. Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Gr...

Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer

Abstract: Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the publication of the American Thyroid Association's guidelines for the management of these disorders was published in 2006, a large amount of new information has become available, prompting a revision of the guidelines. Methods: Relevant articles through December 2008 were reviewed by the task force and categorized by topic and level of evidence according to a modified schema used by the United States Preventative Services Task Force. Results: The revised guidelines for the management of thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, and management of benign thyroid nodules. Recommendations regarding the initial management of thyroid cancer include those relating to optimal surgical management, radioiodine remnant ablation, a...

Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update.

Abstract: Purpose To update the American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guideline recommendations for human epidermal growth factor receptor 2 (HER2) testing in breast cancer to improve the accuracy of HER2 testing and its utility as a predictive marker in invasive breast cancer.

Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Update

Abstract: Purpose.—To update the American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guideline recommendations for human epidermal growth factor receptor 2 (HER2) testing in b...

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum

Abstract: Background: Thyroid disease in pregnancy is a common clinical problem. Since the guidelines for the management of these disorders by the American Thyroid Association (ATA) were first published in 2...