Sara Ahmadi

Positions:

Assistant Professor of Medicine

Medicine, Endocrinology, Metabolism, and Nutrition
School of Medicine

Assistant Professor of Medicine

Medicine, Endocrinology, Metabolism, and Nutrition
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2005

Tehran University of Medical Sciences (Iran)

Research Fellow in Nephrology

University of Texas, Medical Branch at Galveston

Internal Medicine Residency

Henry Ford Health System

Clinical Fellowship in Endocrinology

University of Texas, Medical Branch at Galveston

Publications:

Pituitary dysfunction after traumatic brain injury: screening and hormone replacement

Authors
Guttikonda, S; Ahmadi, S; Urban, RJ
MLA Citation
Guttikonda, Sreedevi, et al. “Pituitary dysfunction after traumatic brain injury: screening and hormone replacement.” Expert Review of Endocrinology & Metabolism, vol. 6, no. 5, Informa UK Limited, Sept. 2011, pp. 697–703. Crossref, doi:10.1586/eem.11.59.
URI
https://scholars.duke.edu/individual/pub1276414
Source
crossref
Published In
Expert Review of Endocrinology & Metabolism
Volume
6
Published Date
Start Page
697
End Page
703
DOI
10.1586/eem.11.59

VARIABILITY IN THYROID CANCER MANAGEMENT AND PROGNOSIS AMONG HISPANIC VERSUS NON-HISPANIC PATIENTS : 17 YEARS DATA FROM UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AND UNIVERSITY HEALTH SYSTEM AT SAN ANTONIO

Authors
Ahmadi, S; Rojas, CR; Policarpio-Nicolas, ML; Metter, D; Avery, D; Prihoda, TJ; Sabra, MM
MLA Citation
Ahmadi, Sara, et al. “VARIABILITY IN THYROID CANCER MANAGEMENT AND PROGNOSIS AMONG HISPANIC VERSUS NON-HISPANIC PATIENTS : 17 YEARS DATA FROM UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AND UNIVERSITY HEALTH SYSTEM AT SAN ANTONIO.” Endocrine Practice, no. aop, AACE Corp (American Association of Clinical Endocrinologists). Crossref, doi:10.4158/ep171852.or.
URI
https://scholars.duke.edu/individual/pub1278323
Source
crossref
Published In
Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
DOI
10.4158/ep171852.or

USING THE ATA AND ACR TI-RADS SONOGRAPHIC CLASSIFICATIONS AS ADJUNCTIVE PREDICTORS OF MALIGNANCY FOR INDETERMINATE THYROID NODULES.

Objective: Thyroid nodules with indeterminate cytology pose management challenges in clinical practice. The aim of this study was to determine the efficacy of ultrasound features in navigating clinical decision making in thyroid nodules with indeterminate cytology. Methods: We retrospectively reviewed ultrasound imaging from 186 adult patients with thyroid nodules and indeterminate cytology who underwent thyroidectomy at a quaternary hospital from 2010-2017. All nodules were classified based on the American Thyroid Association (ATA) and 2017 American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS). Nodules were included if good quality pre-operative ultrasound imaging and surgical pathology were available. Results: A total of 202 thyroid nodules were included. The median age was 57 years; 82.8% were female. Risk of malignancy (ROM) in resected nodules with Bethesda 3 and 4 cytology was 19.4% and 30.3%, respectively. ATA high-suspicious and TI-RADS 5 nodules had high ROM, 100% in both systems for Bethesda 3 nodules; 66.7% and 50.0%, respectively, for Bethesda 4 nodules. For ATA very-low suspicious/TI-RADS 1 and 2, ROM was 0%. ROM in ATA low-suspicious/TI-RADS 3 nodules with Bethesda 3 cytology was lower (15.2% and 16.0%, respectively) than Bethesda 4 cytology (33.8% and 34.3%, respectively). ATA intermediate-suspicious/TI-RADS 4 nodules with Bethesda 4 cytology had a lower ROM (11.1% and 18.2%, respectively) than Bethesda 3 cytology (28.6 % and 31.6%, respectively). Conclusion: Using either the ATA or the TI-RADS system to risk-stratify nodules with indeterminate cytology may help clinicians plan better for additional diagnostic testing and treatment. Abbreviations: ACR = American College of Radiology; ATA = American Thyroid Association; AUS = atypia of undetermined significance; FLUS = follicular lesion of undetermined significance; FN = follicular neoplasm; PPV = positive predictive value; ROM = risk of malignancy; SFN = suspicious for follicular neoplasm; TI-RADS = Thyroid Imaging Reporting and Data System.
Authors
Ahmadi, S; Herbst, R; Oyekunle, T; Jiang, XS; Strickland, K; Roman, S; Sosa, JA
MLA Citation
Ahmadi, Sara, et al. “USING THE ATA AND ACR TI-RADS SONOGRAPHIC CLASSIFICATIONS AS ADJUNCTIVE PREDICTORS OF MALIGNANCY FOR INDETERMINATE THYROID NODULES.Endocr Pract, vol. 25, no. 9, Sept. 2019, pp. 908–17. Pubmed, doi:10.4158/EP-2018-0559.
URI
https://scholars.duke.edu/individual/pub1388418
PMID
31170369
Source
pubmed
Published In
Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Volume
25
Published Date
Start Page
908
End Page
917
DOI
10.4158/EP-2018-0559

Negative Results on Thyroid Molecular Testing Decrease Rates of Surgery for Indeterminate Thyroid Nodules.

Molecular tests and mutational panels such as Afirma Gene Expression Classifier (GEC) and ThyroSeq, respectively, have been used to help risk stratify cytologically indeterminate thyroid nodules with the aim to reduce unnecessary surgeries. We studied the effect of molecular testing on the rate of surgical resection in these nodules. Thyroid nodules with indeterminate (Bethesda III/IV) cytology that underwent molecular testing (GEC or ThyroSeq) at our institution between June 2012 and August 2016 were retrospectively reviewed. We collected demographics, cytology diagnoses, molecular test results, and whether surgical resection was performed. Two hundred eighty-three nodules met inclusion criteria: 202 nodules tested with GEC and 81 tested with ThyroSeq. In the cohort of GEC-tested nodules, 99/202 (49%) yielded "suspicious" and 103/202 (51%) yielded "benign" results, with an overall resection rate of 70/99 (71%) in "suspicious" versus 13/103 (13%) in "benign" nodules. In the cohort of ThyroSeq-tested nodules, 13/81 (16%) of nodules yielded a "high-risk mutation" and 68/81 (84%) of nodules yielded "no high-risk mutation," with overall resection rates of 11/13 (85%) and 30/68 (44%), respectively. Rates of resection were higher for Bethesda IV than for III nodules, regardless of molecular results. For both GEC and ThyroSeq, molecular test results seemed to correlate with the rate of resection at our institution. Rates of resection for cytologically indeterminate nodules that were "benign" or "no high-risk mutation" appeared to differ from those that were "suspicious" or "high-risk mutation" on molecular panel testing by GEC and ThyroSeq, respectively. Our findings support that molecular test results are impacting management.
Authors
Jug, R; Parajuli, S; Ahmadi, S; Jiang, XS
MLA Citation
Jug, Rachel, et al. “Negative Results on Thyroid Molecular Testing Decrease Rates of Surgery for Indeterminate Thyroid Nodules.Endocr Pathol, vol. 30, no. 2, June 2019, pp. 134–37. Pubmed, doi:10.1007/s12022-019-9571-x.
URI
https://scholars.duke.edu/individual/pub1373852
PMID
30825100
Source
pubmed
Published In
Endocr Pathol
Volume
30
Published Date
Start Page
134
End Page
137
DOI
10.1007/s12022-019-9571-x

Changes in Serum Calcitonin Concentrations, Incidence of Medullary Thyroid Carcinoma, and Impact of Routine Calcitonin Concentration Monitoring in the EXenatide Study of Cardiovascular Event Lowering (EXSCEL).

OBJECTIVE: Increases in serum calcitonin, a tumor marker for medullary thyroid carcinoma (MTC), have been associated with glucagon-like peptide 1 receptor agonist use in some preclinical studies. We report calcitonin changes in exenatide-treated and placebo-administered participants and MTC incidence in the EXenatide Study of Cardiovascular Event Lowering (EXSCEL) and consider the impact of within-trial calcitonin monitoring. RESEARCH DESIGN AND METHODS: EXSCEL participants were randomized 1:1 to once-weekly exenatide 2 mg or placebo. Serum calcitonin was measured at baseline (with trial medication discontinued if >40 ng/L) and annually thereafter (with trial medication discontinued if ≥50 ng/L). Median calcitonin concentrations were calculated at each time point, and thyroid malignancies were collected prospectively. Data regarding follow-up after an elevated calcitonin were collected retrospectively. RESULTS: At baseline, 52 (30 exenatide and 22 placebo) participants had calcitonin >40 ng/L, and during follow-up an additional 23 participants (15 exenatide and 8 placebo) had calcitonin ≥50 ng/L in the intention-to-treat population. Median calcitonin concentrations were similar between treatment groups at baseline with no increase over time. Confirmed MTC occurred in three participants (2 exenatide and 1 placebo), all of whom had significantly elevated baseline calcitonin values (413, 422, and 655 ng/L). CONCLUSIONS: During a median 3.2 years' follow-up, no change in serum calcitonin was seen with exenatide therapy. The three confirmed cases of MTC all occurred in participants with markedly elevated baseline calcitonin levels, measured prior to trial medication administration. Regular calcitonin monitoring identified no additional cases of MTC, suggesting no benefit of routine calcitonin monitoring during exenatide treatment.
Authors
Bethel, MA; Patel, RA; Thompson, VP; Merrill, P; Reed, SD; Li, Y; Ahmadi, S; Katona, BG; Gustavson, SM; Ohman, P; Iqbal, N; Gagel, RF; Hernandez, AF; Buse, JB; Holman, RR; EXSCEL Study Group,
URI
https://scholars.duke.edu/individual/pub1381025
PMID
31010875
Source
pubmed
Published In
Diabetes Care
Volume
42
Published Date
Start Page
1075
End Page
1080
DOI
10.2337/dc18-2028