Clinical and ultrasonographic features in cancer risk stratification of indeterminate thyroid nodules

Abstract

Objectives: To estimate the risk of malignancy in indeterminate thyroid nodules and to determine whether certain clinical or radiological parameters can predict the risk of malignancy.Methods: This retrospective study enrolled all adult patients )age ≥14 years( with a cytological diagnosis of atypia/follicular lesion of undetermined significance and follicular neoplasm/suspicious for a follicular neoplasm between January 2014 and January 2020. Fifty patients with surgically treated primary thyroid nodules, documented final histological diagnosis, and ultrasound examination records were included. Thyroid nodules were evaluated radiologically using Thyroid Imaging Reporting and Data System introduced by the American College of Radiology )2017(.

The impact of thyroid imaging reporting and data system on the management of Bethesda III thyroid nodules

“… 18 Moreover, other investigators have argued that the TI-RADS showed at least some correlation between malignant or benign cytological diagnoses. 3 In contrast, other reports showed that ACR TI-RADS does not help in predicting the ROM in patients with Bethesda III nodules 28 , 29 ; this concurs with our present findings.…”

Diagnostic models for predicting malignancy in thyroid nodules classified as Bethesda Category III in an endemic region

“…26 Our study appears to have a broader scope than many previous studies on AUS. While prior research has primarily focused on clinical and ultrasound (USG) variables or demographic and pathological variables, [27][28][29][30][31] in this study includes a comprehensive examination of clinical, USG, and cytopathological (not routinely examined, all presented in Tables 1 and 2) variables. This comprehensive approach could potentially provide a more detailed understanding of AUS.…”

Current controversies in the management of patients with indeterminate thyroid nodules

“…However, other studies found no significant correlation between ROM and age. 2,13,[19][20][21]24 Furthermore, it has been reported that older patients with TNs had a higher ROM. 25 Repeat FNAC.…”

“…Although the majority of TNs are benign and asymptomatic, the risk of malignant transformation ranges between 5 and 15%. 2 The risk of malignancy (ROM) in a solitary TN ranges from 2.7% to 33%; however, from 1.4% to 10% in a multinodular goiter. Barroeta et al 3 reported that the ROM is equal in one or 2 TNs >1 cm and decreases with ≥3 TNs.…”

“…Both Bethesda categories are known for their ambiguity and heterogeneity and the ROM is 5-15% in Bethesda III and 15-30% in Bethesda IV. 2,6 However, according to an updated TBSRTC version, the respective ROMs are 6-18% and 10-40% if noninvasive follicular thyroid neoplasm with papillary-like nuclear features is not considered a malignancy. When it is included in the malignancy risk assessment, the ROM increases to 10-30% in AUS/ FLUS and 25-40% in FN/SFN nodules.…”