Correlation between Thyroid Nodule Calcification Morphology on Ultrasound and Thyroid Carcinoma

Shi, Chao; Li, S; Shi, Tiefeng; Liu, B; Ding, Chao; Qin, Huadong

doi:10.1177/147323001204000136

Cited by 45 publications

(40 citation statements)

References 26 publications

(24 reference statements)

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“…Of these, 235 studies were retrieved for further investigation, and 41 studies (14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54) met the final selection criteria and were included in the analysis. All 41 studies were observational studies published in peer-reviewed journals between 1989 and 2012.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

DIAGNOSIS IN ENDOCRINOLOGY: Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis

Campanella

Ianni

Rota

et al. 2014

European Journal of Endocrinology

106

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Objective: In order to quantify the risk of malignancy of clinical and ultrasonographic features of thyroid nodules (TNs), we did a systematic review and meta-analysis of published studies. Methods: We did a literature search in MEDLINE for studies published from 1st January 1989 until 31st December 2012. Studies were considered eligible if they investigated the association between at least one clinical/ultrasonographic feature and the risk of malignancy, did not have exclusion criteria for the detected nodules, had histologically confirmed the diagnoses of malignancy, and had a univariable analysis available. Two reviewers independently extracted data on study characteristics and outcomes. Results: The meta-analysis included 41 studies, for a total of 29 678 TN. A higher risk of malignancy expressed in odds ratio (OR) was found for the following: nodule height greater than width (OR: 10.15), absent halo sign (OR: 7.14), microcalcifications (OR: 6.76), irregular margins (OR: 6.12), hypoechogenicity (OR: 5.07), solid nodule structure (OR: 4.69), intranodular vascularization (OR: 3.76), family history of thyroid carcinoma (OR: 2.29), nodule size R4 cm (OR: 1.63), single nodule (OR: 1.43), history of head/neck irradiation (OR: 1.29), and male gender (OR: 1.22). Interestingly, meta-regression analysis showed a higher risk of malignancy for hypoechoic nodules in iodine-sufficient than in iodine-deficient geographical areas. Conclusions: The current meta-analysis verified and weighed out each suspicious clinical and ultrasonographic TN feature. The highest risk was found for nodule height greater than width, absent halo sign, and microcalcifications for ultrasonographic features and family history of thyroid carcinoma for clinical features. A meta-analysis-derived grading system of TN malignancy risk, validated on a large prospective cohort, could be a useful tool in TN diagnostic work-up.

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Section: Search Results and Study Characteristicsmentioning

confidence: 99%

DIAGNOSIS IN ENDOCRINOLOGY: Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis

Campanella

Ianni

Rota

et al. 2014

European Journal of Endocrinology

106

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“…However, the reported sensitivity and specificity values in our study correlate with those reported in the literature, with microcalcifications and irregu lar margins representing the most sensitive and specific tests available for stratifying malignant risk. [23][24][25][26] The TI-RADS scoring criteria were developed to help address the challenge of stratifying the risk of malignancy in thyroid nodules, which are prevalent in up to 60% of the general population. 3,12,13 The most recent studies examining TI-RADS, both prospectively and retrospectively, allow for a clear distinction between malignant and benign nodules in the vast majority of cases when all scoring criteria are applied.…”

Section: Discussionmentioning

confidence: 99%

“…14,17,25,27,28 The proper application of this system would benefit most from the use of standardized synoptic reporting tools that have been embraced by the surgical community as well as pathologists. In varied settings, including thyroid cancer and pancreatic cancer, synoptic reporting has been examined by international studies and validated as a method for capturing clinical data and improving patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…While individual assessments of sensitivity and specificity could vary, our results are qualitatively similar to those documented in studies that examined individual ultrasound features and the likelihood of malignancy in both urban and rural settings. 14,17,25,27,28 We acknowledge that there may be differences in the capabilities of individual ultrasonography machines that may limit in some form the reports provided. Finally, this was a retrospective assessment, and over the timeframe of the study there have been upgrades in technology and changes in ultrasonography protocol in different institutions.…”

Section: Limitationsmentioning

confidence: 99%

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The utility of thyroid ultrasonography in the management of thyroid nodules

Gamme

Parrington

Wiebe

et al. 2017

CJS

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Background: Ultrasonography for thyroid nodules is one of the most common imaging tests performed in the general population. Details from ultrasound reports guide biopsies and surgery. This study quantifies the completeness of these reports based on Thyroid Imaging and Reporting System (TI-RADS) criteria and considers their utility in predicting malignant disease. Methods:We retrospectively reviewed ultrasound reports for 329 thyroidectomy patients and extracted data elements using the TI-RADS criteria: nodule size, echogenicity, margins, vascularity, solid/cystic composition and the presence or absence of microcalcifications and the halo sign. We assessed the reports to determine whether individual or multiple criteria were associated with malignancy.Results: More than 97% of reports document nodule size; however, more than 90% of the reports noted only 3 or fewer of the 6 remaining TI-RADS criteria. The presence of microcalcifications was the most sensitive marker of malignancy (> 90%), whereas the documentation of irregular margins was the most specific indicator of malignancy (88%). Overall it was clear that microcalcifications, hypoechogenicity, irregular margins and solid nodules were significantly more likely to be found in malignant neoplasms; their absence predicted benign disease. Because so few reports consistently documented all criteria, the overall ability of thyroid ultrasonography to discriminate between lowerand higher-risk nodules is limited. Conclusion:Although the accuracy of thyroid ultrasonography is good, few ultrasound reports contain the necessary information, as defined by TI-RADS, to predict malignancy and guide management. When reported, microcalcifications and/or irregular margins are the best predictors of malignancy.Contexte : L'échographie des nodules thyroïdiens est l'une des épreuves d'imagerie les plus souvent effectuées dans la population générale. Les détails fournis par l'échographie guident les biopsies et la chirurgie. Cette étude quantifie l'exhaustivité des rapports d'échographie selon les critères TI-RADS (Thyroid Imaging and Reporting System) et en mesure l'utilité pour prédire les cancers.Méthodes : Nous avons passé en revue de façon rétrospective les rapports d'échographie de 329 patients ayant subi une thyroïdectomie et nous en avons extrait les éléments sous l'angle des critères TI-RADS : taille des nodules, échogénicité, marges, vascularité, composition solide c. kystique, présence ou absence de microcalcifications et signe du halo. Nous avons évalué les rapports afin de déterminer si certains critères individuels ou multiples pouvaient être associés au cancer.Résultats : Plus de 97 % des rapports mentionnent la taille des nodules; mais, plus de 90 % des rapports ne font état que de 3 critères ou moins sur les 6 autres critères TI-RADS. La présence de microcalcifications a été le marqueur tumoral le plus sensible (> 90 %), tandis que la présence de marges irrégulières a été le marqueur tumoral le plus spécifique (88 %). Dans l'ensemble, les microcalcifications, l'...

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“…Many sonological features like irregular margins, micro calcifications, taller than wider shape, marked hypoechogenicity have been shown to have predilection for malignancy. [1][2][3][4][5][6][7] However, there is also overlap in the appearance of benign and malignant t hyroid nodules. Due to inconsistent predictive value of USG features, fine needle aspiration and cytopathological…”

Section: Introductionmentioning

confidence: 99%

Application of society of radiologists in ultrasound recommendations for fine needle aspiration of thyroid nodules

et al. 2017

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Background: The Society of Radiologists in Ultrasound (SRU) recommendations on thyroid nodules are intended to "diagnose thyroid cancers that have reached clinical significance,while avoiding unnecessary tests and surgery in patients with benign nodules."Methods: This prospective observational study was conducted on 193 consecutive patients undergoing ultrasonography (USG) guided thyroid FNA. Nodules were categorized as "SRU-positive"and "SRU-negative" based on USG features. The sensitivity and specificity of the SRU recommendations and of various US features for thyroid malignancy were calculated.Results: Of 193 patients subjected to FNA, 83 patients of Bethesda class I,III,IV,V were excluded. Among 110 nodules subjected to FNA, 79 were SRU positive and 31were SRU negative. There were 24 malignancies in 110 FNA (22% malignancy prevelance). There was significant difference between the malignancy rates of SRU positive and negative groups (p=0.0192). The sensitivity, specificity, PPV, NPV of thyroid malignancy in our cohort was 91.6%, 33.7%, 27.8% and 93.5% respectively. Conclusions:The application of SRU recommendations reduces the number of benign nodules that undergo workup. Potentially missed malignancies in SRU negative nodules are less aggressive by histologic type and stage compared to SRU-positive malignancies.

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Correlation between Thyroid Nodule Calcification Morphology on Ultrasound and Thyroid Carcinoma

Abstract: Thyroid microcalcifications are strongly associated with thyroid carcinoma, especially micropapillary carcinoma. When cervical lymph node calcification is present, immediate surgery is required.

Cited by 45 publications

References 26 publications

DIAGNOSIS IN ENDOCRINOLOGY: Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis

DIAGNOSIS IN ENDOCRINOLOGY: Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis

The utility of thyroid ultrasonography in the management of thyroid nodules

Application of society of radiologists in ultrasound recommendations for fine needle aspiration of thyroid nodules

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