Partially Cystic Thyroid Nodules: Ultrasound Findings of Malignancy

Park, Jang Mi; Choi, Younghoon; Kwag, Hyon Joo

doi:10.3348/kjr.2012.13.5.530

Cited by 46 publications

(40 citation statements)

References 13 publications

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“…The malignancy risks of microcalcifications and non-parallel orientation were significantly higher in solid hypoechoic nodules than those in partially cystic or isohyperechoic nodules (15242526). The lower malignancy risk of partially cystic or isohyperechoic nodules may be due to several factors (15).…”

Section: Discussionmentioning

confidence: 90%

A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with Thyroid Nodules

Moon

Na³

et al. 2016

Korean J Radiol

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ObjectiveTo validate a new risk stratification system for thyroid nodules, the Korean Thyroid Imaging Reporting and Data System (K-TIRADS), using a prospective design.Materials and MethodsFrom June 2013 to May 2015, 902 thyroid nodules were enrolled from four institutions. The type and predictive value of ultrasonography (US) predictors were analyzed according to the combination of the solidity and echogenicity of nodules; in addition, we determined malignancy risk and diagnostic performance for each category of K-TIRADS, and compared the efficacy of fine-needle aspiration (FNA) with a three-tier risk categorization system published in 2011.ResultsThe malignancy risk was significantly higher in solid hypoechoic nodules, as compared to partially cystic or isohyperechoic nodules (each p < 0.001). The presence of any suspicious US features had a significantly higher malignancy risk (73.4%) in solid hypoechoic nodules than in partially cystic or isohyperechoic nodules (4.3–38.5%; p < 0.001). The calculated malignancy risk in K-TIRADS categories 5, 4, 3, and 2 nodules were 73.4, 19.0, 3.5, and 0.0%, respectively; and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for malignancy were 95.5, 58.6, 44.5, 96.9, and 69.5%, respectively, in K-TIRADS categories 4 and 5. The efficacy of FNA for detecting malignancy based on K-TIRADS was increased from 18.6% (101/544) to 22.5% (101/449), as compared with the three-tier risk categorization system (p < 0.001).ConclusionThe proposed new risk stratification system based on solidity and echogenicity was useful for risk stratification of thyroid nodules and the decision for FNA. The malignancy risk of K-TIRADS was in agreement with the findings of a previous retrospective study.

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Section: Discussionmentioning

confidence: 90%

A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with Thyroid Nodules

Moon

Na³

et al. 2016

Korean J Radiol

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“…For example, certain US features such as cystic dominancy, macrocalcification, size less than 5-10 mm, or hypoechogenicity, have been reported to increase the likelihood of nondiagnostic sampling despite highly variable nondiagnostic rates between studies (13, 14, 15, 16, 18, 19, 20, 21, 23, 39, 62, 63, 64). Particularly, cystic dominancy and intranodular macrocalcification were reported to be independent findings that increase the possibility of nondiagnostic results, even when experienced operators performed US-FNA (13).…”

Section: Strategies For Minimizing Nondiagnostic Resultsmentioning

confidence: 99%

Ultrasound-Guided Fine Needle Aspiration of Thyroid Nodules: A Consensus Statement by the Korean Society of Thyroid Radiology

et al. 2015

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Ultrasound (US)-guided fine needle aspiration (US-FNA) has played a crucial role in managing patients with thyroid nodules, owing to its safety and accuracy. However, even with US guidance, nondiagnostic sampling and infrequent complications still occur after FNA. Accordingly, the Task Force on US-FNA of the Korean Society of Thyroid Radiology has provided consensus recommendations for the US-FNA technique and related issues to improve diagnostic yield. These detailed procedures are based on a comprehensive analysis of the current literature and from the consensus of experts.

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“…The diagnostic recommendations for nodules in categories 1‐4 continue to be debated, especially for TI‐RADS categories 3 and 4. Some researchers classify cystic‐based nodules as level 1 . Others classify Hashimoto's thyroiditis as level 1 and even classify Hashimoto's thyroiditis nodules as level 1, which is not appropriate, based on reports in the literature that the frequency of malignant transformation in patients with Hashimoto's thyroiditis is 6‐10 times greater than that in patients with a normal thyroid …”

Section: Introductionmentioning

confidence: 99%

A new ultrasound nomogram for differentiating benign and malignant thyroid nodules

Chen¹,

Zhang²,

Meng³

et al. 2018

Clinical Endocrinology

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Summary Objective The Thyroid Imaging Reporting and Data System (TI‐RADS) is commonly used for risk stratification of thyroid nodules. However, this system has a poor sensitivity and specificity. The aim of this study was to build a new model based on TI‐RADS for evaluating ultrasound image patterns that offer improved efficacy for differentiating benign and malignant thyroid nodules. Design and Patients The study population consisted of 1092 participants with thyroid nodules. Measurements The nodules were analysed by the TI‐RADS and the new model. The prediction properties and decision curve analysis of the nomogram were compared between the two models. Results The proportions of thyroid cancer and benign disease were 36.17% and 63.83%. The new model showed good agreement between the prediction and observation of thyroid cancer. The nomogram indicated excellent prediction properties with an area under the curve (AUC) of 0.946, sensitivity of 0.884 and specificity of 0.917 for training data as well as a high sensitivity, specificity, negative predictive value and positive predictive value for the validation data also. The optimum cut‐off for the nomogram was 0.469 for predicting cancer. The decision curve analysis results corroborated the good clinical applicability of the nomogram and the TI‐RADS for predicting thyroid cancer with wide and practical ranges for threshold probabilities. Conclusions Based on the TI‐RADS, we built a new model using a combination of ultrasound patterns including margin, shape, echogenic foci, echogenicity and nodule halo sign with age to differentiate benign and malignant thyroid nodules, which had high sensitivity and specificity.

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Partially Cystic Thyroid Nodules: Ultrasound Findings of Malignancy

Cited by 46 publications

References 13 publications

A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with Thyroid Nodules

A Multicenter Prospective Validation Study for the Korean Thyroid Imaging Reporting and Data System in Patients with Thyroid Nodules

Ultrasound-Guided Fine Needle Aspiration of Thyroid Nodules: A Consensus Statement by the Korean Society of Thyroid Radiology

A new ultrasound nomogram for differentiating benign and malignant thyroid nodules

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