Predictive Value of Sonographic Features in Preoperative Evaluation of Malignant Thyroid Nodules in a Multinodular Goiter

Salmaslıoğlu, Artür; Erbil, Yeşim; Dural, Ahmet Cem; İşsever, Halim; Kapran, Yersu; Özarmağan, Selçuk; Tezelman, Serdar

doi:10.1007/s00268-008-9600-2

Cited by 60 publications

(49 citation statements)

References 27 publications

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“…4 These features have been identified as major predictors of malignancy in thyroid nodules in similar studies also. 5 According to the 2015 American Thyroid Association Guideline Task Force, solid component hypoechoic thyroid nodules with one or more of the following features have over 70-90% risk of malignancy: irregular margins, micro-calcifications, taller than wide shape, and rim calcifications. 6 In the present study, for detection of malignancy ultrasound has a sensitivity of 87.2%, specificity of 79.2%, positive predictive value of 89.1 %, negative predictive value of 76% and an overall accuracy of 84.5%, which is in concordance with literature.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of ultrasonography in goiters: a tertiary centre experience

Manikantan¹,

Ravi²,

Chisthi³

2017

Int J Res Med Sci

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Background: Thyroid diseases are highly prevalent in India, especially in the southern states. Evaluation of thyroid pathologies revolves mainly on imaging and cytology. Recent advances in thyroid imaging have greatly improved the diagnosis, treatment and follow-up in thyroid diseases. Though there are advanced modalities including Computed Tomography and Magnetic Resonance Imaging, Ultrasonography remains the cornerstone for the evaluation of thyroid gland, due to its ubiquitous availability and cost-effectiveness. The objectives of the study were to find out the diagnostic accuracy of ultrasonography in thyroid swellings and to find out the most reliable diagnostic feature of thyroid malignancy in ultrasonography.Methods: This was an observational study, conducted on 71 patients admitted to the General surgical wards of Government Medical College, Trivandrum, with thyroid swellings, for a period of 18 months. For all these patients, ultrasound scan of the thyroid gland was done on an ultrasound machine with a 17/5 MHz linear transducer, by experienced faculty.Results: Ultrasonography was found to have a sensitivity of 87.2% and a specificity of 79.2% in diagnosing thyroid pathologies. The most common malignancy of thyroid found in the study was papillary carcinoma and the most reliable ultrasound finding suggestive of malignancy was microcalcification.Conclusions: As per the present study, it is concluded that high resolution ultrasonography is very useful in diagnosing the nature of thyroid swellings, with an accuracy rate of 84.5%. Ultrasonography is a valuable diagnostic tool in the evaluation of thyroid diseases and is the imaging modality of choice.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of ultrasonography in goiters: a tertiary centre experience

Manikantan¹,

Ravi²,

Chisthi³

2017

Int J Res Med Sci

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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%

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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“…However, microcalcification and marginal iregularity which are associated with malignancy were similar in exophytic and nonexophytic groups. Solid consistency is more common in malignant thyroid nodules and the vast majority (82% -91%) of thyroid cancers are solid (10)(11)(12). In a study including 360 consecutively surgically removed thyroid cancers, 88% were reported to be solid or minimally cystic (13).…”

Section: Discussionmentioning

confidence: 99%

Rate of Malignancy in Exophytic Thyroid Nodules

et al. 2017

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Background: There are ultrasonography (US) features suggested to be associated with a higher risk of malignancy in thyroid nodules. However, exophytic appearence of thyroid nodules has not been studied previously. Objectives: To evaluate US features, and cytological and histopathological findings in exophytic thyroid nodules. Patients and Methods:Patients with an exophytic thyroid nodule who underwent fine needle aspiration biopsy (FNAB) between January and July 2015 were evaluated prospectively. Demographical data, US features, and cytology results were noted and histopathological findings were determined in operated patients. The results were compared with non-exophytic nodules of age and sex matched patients. Results: Data of 253 exophytic nodules in 247 patients and 529 non-exophytic nodules in 357 patients were analyzed. Hypoechogenity, mixed texture, and absence of peripheral halo were significantly higher in exophytic nodules (P < 0.001, P < 0.001, and P = 0.018, respectively). Nondiagnostic, atypia of undetermined significance/follicular lesion of undetermined significance and suspicious for malignancy cytology results were significantly higher in exophytic nodules (P = 0.002, P < 0.001 and P < 0.001 respectively). 6.7% of exophytic nodules and 1.9% of non-exophytic nodules had malignant cytology (P = 0.001). Histopathologically, 35 (47.9%) of 73 exophytic nodules and 18 (24.3%) of 74 non-exophytic nodules were malignant (P < 0.01). Capsular invasion was higher in the malignant exophytic group (53.5% vs 14.3%, P = 0.027). US features other than hypoechoic pattern which was higher in the malignant group were similar in benign and malignant exophytic nodules. Conclusions: Exophytic nodules seem to carry a higher rate of malignancy both cytologically and histopathologically. Suspicous US features except hypoechoic pattern were not higher in malignant compared to benign exophytic nodules.

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Predictive Value of Sonographic Features in Preoperative Evaluation of Malignant Thyroid Nodules in a Multinodular Goiter

Abstract: Although we did not identify a single feature indicative of malignancy in the sonographic examination of nodules, microcalcification and blurred margin were the strongest correlates for malignancy.

Cited by 60 publications

References 27 publications

Diagnostic accuracy of ultrasonography in goiters: a tertiary centre experience

Diagnostic accuracy of ultrasonography in goiters: a tertiary centre experience

The utility of thyroid ultrasonography in the management of thyroid nodules

Rate of Malignancy in Exophytic Thyroid Nodules

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