Role Of Ultrasonography in Predicting Malignancy in Patients with Thyroid Nodules

Abstract

The use of ultrasonography (USG) has become an essential part of endocrine surgical practice. We evaluated the value of USG in predicting malignancy of thyroid nodules. The accuracy of USG in 857 patients who underwent fine-needle aspiration (FNA) with or without surgery was analyzed in a prospective setting. The diagnostic accuracy of USG was compared to that of FNA and of combined models in 153 operated patients. The malignancy-predicting value of USG in follicular neoplasms and its relation to nodule size were also investigated. Sensitivity, specificity, and overall accuracy (OA) of USG were 84.9%, 95.5%, and 93.7%, respectively. In operated patients, USG had accuracy comparable to that of FNA and combined models (sensitivity 93.3%, specificity 90.6%, OA 92.0%) regardless of nodule size but showed a significant rate of indeterminate results (29.4%). For follicular neoplasms, the sensitivity, specificity, and OA of USG were 100%, 95.4%, and 96.1%, respectively, with indeterminate results for three malignant nodules (42.8%). This acceptable malignancy-predicting value of USG in thyroid nodules supports the potential role of USG for predicting malignancy in selected patients with thyroid nodules. However, the high rate of indeterminate results precludes it from being a standard independent diagnostic method for the present time.

How to combine ultrasound and cytological information in decision making about thyroid nodules

“…When the results of FNAB and US indicated that the lesion was benign, we chose clinical follow-up rather than surgery. Focal thyroid nodules that had not been operated on were excluded to analyze the false-negative rate, resulting in a relatively low negative predictive value compared with other studies [6, [47][48][49]. Therefore, the false-negative rate of 5.8% may not be an accurate measurement.…”

Evaluation of Thyroid Nodules in Turkish Population

“…In Turkey, the prevalence of thyroid nodules was reported as 33% in a study which included 1,831 subjects screened for thyroid nodules (7). The (10). In the present study, we correlated the findings of ultrasonography, scintigraphy, FNA and thyroidectomy in patients with nodular thyroid disease.…”

Impact of nodular size on the predictive values of gray-scale, color-Doppler ultrasound, and sonoelastography for assessment of thyroid nodules

“…However, performing FNAB on every thyroid nodule detected by ultrasound is not cost-effective due to the high prevalence of nodules. Ultrasound is the most sensitive test available to detect thyroid lesions (Moon H.C. et al, 2007) and may be used to further characterize thyroid nodules, providing an assessment of risk of malignancy, and thereby narrowing down those nodules which require FNAB. Numerous studies have investigated the sonographic features of nodules as predictors of malignancy (Reading et al, 2005;Hoang et al, 2007;Moon W.J.…”