Role of ultrasound, clinical and scintigraphyc parameters to predict malignancy in thyroid nodule

Abstract

BackgroundThis study aimed to evaluate clinical, laboratory, ultrasound (US) and scintigraphyc parameters in thyroid nodule and to develop an auxiliary model for clinical application in the diagnosis of malignancy.MethodsWe assessed 143 patients who were surgically treated at a single center, 65% (93) benign vs. 35% (50) malignant lesions at final histology (1998-2008). The clinical, laboratory, scintigraphyc and US features were compared and a prediction model was designed after the multivariate analysis.ResultsThere were no differences in gender, serum TSH and FT4 levels, thyroid auto-antibodies (TAb), thyroid dysfunction and scintigraphyc results (P = 0.33) between benign and malignant nodule groups. The sonographic study showed differences when the presence of suspected characteristics was found in the nodules of the malignant lesions group, such as: microcalcifications, central flow, border irregularity and hypoechogenicity. After the multivariate analysis the model obtained showed age (>39 years), border irregularity, microcalcifications and nodule size over 2 cm as predictive factors of malignancy, featuring 81.7% of accuracy.ConclusionsThis study confirmed a significant increase of risk for malignancy in patients of over 39 years and with suspicious features at US.

Thyroid Masses: An Analysis of 135 Cases

“…Furthermore, it was observed that as the solid component of the nodule increases (mixed echogenicity), the risk of malignancy increases. The presence of micro-calcification was observed to significantly increase the risk of malignancy in the nodule, similar to the literature (9,10,(12)(13)(14)(15)(16).…”

“…Micro-calcification, not containing a cystic component and heterogeneous internal structure have been reported as important USG findings in the diagnosis of thyroid carcinoma in many studies (9,10). In our study, the comparison of pre-operative USG findings and main specimen pathology results revealed a significantly higher risk of malignancy in solid hypo echoic nodules compared to others (11)(12)(13)(14). Furthermore, it was observed that as the solid component of the nodule increases (mixed echogenicity), the risk of malignancy increases.…”

“…Recently, in our clinics, all thyroid FNAB are performed with the guidance of USG. In different studies performing cytological evaluations with FNAB, the false negativity rate of malignancy was reported as 0-4%, and the false negative rate as 4-20% (6,12,17). In our study, the false positivity and negativity rates were 0% and 15.6%, respectively.…”

Relationship Between Thyroid Nodule Diameter and Malignancy: Does Nodule Diameter Actually Increase Probability of Malignancy?

“…Türkiye'de yapılan çalışmalarda, bu oran yaklaşık %2,8 olarak bulunmuştur (9). Ancak USG'nin gelişmesi ile tiroid nodül insidansının %16-67 olduğu görülmüştür (10). Bu nodüllerin birçoğu, non-palpabl (%90) ve benign karakterdedir (11,12).…”

The Management of Thyroid Nodules

“…Further cytological examination is needed for nodules having a hypoechoic appearance with one or other suspicious findings (1,2). In a study, it was reported that the coexistence of age at 39 years or above, an irregular margin, microcalcification, and the nodule being larger than 2 cm could predict malignancy at an accuracy rate of 81.7% (11). Moreover, it was specified that the specificity of a spongiform appearance for demonstrating a benign nodule was 99.7% and the negative predictive value for malignancy was 98.5%.…”