Thyroid Nodule Size and Prediction of Cancer: A Study at Tertiary Care Hospital in Saudi Arabia

Al‐Hakami, Hadi; Alqahtani, Raneem; Alahmadi, Asim; Almutairi, Dakheelallah; Algarni, Mohammed; Alandejani, Talal

doi:10.7759/cureus.7478

Cited by 20 publications

(25 citation statements)

References 24 publications

(34 reference statements)

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“…( 6 ) suggest that size <2 cm is associated with an increased risk of well-differentiated thyroid cancer, which is also supported by Hadi et al. ( 19 ) However, Miller et al. ( 20 ) and Karman et al.…”

Section: Discussionmentioning

confidence: 59%

“…Irregular shape (taller than wide) was also usually contributed to predict the malignancy of the intermediate thyroid nodule (14,16,17). Nodule size is also reported to have predictive value of malignancy in several studies (8,18), and Jung et al (6) suggest that size <2 cm is associated with an increased risk of well-differentiated thyroid cancer, which is also supported by Hadi et al (19) However, Miller et al (20) and Karman et al (21) demonstrated that size >2 cm may be associated with thyroid malignancy. In our study, we found that nodule size in the malignant group is significantly smaller than that in the benign group, and on the multivariate analysis this factor was confirmed to be an independent predictor for malignancy and a threshold of approximately 1 cm in nodule diameter.…”

Section: Discussionmentioning

confidence: 69%

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Surgical Outcome and Malignant Risk Factors in Patients With Thyroid Nodule Classified as Bethesda Category III

et al. 2021

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BackgroundThyroid nodules are a very common finding in the general population. Fine-needle aspiration (FNA) has been recommended as the initial test for the evaluation of thyroid nodules. The trend on reporting as atypia of undetermined significance (AUS) has been significantly increased, but the malignant risk is still controversial among different studies. The aim of this study is to investigate the malignancy risk of thyroid nodules reported as Bethesda category III (AUS/FLUS) on initial FNA.MethodWe reviewed 272 papillary thyroid cancer (PTC) patients with suspicious thyroid nodules who underwent fine-needle aspiration and received surgical treatment during 2019 to 2020.ResultsOne hundred ten (40.4%) patients were diagnosed with PTC. Multivariate analysis showed that microcalcification (p = 0.037, OR = 2.260, 95% CI: 1.051–4.860), shape (p = 0.003, OR = 4.367, 95% CI: 1.629–11.705), diameters (p = 0.002, OR = 0.278, 95% CI: 0.123–0.631), anti-thyroglobulin antibodies (TGAb) (p = 0.002, OR = 0.150, 95% CI: 0.046–0.494), anti-thyroid peroxidase antibody (A-TPO) (p = 0.009, OR = 4.784, 95% CI: 1.486–15.401), and nodule goiter (p < 0.001, OR = 0.100, 95% CI: 0.046–0.217) were independent malignant risk factors in patients with thyroid nodule classified as Bethesda category III.ConclusionIn this study, malignant risk factors in patients with thyroid nodule classified as Bethesda category III were significantly associated with preoperative serum TGAb, A-TPO, microcalcification, irregular shape, and nodule diameters. Nodules with malignant factors should be carefully elevated; surgery may be the better option for those patients.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 69%

Surgical Outcome and Malignant Risk Factors in Patients With Thyroid Nodule Classified as Bethesda Category III

et al. 2021

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“…Our results indicated no significant relation between the nodule size and risk of malignancy. There is a controversy whether thyroid cancer risk rises with increasing nodule size [18,19]. It has also been mentioned that the impact of size on the nodule malignancy risk could be variable by histopathologic type of the thyroid cancers.…”

Section: Discussionmentioning

confidence: 99%

Can sonographic features of microcalcification predict thyroid nodule malignancy? a prospective observational study

Nabahati

Mehraeen

Moazezi

et al. 2021

Egypt J Radiol Nucl Med

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Background The aim of this study was to investigate the diagnostic accuracy of microcalcification, as well as its associated sonographic features, for prediction of thyroid nodule malignancy. We prospectively assessed the patients with thyroid nodule, who underwent ultrasound-guided fine-needle aspiration during 2017–2020 in Babol, northern Iran. The ultrasonographic characteristics of the nodules, as well as their cytological results, were recorded. We used regression analysis to evaluate the relation between sonographic findings and nodule malignancy. A receiver operator characteristics (ROC) analysis was also used to estimate the ability of ultrasound to predict the characteristic features of malignancy, as estimated by the area under the curve (AUC). Results Overall, 1129 thyroid nodules were finally included in the study, of which 452 (40%) had microcalcification. A significant positive association was found between nodule malignancy and microcalcification in both univariate (OR=3.626, 95% CI 2.258–5.822) and multivariable regression analyses (OR=1.878, 95% CI 1.095–3.219). In the nodules with microcalcification, significant positive relations were seen between malignancy and hypoechogenicity (OR=3.833, 95% CI 1.032–14.238), >5 microcalcification number (OR=3.045, 95% CI 1.328–6.982), irregular margin (OR=3.341, 95% CI 1.078–10.352), and lobulated margin (OR=5.727, 95% CI 1.934–16.959). The ROC analysis indicated that AUC for hypoechogenicity, >5 microcalcification number, irregular margin, and lobulated margin were 60%, 62%, 55%, and 60%, respectively, in predicting malignant thyroid nodules. Conclusion The findings indicated that microcalcification can be a potential predictor of thyroid nodule malignancy. Also, the presence of irregular or lobulated margins, multiple intranodular microcalcification (>5 microcalcifications), and/or hypoechogenicity can improve the ability of microcalcification in distinguishing malignant from benign nodules.

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“…According to the findings, the size of the thyroid nodules was not identified as a potential predictor of malignancy in the peripherally calcified nodules. There are conflicting findings on the impact of size on thyroid cancer risk, and both positive and negative associations have been reported between size and malignancy risk [ 20 ]. In their study, Kamran et al .…”

Section: Discussionmentioning

confidence: 99%

Different sonographic features of peripheral thyroid nodule calcification and risk of malignancy: a prospective observational study

Nabahati¹,

Ghaemian²,

Moazezi³

et al. 2021

Pol J Radiol

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IntroductionTo investigate the association of peripheral calcification, as well as its sonographic features, with thyroid nodule malignancy.Material and methodsThis study was prospectively conducted during 2015-2020 on patients diagnosed with thyroid nodule undergoing ultrasound-guided fine-needle aspiration in Shahid Beheshti teaching hospital or private offices in Babol, northern Iran. The ultrasonographic characteristics of the nodules, as well as the cytological findings, were recorded. Regression analysis was used to assess the relationship between sonographic results and malignancy. We also used receiver operator characteristics (ROC) analysis to estimate the ability of ultrasound to predict the characteristic features of malignancy, as estimated by the area under the curve (AUC).ResultsA total of 1857 thyroid nodules were finally included, of which 84 were peripherally calcified nodules. There was a significant positive association between the nodule malignancy and peripheral calcification (OR = 2.23, 95% CI: 1.13-4.35). In the nodules with peripheral calcification, significant positive associations were seen between malignancy and lobulated margin (OR = 3.85, 95% CI: 1.02-14.54) and solid composition (OR = 4.05, 95% CI: 0.99-16.53). The ROC analysis indicated that AUC for lobulated margin and solid composition was 63.8% and 66.5%, respectively, in predicting malignant thyroid nodules.ConclusionsThe findings showed that peripheral calcification on sonography can be a potential indicator of malignant thyroid nodules. Also, the presence of lobulated margin and/or solid composition, besides peripheral calcification, can be helpful in better distinguishing malignant from benign nodules.

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Thyroid Nodule Size and Prediction of Cancer: A Study at Tertiary Care Hospital in Saudi Arabia

Cited by 20 publications

References 24 publications

Surgical Outcome and Malignant Risk Factors in Patients With Thyroid Nodule Classified as Bethesda Category III

Surgical Outcome and Malignant Risk Factors in Patients With Thyroid Nodule Classified as Bethesda Category III

Can sonographic features of microcalcification predict thyroid nodule malignancy? a prospective observational study

Different sonographic features of peripheral thyroid nodule calcification and risk of malignancy: a prospective observational study

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