Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China

Abstract

Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ≥1 were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ≤2 favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

“…Similarly, Yoon et al defined a nomogram which is formed of same ultrasonographic features combined with age and nodule size, and showed that it can be used for prediction of malignancies ). An eastern China based recent study also showed that, a scoring system which was developed on the basis of different ultrasonographic features of thyroid nodules can be used for predicting histopathological outcome (Cheng et al, 2013). Not only ultrasonography seems to be a legit tool for predicting malignancy, but also more studies and meta-analyses are needed to define a universally viable set of criteria.…”

Prediction of central lymph node metastasis in 392 patients with cervical lymph node-negative papillary thyroid carcinoma in Eastern China

“…Due to the wide use of high-resolution thyroid ultrasound (US) and fine needle aspiration cytology (FNAC) under US guidance, a number of patients are diagnosed with PTMC without palpable thyroid nodules, which may explain the high incidence during previous years in Eastern China (2,3). The prognosis for PTMC patients is favorable, however, there remains a 1% disease-associated mortality rate, a 5% lymph node recurrence rate and a 2.5% distant metastasis rate (4-7).…”

Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy in Malignant Thyroid Nodules: Utility for Micronodules

“…A large number of studies have reported that the early diagnosis of thyroid cancer reduced recurrence and mortality (Mazzaferri and Kloos, 2001 less than 10 mm in diameter is particularly important due to high risk of lymph node metastasis and multicentricity (Xie et al, 2009). Currently, there is no any guideline for determining which thyroid nodules for biopsy, especially for micronodules (Cheng et al, 2013).…”