Validation of Four Thyroid Ultrasound Risk Stratification Systems in Patients with Hashimoto’s Thyroiditis; Impact of Changes in the Threshold for Nodule’s Shape Criterion

Słowińska-Klencka, Dorota; Klencki, Mariusz; Wojtaszek-Nowicka, Martyna; Wysocka-Konieczna, Kamila; Woźniak-Oseła, Ewa; Popowicz, Bożena

doi:10.3390/cancers13194900

Cited by 4 publications

(4 citation statements)

References 48 publications

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“…The sphericity feature had the largest weight coefficient. This feature is similar to the results of Dorota et al [24] in evaluating the relationship between TN shape and malignant nodules.…”

Section: Discussionsupporting

confidence: 89%

Ultrasound Radiomics Nomogram to Diagnose Sub-Centimeter Thyroid Nodules Based on ACR TI-RADS

Zhang

et al. 2022

Cancers

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The aim of the present study was to develop a radiomics nomogram to assess whether thyroid nodules (TNs) < 1 cm are benign or malignant. From March 2021 to March 2022, 156 patients were admitted to the Affiliated Hospital of Nantong University, and from September 2017 to March 2022, 116 patients were retrospectively collected from the Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine. These patients were divided into a training group and an external test group. A radiomics nomogram was established using multivariate logistics regression analysis using the radiomics score and clinical data, including the ultrasound feature scoring terms from the thyroid imaging reporting and data system (TI-RADS). The radiomics nomogram incorporated the correlated predictors, and compared with the clinical model (training set AUC: 0.795; test set AUC: 0.783) and radiomics model (training set AUC: 0.774; test set AUC: 0.740), had better discrimination performance and correction effects in both the training set (AUC: 0.866) and the test set (AUC: 0.866). Both the decision curve analysis and clinical impact curve showed that the nomogram had a high clinical application value. The nomogram constructed based on TI-RADS and radiomics features had good results in predicting and distinguishing benign and malignant TNs < 1 cm.

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Section: Discussionsupporting

confidence: 89%

Ultrasound Radiomics Nomogram to Diagnose Sub-Centimeter Thyroid Nodules Based on ACR TI-RADS

Zhang

et al. 2022

Cancers

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“…In the population examined at our center, the percentage of PTC among cancers was markedly lower, especially in nodules with undetermined cytology [9]. The effectiveness of the assessment of ultrasound malignancy risk features in that group of nodules is also lower, but as we showed earlier, the diagnostic value of TIRADS systems is similar in patients with and without HT [51]. Therefore, our observation of a higher frequency of the surgical treatment performed directly after the first diagnosis of category III in patients without HT was probably a consequence of larger nodules' sizes and not an especially suspicious ultrasound image.…”

Section: Discussionmentioning

confidence: 57%

Hashimoto’s Thyroiditis Does Not Influence the Malignancy Risk in Nodules of Category III in the Bethesda System

Słowińska-Klencka

Popowicz

Klencki

2022

Cancers

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The aim of this study was to evaluate the risk of malignancy (RoM) in category III thyroid nodules of the Bethesda system in patients with and without Hashimoto thyroiditis (HT) and to analyze whether obtaining category III with a repeat FNA (rFNA) increases RoM. The study included 563 HT and 1250 non-HT patients; rFNA was performed in 349 and 575 patients, and surgical treatment in 160 and 390, respectively. There was no difference in RoM between HT and non-HT patients in the whole examined population (lower limit of RoM), nor in operated patients (upper limit of RoM), HT: 5.0–17.5%, non-HT: 4.7–15.1%. RoM in patients with AUS nodules (with nuclear atypia) was similar in both groups (HT: 21.7–40.0%, non-HT: 16.9–41.4%), as it was in patients with FLUS nodules (with architectural atypia) (HT: 3.5–13.3%, non-HT: 4.0–13.0%). In patients from both groups together, with category III diagnosed twice and AUS identified at least once, RoM was 16.7–50.0% and it was higher than that in patients with FLUS nodule diagnosed twice: 3.2–13.0% (p < 0.005). Concluding, RoM in category III nodules is not affected by the presence of HT. Subcategorization of category III nodules (FLUS vs. AUS) may provide guidance toward further follow-up or surgery in both groups.

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“…Echogenic septations, inhomogeneous parenchyma, and diffuse hypoechogenicity and pseudonodules, are the characteristics of HT under US imaging, which may influence the identification of nodules 14 , 15 and make it difficult to differentiate between cancers and benign lesions. 16 These difficulties are commonly aggravated by small nodules. Therefore, to precisely identify thyroid cancer with HT, a better understanding of US images of thyroid nodules in HT patients is required.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Various Ultrasound-Based Malignant Risk Stratification Systems on an Occasion for Assessing Thyroid Nodules in Hashimoto’s Thyroiditis

Zhao¹,

Zhang²,

Xu³

2023

IJGM

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Purpose To compare the diagnostic performance and unnecessary ultrasound-guided fine-needle aspiration (US-FNA) biopsy rate of the 2015 American Thyroid Association (ATA), 2016 Korean Society of Thyroid Radiology (KSThR), and 2017 American College of Radiology (ACR) guidelines for patients with and without Hashimoto’s thyroiditis (HT). Patients and Methods This retrospective study included 716 nodules from 696 consecutive patients, which were classified using the categories defined by the three guidelines: ATA, KSThR, and ACR. The malignancy risk in each category was calculated and the diagnostic performance and unnecessary fine-needle aspiration (FNA) rates of the three guidelines were compared. Results In total, 426 malignant and 290 benign nodules were identified. Patients with malignant nodules had lower total thyroxine levels and higher thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody levels than those without malignant nodules (all P <0.01). The margin difference was significant in non-HT patients ( P <0.01), but comparable in HT patients ( P =0.55). The calculated malignancy risks of high and intermediate suspicion nodules in the ATA and KSThR guidelines and moderately suspicious nodules in the ACR guidelines were significantly lower in non-HT patients compared with HT patients ( P <0.05). The ACR guidelines showed the lowest sensitivity, highest specificity, and lowest unnecessary FNA rates in patients with and without HT. Compared to non-HT patients, HT patients had significantly lower unnecessary FNA rates ( P <0.01). Conclusion HT was associated with a higher malignancy rate of thyroid nodules with intermediate suspicion according to the ATA, KSThR, and ACR guidelines. The three guidelines, especially ACR, were likely to be more effective and could allow a greater reduction in the percentage of benign nodules biopsied in patients with HT.

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Validation of Four Thyroid Ultrasound Risk Stratification Systems in Patients with Hashimoto’s Thyroiditis; Impact of Changes in the Threshold for Nodule’s Shape Criterion

Cited by 4 publications

References 48 publications

Ultrasound Radiomics Nomogram to Diagnose Sub-Centimeter Thyroid Nodules Based on ACR TI-RADS

Ultrasound Radiomics Nomogram to Diagnose Sub-Centimeter Thyroid Nodules Based on ACR TI-RADS

Hashimoto’s Thyroiditis Does Not Influence the Malignancy Risk in Nodules of Category III in the Bethesda System

Comparison of Various Ultrasound-Based Malignant Risk Stratification Systems on an Occasion for Assessing Thyroid Nodules in Hashimoto’s Thyroiditis

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