Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study.
By W. Moon, S. Jung, Jeong Hyun Lee, D. Na, J. Baek, Young Hen Lee, Jinna Kim, H. Kim, J. Byun, Dong Hoon Lee. Radiology, 2008
1,096 citations recorded by the source corpus.
PURPOSE To retrospectively evaluate the diagnostic accuracy of ultrasonographic (US) criteria for the depiction of benign and malignant thyroid nodules by using tissue diagnosis as the reference standard. MATERIALS AND METHODS This study had institutional review board approval, and informed consent was waived. From January 2003 through June 2003, 8024 consecutive patients had undergone thyroid US at nine affiliated hospitals. A total of 831 patients (716 women, 115 men; mean age, 49.5 years +/- 13.8 [standard deviation]) with 849 nodules (360 malignant, 489 benign) that were diagnosed at surgery or biopsy were included in this study. Three radiologists retrospectively evaluated the following characteristics on US images: nodule size, presence of spongiform appearance, shape, margin, echotexture, echogenicity, and presence of microcalcification, macrocalcification, or rim calcification. A chi(2) test and multiple regression analysis were performed. Sensitivity, specificity, and positive and negative predictive values were obtained. RESULTS Statistically significant (P < .05) findings of malignancy were a taller-than-wide shape (sensitivity, 40.0%; specificity, 91.4%), a spiculated margin (sensitivity, 48.3%; specificity, 91.8%), marked hypoechogenicity (sensitivity, 41.4%; specificity, 92.2%), microcalcification (sensitivity, 44.2%; specificity, 90.8%), and macrocalcification (sensitivity, 9.7%; specificity, 96.1%). The US findings for benign nodules were isoechogenicity (sensitivity, 56.6%; specificity, 88.1%; P < .001) and a spongiform appearance (sensitivity, 10.4%; specificity, 99.7%; P < .001). The presence of at least one malignant US finding had a sensitivity of 83.3%, a specificity of 74.0%, and a diagnostic accuracy of 78.0%. For thyroid nodules with a diameter of 1 cm or less, the sensitivity of microcalcifications was lower than that in larger nodules (36.6% vs 51.4%, P < .05). CONCLUSION Shape, margin, echogenicity, and presence of calcification are helpful criteria for the discrimination of malignant from benign nodules; the diagnostic accuracy of US criteria is dependent on tumor size.
Subfields: Endocrinology, Diabetes and Metabolism, Surgery
View Paper: https://www.semanticscholar.org/paper/719e74bd69560b91131b101d281c626c17ff7d36
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In Endocrinology, Diabetes and Metabolism
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Citations in the corpus
- 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer (2009, positive): “Similarly, excellent clinical outcomes are seen in FTCs that manifest only capsular invasion without vascular invasion (494–496).”
- Applications of machine learning and deep learning to thyroid imaging: where do we stand? (2020, background): “They were initially introduced as qualitative grading systems for the simple classification of thyroid nodules that show any suspicious US features such as malignancy, the inclusion of microcalcifications, a taller-than-wide shape, spiculated margin, and marked hypoechogenicity [3,17,18].”
- Ultrasonography Diagnosis and Imaging-Based Management of Thyroid Nodules: Revised Korean Society of Thyroid Radiology Consensus Statement and Recommendations (2016, background): “An isoechoic spongiform nodule can be regarded as a benign nodule with a malignancy risk less than 1% (27-30).”