Association of patient characteristics, ultrasound features, and molecular testing with malignancy risk in Bethesda <scp>III–V</scp> thyroid nodules

Talmor, Guy; Badash, Ido; Zhou, Sheng; Kim, Yun Ji; Kokot, Niels; Hsueh, Wayne D.; Chambers, Tamara

doi:10.1002/lio2.847

Cited by 1 publication

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“…In the present study, the median age was 48 years and no significant differences between the cancer and cancer-free group were observed, with a greater proportion of females (82%) compared to males, which is comparable to other published studies ( 44 , 50 ). According to our results, age cannot be used as a reliable factor in predicting malignancy, findings which differ from several others in specialized literature, where younger age was identified as an independent risk factor for thyroid cancer in indeterminate nodules and an inverse correlation between patient age and malignancy risk for nodules undergoing FNA was reported ( 51 – 53 ). However, we did find that female gender is a significant risk factor for malignancy, which is in line with other studies ( 53 , 54 ).…”

Section: Discussioncontrasting

confidence: 99%

Impact of ultrasound elastography in evaluating Bethesda category IV thyroid nodules with histopathological correlation

Latia,

Borlea,

Mihuta

et al. 2024

Front. Endocrinol.

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IntroductionFine needle aspiration (FNA) is the gold standard method recommended in the diagnosis of thyroid nodules. Bethesda IV cytology results are identified in 7-9% of nodules investigated through FNA, with reported malignancy rate in a wide range of 10-40%. The recommended treatment is either surgical or risk additional molecular testing before surgery. However, a large number of nodules belonging to this category (60-80%) are observed to be benign after surgical excision, which can put the patient at risk of unnecessary surgical morbidity. This study aimed to assess the diagnostic performance of conventional ultrasound, the ACR TI-RADS score and elastography in cases of Bethesda IV cytology on FNA.MethodsWe evaluated ninety-seven consecutive cases with Bethesda category IV results on FNA by using conventional B-mode ultrasound, qualitative strain or shear-wave elastography (Hitachi Preirus Machine, Hitachi Inc., Japan and Aixplorer Mach 30 Supersonic Imagine, Aix-en-Provence, France) and all nodules were classified according to the ACR TI-RADS system. Conventional ultrasound was used to categorize the nodules as potentially malignant based on the following features: hypoechogenicity, inhomogeneity, a taller than wide shape, irregular margins, presence of microcalcifications, an interrupted thyroid capsule and suspicious cervical lymph nodes. Elastography classified nodules with increased stiffness as suspicious for malignancy.ResultsWe considered pathology results as the gold standard diagnosis, finding that 32 out of 97 nodules were carcinomas (33%) and 65 out of 97 were benign nodules (67%). The benign group included twenty cases of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Finally, we compared ultrasound data with pathology results, which showed that nineteen out of the 32 malignant nodules presented with increased stiffness on elastography (p=0.0002). On conventional ultrasound, we found that microcalcifications (p=0.007), hypoechogenicity and irregular margins (p=0.006) are features which can distinguish between benign and malignant nodules with statistical significance.DiscussionIntegrating elastography as a parameter of the ACR TI-RADS score in the evaluation of Bethesda category IV nodules showed a sensitivity of 90.62% in detecting thyroid cancer cases (p=0.006). We can conclude that elastographic stiffness as an addition to high risk features observed on conventional ultrasound improves the detection of malignant nodules in cases with Bethesda IV cytology.

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Section: Discussioncontrasting

confidence: 99%

Impact of ultrasound elastography in evaluating Bethesda category IV thyroid nodules with histopathological correlation

Latia,

Borlea,

Mihuta

et al. 2024

Front. Endocrinol.

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Association of patient characteristics, ultrasound features, and molecular testing with malignancy risk in Bethesda III–V thyroid nodules

Abstract: Objective: To evaluate the role of patient characteristics, ultrasound findings, and molecular testing in predicting risk of malignancy in Bethesda III, IV, and V thyroid nodules.

Cited by 1 publication

References 35 publications

Impact of ultrasound elastography in evaluating Bethesda category IV thyroid nodules with histopathological correlation

Impact of ultrasound elastography in evaluating Bethesda category IV thyroid nodules with histopathological correlation

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