Comparison of different systems of ultrasound (US) risk stratification for malignancy in elderly patients with thyroid nodules. Real world experience

Abstract

Comparison of different systems of (US) risk stratification for malignancy in elderly patients with thyroid nodules. Real world experience.

Sonographic Risk Stratification Systems for Thyroid Nodules as Rule-Out Tests in Older Adults

“…These points should be taken into consideration when current guidelines are updated or in the development of new systems. These results were consistent with data reported by Di Fermo et al [ 15 ], which supported the validity of sonographic stratification systems in elderly patients, even if the specificity of suspicious features, in this setting, was lower than expected. Conversely, in our cohort, there was no significant difference in diagnostic performance between the ATA and AACE/ACE/AME systems.…”

“…Most recently, the ACR TIRADS and the sonographic risk-stratification systems proposed by the American Thyroid Association (ATA) [ 2 ] and the American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi (AACE/ACE/AME) guidelines [ 1 ] have been validated in a geriatric population [ 15 ]. In that study, it is suggested that age might be a confounder since some suspicious US features of thyroid nodules lack specificity in elderly patients [ 15 ].…”

Thyroid Nodule Evaluation and Management in Older Adults: A Review of Practical Considerations for Clinical Endocrinologists

“…44 Another cross-sectional study of 1,867 patients with thyroid nodules referred to an academic center for an FNA biopsy (median age, 71 years) comparatively assessed the performance of the ACR-TIRADS, ATA and AACE/ACE/AME classification systems in an older adult population. 43 Overall, the majority of patients had benign cytology (83%) and only 3% had cytology consistent with malignancy. 43 Of 50 malignant nodules, 31 (62%) underwent surgical resection.…”

“…43 Overall, the majority of patients had benign cytology (83%) and only 3% had cytology consistent with malignancy. 43 Of 50 malignant nodules, 31 (62%) underwent surgical resection. The reasons for deferred surgery were not reported.…”

“…16,42 J o u r n a l P r e -p r o o f A few studies have evaluated the validity of using the aforementioned ultrasoundbased risk stratification systems specifically in older patients. 43,44 .6% vs 10.8% microcalcifications; p=0.005). 44 Use of ACR-TIRADS as a rule-out test resulted in the highest avoidance of biopsies in both age groups and had the highest specificity.…”