Distinct Diagnostic Criteria for Ultrasonographic Examination of Papillary Thyroid Carcinoma: A Multicenter Study

Abstract

Recent advances permitting high-resolution ultrasonography have made ultrasonographic examination of nodular thyroid diseases an accessible examination for routine practice. However, diagnostic criteria for ultrasonographic examination of thyroid nodules are not surely established. To identify the optimal strategy for well standardized differential diagnosis of papillary thyroid carcinoma and benign nodules, we evaluated the significance of individual ultrasonographic characteristics of thyroid nodules in a multicenter study. Ten characteristics in ultrasonograms from 53 patients scored by 17 investigators from 15 centers were analyzed by t tests and logistic regression analyses. Between benign and papillary thyroid cancer groups, all characteristics but not size or multiplicity of strong echoes, which suggest calcifications, were significant parameters. Logistic regression analyses showed that border character, shape, and internal echo level are highly significant parameters (p < 0.0005). A multiple logistic regression showed to be the most important predictors of pathologic diagnosis. The diagnostic criterion with border character and internal echo level yielded 93% sensitivity and 92% specificity. In conclusion, univariate and multivariate analyses identified border character, shape, internal echo level, but not strong echoes (calcifications), as important characteristics in differentiating papillary thyroid carcinoma from benign nodules. These results will contribute to standardization of accurate ultrasonographic diagnosis of papillary thyroid carcinoma.

DIAGNOSIS IN ENDOCRINOLOGY: Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis

“…Of these, 235 studies were retrieved for further investigation, and 41 studies (14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54) met the final selection criteria and were included in the analysis. All 41 studies were observational studies published in peer-reviewed journals between 1989 and 2012.…”

Latin American Thyroid Society recommendations for the management of thyroid nodules

“…The best compromise between the risk of missing carcinomas of potential clinical aggressiveness and the need to avoid unnecessary procedures is probably to use FNAB on nodules with at least one of the following components: microcalcifications, blurred margins, or hypoechoic pattern (19,20). Color and power Doppler sonography have been widely evaluated as diagnostic tools for detecting thyroid cancer.…”

Ultrasound-Based Diagnostic Classification for Solid and Partially Cystic Thyroid Nodules

“…[1][2][3][4][5][6][7][8][9][10] Currently, US-FNA is the accepted method for the diagnostic evaluation of thyroid nodules. [11][12][13][14][15] This approach, however, is limited by its invasiveness, cost, the possibility of inadequate sampling and/or indeterminate cytology, and operator dependency.…”