The comparison of accuracy of ultrasonographic features versus ultrasound-guided fine-needle aspiration cytology in diagnosis of malignant thyroid nodules

Nabahati, Mehrdad; Moazezi, Zoleika; Fartookzadeh, Soude; Mehraeen, Rahele; Ghaemian, Naser; Sharbatdaran, Majid

doi:10.1007/s40477-019-00377-2

Cited by 22 publications

(18 citation statements)

References 39 publications

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“…27 In the present study, hypoechogenicity as one of sonographic characteristics was the most worth measure to predict malignancy (91.5%), with 0.96% sensitivity, 87% specificity and 92% accuracy. Other studies by Nabahati et al, 14 and Alam et al, 28 have reported that hypoechogenicity was most anticipated scale for malignancy, these rates were observed, (53% sensitivity, 77% specificity), (42% sensitivity and 75% specificity), respectively, which were in contrast to our data. Furthermore, in conflict with our results, in another study by Sankhla et al, 2001, found 33% of hypoechoic malignant nodules and 11% of hyperechoic malignant nodules.…”

Section: Discussioncontrasting

confidence: 99%

“…According to our results, calcification was related to low specificity (0.71%), but high sensitivity (0.96%), which was in contrast with the previously published data like, Alam et al, 2014, Kim et al, 2002, Papini et al, 2002 and Nabahati et al, 2019. 14,28,30,31 Of course, some studies are in agreement with our results, which showed a higher rate of sensitivity such as Xu et al,2017, 32 moreover, microcalcification was associated with malignancy (97.0%) and benign (3.0%), but there were conflicting data about absent, eggshell, coarse, and macrocalcification such as studies published from Petrone et al, 2012, Kim et al, 2013, and Park et al, 2014. 33-35 A study by Koike et al, 2001, 36 indicated that calcification had a sensitivity of 88.7% and Ram et al, 2015 showed a high sensitivity (80%) and a relatively lower specificity (68%) for calcification, 19 results of these two studies are relatively close to our findings for calcification (both micro as well as macro).…”

Section: Discussionmentioning

confidence: 99%

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Comparison between ultrasonographic findings and fine needle aspiration cytology in differentiating malignant and benign thyroid nodules

2019

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The purpose of research was comparing the ultrasound (US) features and fine-needle aspiration cytology (FNAC) in detecting the thyroid nodules in clinical practice. A cross-sectional analytical study retrospectively reviewed the US and FNAC findings for a total of 170 thyroid nodules. The US features that we compared included echogenicity, calcifications, shape, halo and Doppler, between 2017 and 2018. Totally, 170 nodules of thyroid were studied, which contained 72 (42.4%) benign and 98 (57.6%) malignant thyroid nodules. The sonographic features were significantly associated with malignancy such as microcalcification (97.0%), hyperechogenicity (91.5%), wider than taller shape (98.0%), absent halo (90.9%) and positive Doppler (78.0%) (P < 0.01). The altogether accuracies of calcification, echogenicity, shape, halo, and Doppler were 0.96, 0.92, 0.97,0.82 and 0.82, respectively. Our data suggest that US features could be a good sonographic criterion for recommending FNA cytology with follow‐up thyroid sonography and FNA.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison between ultrasonographic findings and fine needle aspiration cytology in differentiating malignant and benign thyroid nodules

2019

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“…According to our experience, like some other studies [19,20], the size of the nodules is not a good indicator of the risk of malignancy of thyroid nodules. However, some researches claim that there is a strong association between these two factors as the larger size of the nodules correlates with a higher malignancy rate with a threshold of 2.0 cm [21,22].…”

Section: Discussionsupporting

confidence: 44%

Correlation of the Thyroid Nodules' Sonographic Features With Fine Needle Aspiration (FNA) Cytology Results

Arefzadeh

Avanaki

Abrishami

2020

Preprint

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Background: Thyroid nodules are a common finding in clinical practice. Although ultrasonography is an accepted method for evaluating and following these nodules, Fine Needle Aspiration (FNA) is the procedure of choice for assessing the risk of malignancy. This study aims to determine the correlation between sonographic features of thyroid nodules based on Thyroid Imaging Reporting and Data System (TIRADS) classification and the cytology results obtained by FNA of thyroid nodules.Methods: In this prospective cohort study, 147 patients with thyroid nodules underwent FNA under the guide of ultrasonography based on TIRADS classification, and their sonographic features were recorded. The pathologic findings were also obtained according to the Bethesda system. Finally, the association between sonographic features and cytology results were analyzed.Results: 147 patients with a mean ± SD age of 49.8 ± 13.7 years were assessed. 16 (10.9%) nodules were malignant, and 131 nodules (89.1%) were benign. The association of TIRADS categories with the risk of malignancy is as follows: TIRADS 1 (0%), TIRADS 2 (16.9%), TIRADS 3 (10.5%), TIRADS 4 (16.7%), and TIRADS 5 (0%). The location of thyroid nodules and their bloody lamellae were significantly correlated with the risk of malignancy (P value< 0.05). However, the association between the risk of and gender, calcification, hardness, halo sign and nodules’ echogenicity were not statistically significant. Conclusions: Although there are trusted classifications for categorizing the thyroid nodules, there is still uncertainty in utilizing them as an accepted method of choice for managing the thyroid nodules, as various sonographic features are shared between benign and malignant ones.

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“…Although there is a potential bias in our cohort due to its restriction to surgically managed nodules, it is challenging to better define outcome; of note, some related studies have evaluated clinical and sonographic variables against cytologic (rather than histologic) outcome, but this approach is suboptimal and prohibits the use of cytology as an input variable 16,24,25 . Alternately, while long‐term clinical follow‐up and/or “benign” FNA molecular testing might be utilized as outcome surrogates for non‐surgically managed nodules, they each have significant limitations, notably, the variable accuracy of the different available molecular tests and the slow progression of most thyroid cancers.…”

Section: Discussionmentioning

confidence: 99%

The gray zone of thyroid nodules: Using a nomogram to provide malignancy risk assessment and guide patient management

2021

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Background Thyroid nodules have a low prevalence of malignancy and most proven cancers do not behave aggressively. Thus, risk‐stratification of nodules is a critical step to avoid surgical overtreatment. We hypothesized that a risk management system superior to those currently in use could be created to reduce the number of clinically indeterminate nodules (i.e., the “gray zone”) by concurrently considering the malignancy risks conferred by clinical, ultrasonographic, and cytologic variables. Methods Thyroidectomy cases were reviewed from three institutions. Their benign versus malignant outcome was used to evaluate the variables for correlation. A binary logistic regression model was trained and, using indeterminate nodules with Bethesda III and IV results, validated. A scoring nomogram was designed to demonstrate the application of the model in clinical practice. Results One hundred thirty thyroidectomies (28% malignant) met inclusion criteria. The final logistic regression model included difficulty in swallowing, hypothyroidism, echogenicity, hypervascularity, margins, calcification, and cytology diagnosis as input parameters. The model was highly successful in determining the outcome (p value: 0.001) with a R2(Nagelkerke) score of 0.93. The area under the curve as determined by receiver operating characteristics was 0.91. The accuracy of the model on the training dataset was 93% (sensitivity and specificity 92% and 96%, respectively) and, on the validation dataset, 80% (sensitivity and specificity 91% and 67%, respectively). Conclusions We report a model for risk assessment of thyroid nodules that has the potential to significantly reduce indeterminates and surgical overtreatment. We illustrate its application via a straightforward nomogram, which integrates clinical, ultrasonographic, and cytologic data, and can be used to create clear, evidence‐based management plans for patients.

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The comparison of accuracy of ultrasonographic features versus ultrasound-guided fine-needle aspiration cytology in diagnosis of malignant thyroid nodules

Cited by 22 publications

References 39 publications

Comparison between ultrasonographic findings and fine needle aspiration cytology in differentiating malignant and benign thyroid nodules

Comparison between ultrasonographic findings and fine needle aspiration cytology in differentiating malignant and benign thyroid nodules

Correlation of the Thyroid Nodules' Sonographic Features With Fine Needle Aspiration (FNA) Cytology Results

The gray zone of thyroid nodules: Using a nomogram to provide malignancy risk assessment and guide patient management

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