The Prediction of Malignancy Risk in Thyroid Nodules Classified as Bethesda System Category III (AUS/FLUS) and the Role of Ultrasound Finding for Prediction of Malignancy Risk

Alshahrani, Ali; Alamri, Abdulrahman S; Balkhoyor, Abdulrahman H; Mahzari, Moeber; Alshieban, Saeed; Majed, Pharaon M

doi:10.7759/cureus.17924

Cited by 8 publications

(8 citation statements)

References 16 publications

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“…This contradicts the findings of a retrospective study involving AUS/FULS nodules, which found a significant association between nodule site (right vs. left vs. bilateral) and the final pathology (p < 0.001). 24 Moreover, our findings found no correlation between nodule size and final pathology; this concurred with previous studies. 20 , 25 …”

Section: Discussionsupporting

confidence: 92%

The impact of thyroid imaging reporting and data system on the management of Bethesda III thyroid nodules

Alqahtani

Al-Sobhi²,

Alturiqy³

et al. 2023

Journal of Taibah University Medical Sciences

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Section: Discussionsupporting

confidence: 92%

The impact of thyroid imaging reporting and data system on the management of Bethesda III thyroid nodules

Alqahtani

Al-Sobhi²,

Alturiqy³

et al. 2023

Journal of Taibah University Medical Sciences

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“…The authors reported that in the presence of any one of these suspicious features, ultrasound had a pooled sensitivity and specificity of 0.75 and 0.48, respectively, and with any two or three suspicious features, the sensitivity and specificity increased to 0.77 and 0.71, respectively. Alshahrani et al (20) noted that nodules with multiple numbers, irregular margins, microcalcification, and hypoechogenicity were significantly more likely to be malignant based on an analysis of 187 patients. A similar finding was also confirmed by Cho et al (21), Erdogan-Durmus et al (2), and in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Alshahrani et al. ( 20 ) noted that nodules with multiple numbers, irregular margins, microcalcification, and hypoechogenicity were significantly more likely to be malignant based on an analysis of 187 patients. A similar finding was also confirmed by Cho et al.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Malignancy in Thyroid Nodules Classified as Bethesda Category III

Liu

Wang

et al. 2022

Front. Endocrinol.

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ObjectiveTo determine predictors of malignancy in surgically treated Bethesda category III nodules.MethodsPatients with surgically treated thyroid nodules classified as Bethesda category III were retrospectively enrolled. The association between clinical/sonographic features and postoperative pathology was evaluated using univariate and multivariate analyses.ResultsA total of 188 nodules from 184 patients were included. The overall malignancy rate was 54.3%. In univariate analysis, male sex, aspect ratio >1, microcalcification, unclear boundary, BRAFV600E mutation, and nuclear atypia were significantly associated with malignant disease in Bethesda category III nodules. Multivariate analysis confirmed that male sex, aspect ratio >1, microcalcification, and BRAFV600E mutation were independent predictors of malignant disease.ConclusionsMalignant disease was common in Bethesda category III nodules, and surgical treatment was strongly indicated in the presence of male sex, aspect ratio>1, microcalcification, and BRAFV600E mutation.

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“…Hence, the majority of thyroid nodules assigned to this category qualify for diagnostic surgery to determine the final diagnosis [ 3 , 4 , 10 ]. Overall, there is considerable variability between cytopathologists as well as the institutions that use this category [ 11 , 12 ]. Based on Mosca et al’s [ 6 ] opinion, we also confirmed that the value of this cytology diagnosis obtained through ultrasound-guided fine-needle aspiration biopsy (UG-FNAB) procedures is strongly dependent on the examiner’s experience and other technical details.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule Diagnosis

et al. 2022

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Thyroid-stimulating hormone (TSH) is a growth factor associated with the initiation and progression of well-differentiated thyroid cancer (WDTC). Atypia of undetermined significance and follicular lesion of undetermined significance (AUS/FLUS) are the most uncertain cytological diagnoses of thyroid nodules. The aim of the study was to determine the association of histopathological diagnosis with preoperative serum TSH levels in patients with AUS/FLUS thyroid nodule diagnosis. Among 5028 individuals with thyroid nodules, 342 (6.8%) with AUS/FLUS diagnoses were analyzed. The frequency of all histopathology diagnoses was assessed for associations with preoperative serum TSH levels. The median TSH concentration was significantly higher in patients with AUS/FLUS diagnosis and histopathology of WDTC than in patients with the same cytology result and histopathology of a benign tumor (p < 0.0001). The diagnostic potential of serum TSH level was determined to evaluate risk of malignancy in patients with thyroid nodules classified into the Bethesda III category. ROC analysis showed the TSH concentration at a cutoff point of 2.5 mIU/L to be an acceptable prognostic factor for WDTC. For this optimal cutoff point, the AUC was 0.877, the sensitivity was 0.830, and the specificity was 0.902. Preoperative serum TSH levels in patients with AUS/FLUS thyroid tumor diagnosis should be taken into consideration in the decision-making process and clinical management.

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The Prediction of Malignancy Risk in Thyroid Nodules Classified as Bethesda System Category III (AUS/FLUS) and the Role of Ultrasound Finding for Prediction of Malignancy Risk

Abstract: To predict the risk of malignancy in category III of the Bethesda System for Reporting Thyroid

Cited by 8 publications

References 16 publications

The impact of thyroid imaging reporting and data system on the management of Bethesda III thyroid nodules

The impact of thyroid imaging reporting and data system on the management of Bethesda III thyroid nodules

Predictors of Malignancy in Thyroid Nodules Classified as Bethesda Category III

Assessment of Preoperative TSH Serum Level and Thyroid Cancer Occurrence in Patients with AUS/FLUS Thyroid Nodule Diagnosis

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