Thyroid nodule size calculated using ultrasound and gross pathology as predictors of cancer: A 23‐year retrospective study

Abstract

Background Thyroid nodules are very common. Ultrasound (US) and fine needle aspiration (FNA) are both integral in cancer screening. This study investigated the concordance between thyroid nodule sizes measured by US and gross pathologic examination and their relationship with malignancy. Methods A retrospective design was used to select consecutive patients with proven carcinoma of the thyroid. The number and maximum diameter of nodules, rates and types of malignancy, as well as predictors of malignancy were determined. Results The 10 944 patients examined had 15 283 thyroid nodules, 44.6% of which were malignant. Of the 4449 nodules sampled by FNA and the 8748 not sampled by FNA, 76.5% and 30.5% were malignant, respectively. The sensitivity, specificity, positive and negative predictive values (NPVs), and overall accuracy of FNA based on final pathology were 97.9%, 96.3%, 98.8%, 93.5%, and 97.5%, respectively. Nodule sizes determined by US were comparable with most nodules having either the same size range (n = 2959, 77.7%) or differing only by one size range (n = 770, 20.5%). Conclusions Thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates. Nodule size estimated by US shows relatively good correlation with final pathologic size. However, thyroid nodules should undergo FNA regardless of size. If the FNA is not benign, nodule size should influence therapeutic decision making.

RETRACTED: Ultrasound Parameters of Thyroid Nodules and the Risk of Malignancy: A Retrospective Analysis

“…The study reported that the risk of malignancy for thyroid nodule(s) was higher for those having 2 cm or lesser size in ultrasound. These results of the study were consistent with the results of retrospective studies 5,19 and prospective study 20 but were contraindicated with the results of retrospective studies. 8,9,[21][22][23] The papillary thyroid carcinoma has an inverse relationship with thyroid nodule size.…”

“…These results of the study were consistent with the results of retrospective studies. 5,12,19 The size difference by ultrasound finding is required to be in consideration to avoid unnecessary surgery. The study reported that the risk of malignancy for thyroid nodule(s) was higher for those having 2 cm or lesser size in ultrasound.…”

A Prospective Observational Study Assessing the Relationship Between Solitary Thyroid Nodule Size and Incidence of Malignancy

“…A large nodule size ≥30 mm showed a higher malignancy risk than smaller nodules in intermediateand low-suspicion nodules [27]. Zhao et al concluded that thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates [26]. Our findings support the results of other studies highlighting that there is still uncertainty in relation to the impact of the size of a solitary thyroid nodule and the risk of malignancy.…”

“…Zhao et al concluded that nodule size estimated by ultrasound (US) shows relatively good correlation with final pathologic size. However, thyroid nodules should undergo FNA regardless of size [26].…”

Tiroid nodül boyutunun sonografik ve patolojik uyumluluğunun değerlendirilmesi

“…10 Malignite ve nodül boyutu korelasyonu ile ilgili yapılmış çok sayıda çalışma olmasına rağmen, nodülün patolojik ve sonografik boyutu arasında korelasyonu değerlendiren çalışma sayısı azdır. 6,8,11 Bu çalışmada tiroid nodülü olan hastaların yönetiminde önemli bir parametre olan USG'de raporlanan nodül boyutu ile patolojik nodül boyutu arasındaki uyumluluk durumunu tiroidektomi yapılan hastalarda değerlendirmeyi amaçladık. USG ve İİA; tiroid nodülü olan hastaların değerlendirmesinde kullanılan temel değerlendirme yöntemleridir.…”