Sonographic criteria predictive of benign thyroid nodules useful in avoiding unnecessary ultrasound-guided fine needle aspiration

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6 Citations (Scopus)

Abstract

There has been no individual ultrasound feature of having high accuracy for diagnosis of thyroid malignancy. In this study, we aimed to establish feature-oriented criteria to characterize benign thyroid nodules that do not require ultrasound (US)-guided fine needle aspiration (FNA). Methods: We reviewed 374 patients with thyroid nodules who had undergone US-guided FNA at our institution (2005-2008). Thyroid nodules were classified into two groups: Category 1 (benign nodules that required follow-up 6-12 months later but not US-guided FNA); and Category 2 (indeterminate nodules or suspected carcinoma that required US-guided FNA). To test the validity, we reviewed 315 consecutive patients who had histologically proven thyroid carcinoma (n=39) and randomly selected 40 of the 276 patients with benign nodules (2009-2010). Results: Of 374 nodules, 354 (95%) were benign and 20 (5%) malignant. On US, 260 nodules had no calcification, no increase in vascularity, well-defined margin, and no lymphadenopathy (Category 1). Using a combination of these four features, we were able to discriminate benign from indeterminate nodules or suspected malignant nodules with a sensitivity of 73%, and specificity and positive predictive value of 100%. Validity testing revealed that none of the 39 malignant thyroid nodules had all four US features. All Category 1 nodules (2005-2008) remained benign at the 3-years follow up. Conclusion: The combination of four US features of Category 1 nodules is highly predictive of benign disease, and we could avoid unnecessary US-guided FNA in 69.5% of our patients using this combined features.

Original languageEnglish
Pages (from-to)590-597
Number of pages8
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Volume114
Issue number7
DOIs
Publication statusPublished - Jul 1 2015

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Thyroid Nodule
Fine Needle Biopsy
Thyroid Neoplasms
Thyroid Gland
Carcinoma
Sensitivity and Specificity
Neoplasms

Keywords

  • Aspiration
  • Biopsy
  • Nodule
  • Thyroid gland
  • Ultrasound

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Sonographic criteria predictive of benign thyroid nodules useful in avoiding unnecessary ultrasound-guided fine needle aspiration",
abstract = "There has been no individual ultrasound feature of having high accuracy for diagnosis of thyroid malignancy. In this study, we aimed to establish feature-oriented criteria to characterize benign thyroid nodules that do not require ultrasound (US)-guided fine needle aspiration (FNA). Methods: We reviewed 374 patients with thyroid nodules who had undergone US-guided FNA at our institution (2005-2008). Thyroid nodules were classified into two groups: Category 1 (benign nodules that required follow-up 6-12 months later but not US-guided FNA); and Category 2 (indeterminate nodules or suspected carcinoma that required US-guided FNA). To test the validity, we reviewed 315 consecutive patients who had histologically proven thyroid carcinoma (n=39) and randomly selected 40 of the 276 patients with benign nodules (2009-2010). Results: Of 374 nodules, 354 (95{\%}) were benign and 20 (5{\%}) malignant. On US, 260 nodules had no calcification, no increase in vascularity, well-defined margin, and no lymphadenopathy (Category 1). Using a combination of these four features, we were able to discriminate benign from indeterminate nodules or suspected malignant nodules with a sensitivity of 73{\%}, and specificity and positive predictive value of 100{\%}. Validity testing revealed that none of the 39 malignant thyroid nodules had all four US features. All Category 1 nodules (2005-2008) remained benign at the 3-years follow up. Conclusion: The combination of four US features of Category 1 nodules is highly predictive of benign disease, and we could avoid unnecessary US-guided FNA in 69.5{\%} of our patients using this combined features.",
keywords = "Aspiration, Biopsy, Nodule, Thyroid gland, Ultrasound",
author = "Tay, {Shee Yen} and Chen, {Chia Yuen} and Chan, {Wing P.}",
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language = "English",
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AU - Tay, Shee Yen

AU - Chen, Chia Yuen

AU - Chan, Wing P.

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N2 - There has been no individual ultrasound feature of having high accuracy for diagnosis of thyroid malignancy. In this study, we aimed to establish feature-oriented criteria to characterize benign thyroid nodules that do not require ultrasound (US)-guided fine needle aspiration (FNA). Methods: We reviewed 374 patients with thyroid nodules who had undergone US-guided FNA at our institution (2005-2008). Thyroid nodules were classified into two groups: Category 1 (benign nodules that required follow-up 6-12 months later but not US-guided FNA); and Category 2 (indeterminate nodules or suspected carcinoma that required US-guided FNA). To test the validity, we reviewed 315 consecutive patients who had histologically proven thyroid carcinoma (n=39) and randomly selected 40 of the 276 patients with benign nodules (2009-2010). Results: Of 374 nodules, 354 (95%) were benign and 20 (5%) malignant. On US, 260 nodules had no calcification, no increase in vascularity, well-defined margin, and no lymphadenopathy (Category 1). Using a combination of these four features, we were able to discriminate benign from indeterminate nodules or suspected malignant nodules with a sensitivity of 73%, and specificity and positive predictive value of 100%. Validity testing revealed that none of the 39 malignant thyroid nodules had all four US features. All Category 1 nodules (2005-2008) remained benign at the 3-years follow up. Conclusion: The combination of four US features of Category 1 nodules is highly predictive of benign disease, and we could avoid unnecessary US-guided FNA in 69.5% of our patients using this combined features.

AB - There has been no individual ultrasound feature of having high accuracy for diagnosis of thyroid malignancy. In this study, we aimed to establish feature-oriented criteria to characterize benign thyroid nodules that do not require ultrasound (US)-guided fine needle aspiration (FNA). Methods: We reviewed 374 patients with thyroid nodules who had undergone US-guided FNA at our institution (2005-2008). Thyroid nodules were classified into two groups: Category 1 (benign nodules that required follow-up 6-12 months later but not US-guided FNA); and Category 2 (indeterminate nodules or suspected carcinoma that required US-guided FNA). To test the validity, we reviewed 315 consecutive patients who had histologically proven thyroid carcinoma (n=39) and randomly selected 40 of the 276 patients with benign nodules (2009-2010). Results: Of 374 nodules, 354 (95%) were benign and 20 (5%) malignant. On US, 260 nodules had no calcification, no increase in vascularity, well-defined margin, and no lymphadenopathy (Category 1). Using a combination of these four features, we were able to discriminate benign from indeterminate nodules or suspected malignant nodules with a sensitivity of 73%, and specificity and positive predictive value of 100%. Validity testing revealed that none of the 39 malignant thyroid nodules had all four US features. All Category 1 nodules (2005-2008) remained benign at the 3-years follow up. Conclusion: The combination of four US features of Category 1 nodules is highly predictive of benign disease, and we could avoid unnecessary US-guided FNA in 69.5% of our patients using this combined features.

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