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Benign and Malignant Thyroid Nodules : US Differentiation-Multicenter Retrospective Study

Radiology, 2008-06, Vol.247 (3), p.762-770 [Peer Reviewed Journal]

2008 INIST-CNRS ;(c) RSNA, 2008. ;ISSN: 0033-8419 ;EISSN: 1527-1315 ;DOI: 10.1148/radiol.2473070944 ;PMID: 18403624 ;CODEN: RADLAX

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  • Title:
    Benign and Malignant Thyroid Nodules : US Differentiation-Multicenter Retrospective Study
  • Author: MOON, Won-Jin ; SO LYUNG JUNG ; JEONG HYUN LEE ; DONG GYU NA ; BAEK, Jung-Hwan ; YOUNG HEN LEE ; KIM, Jinna ; HYUN SOOK KIM ; JUN SOO BYUN ; DONG HOON LEE
  • Subjects: Biological and medical sciences ; Chi-Square Distribution ; Diagnosis, Differential ; Endocrinopathies ; Female ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Predictive Value of Tests ; Regression Analysis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Nodule - diagnostic imaging ; Thyroid. Thyroid axis (diseases) ; Ultrasonography
  • Is Part Of: Radiology, 2008-06, Vol.247 (3), p.762-770
  • Description: To retrospectively evaluate the diagnostic accuracy of ultrasonographic (US) criteria for the depiction of benign and malignant thyroid nodules by using tissue diagnosis as the reference standard. This study had institutional review board approval, and informed consent was waived. From January 2003 through June 2003, 8024 consecutive patients had undergone thyroid US at nine affiliated hospitals. A total of 831 patients (716 women, 115 men; mean age, 49.5 years +/- 13.8 [standard deviation]) with 849 nodules (360 malignant, 489 benign) that were diagnosed at surgery or biopsy were included in this study. Three radiologists retrospectively evaluated the following characteristics on US images: nodule size, presence of spongiform appearance, shape, margin, echotexture, echogenicity, and presence of microcalcification, macrocalcification, or rim calcification. A chi(2) test and multiple regression analysis were performed. Sensitivity, specificity, and positive and negative predictive values were obtained. Statistically significant (P < .05) findings of malignancy were a taller-than-wide shape (sensitivity, 40.0%; specificity, 91.4%), a spiculated margin (sensitivity, 48.3%; specificity, 91.8%), marked hypoechogenicity (sensitivity, 41.4%; specificity, 92.2%), microcalcification (sensitivity, 44.2%; specificity, 90.8%), and macrocalcification (sensitivity, 9.7%; specificity, 96.1%). The US findings for benign nodules were isoechogenicity (sensitivity, 56.6%; specificity, 88.1%; P < .001) and a spongiform appearance (sensitivity, 10.4%; specificity, 99.7%; P < .001). The presence of at least one malignant US finding had a sensitivity of 83.3%, a specificity of 74.0%, and a diagnostic accuracy of 78.0%. For thyroid nodules with a diameter of 1 cm or less, the sensitivity of microcalcifications was lower than that in larger nodules (36.6% vs 51.4%, P < .05). Shape, margin, echogenicity, and presence of calcification are helpful criteria for the discrimination of malignant from benign nodules; the diagnostic accuracy of US criteria is dependent on tumor size.
  • Publisher: Oak Brook, IL: Radiological Society of North America
  • Language: English
  • Identifier: ISSN: 0033-8419
    EISSN: 1527-1315
    DOI: 10.1148/radiol.2473070944
    PMID: 18403624
    CODEN: RADLAX
  • Source: MEDLINE
    Alma/SFX Local Collection
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