Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China

  • Cheng, Pu (Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University) ;
  • Chen, En-Dong (Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University) ;
  • Zheng, Hua-Min (Department of Diagnostic Ultrasound, The First Affiliated Hospital of Wenzhou Medical University) ;
  • He, Qiu-Xiang (Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University) ;
  • Li, Quan (Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University)
  • Published : 2013.08.30
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Abstract

Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ${\geq}1$ were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ${\leq}2$ favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

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References

  1. Cavaliere A, Colella R, Puxeddu E, et al (2009). A useful ultrasound score to select thyroid nodules requiring fine needle aspiration in an iodine-deficient area. J Endocrinol Invest, 32, 440-4. https://doi.org/10.1007/BF03346483
  2. Cooper DS, Doherty GM, Haugen BR, et al (2009). Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 19, 1167-214. https://doi.org/10.1089/thy.2009.0110
  3. Giordano D, Gradoni P, Oretti G, Molina E, Ferri T (2010). Treatment and prognostic factors of papillary thyroid microcarcinoma. Clin Otolaryngol, 35, 118-24. https://doi.org/10.1111/j.1749-4486.2010.02085.x
  4. Grani G, Calvanese A, Carbotta G, et al (2013). Intrinsic factors affecting adequacy of thyroid nodule fine-needle aspiration cytology. Clin Endocrinol (Oxf), 78, 141-4. https://doi.org/10.1111/j.1365-2265.2012.04507.x
  5. Hegedus L (2004). Clinical practice. The thyroid nodule. N Engl J Med, 351, 1764-71. https://doi.org/10.1056/NEJMcp031436
  6. Iannuccilli JD, Cronan JJ, Monchik JM (2004). Risk for malignancy of thyroid nodules as assessed by sonographic criteria: the need for biopsy. J Ultrasound Med, 23, 1455-64.
  7. Kang HW, No JH, Chung JH, et al (2004). Prevalence, clinical and ultrasonographic characteristics of thyroid incidentalomas. Thyroid, 14, 29-33. https://doi.org/10.1089/105072504322783812
  8. Kim GR, Kim MH, Moon HJ, et al (2013b). Sonographic characteristics suggesting papillary thyroid carcinoma according to nodule size. Ann Surg Oncol, 20, 906-13. https://doi.org/10.1245/s10434-012-2830-4
  9. Kim JY, Kim SY, Yang KR (2013a). Ultrasonographic criteria for fine needle aspiration of nonpalpable thyroid nodules 1-2 cm in diameter. Eur J Radiol, 82, 321-6. https://doi.org/10.1016/j.ejrad.2012.10.017
  10. Kim JY, Lee CH, Kim SY, et al (2008). Radiologic and pathologic findings of nonpalpable thyroid carcinomas detected by ultrasonography in a medical screening center. J Ultrasound Med, 27, 215-23.
  11. Kim KM, Park JB, Kang SJ, Bae KS (2013c). Ultrasonographic guideline for thyroid nodules cytology: single institute experience. J Korean Surg Soc, 84, 73-9. https://doi.org/10.4174/jkss.2013.84.2.73
  12. Lee MJ, Hong SW, Chung WY, et al (2011). Cytological results of ultrasound-guided fine-needle aspiration cytology for thyroid nodules: emphasis on correlation with sonographic findings. Yonsei Med J, 52, 838-44. https://doi.org/10.3349/ymj.2011.52.5.838
  13. Lingam RK, Qarib MH, Tolley NS (2013). Evaluating thyroid nodules: predicting and selecting malignant nodules for fine-needle aspiration (FNA) cytology. Insights Imaging, 4, 617-24. https://doi.org/10.1007/s13244-013-0256-6
  14. Moon HJ, Son E, Kim EK, Yoon JH, Kwak JY (2012). The diagnostic values of ultrasound and ultrasound-guided fine needle aspiration in subcentimeter-sized thyroid nodules. Ann Surg Oncol, 19, 52-9. https://doi.org/10.1245/s10434-011-1813-1
  15. Nixon IJ, Ganly I, Hann LE, et al (2013). Nomogram for selecting thyroid nodules for ultrasound-guided fine-needle aspiration biopsy based on a quantification of risk of malignancy. Head Neck, 35, 1022-5. https://doi.org/10.1002/hed.23075
  16. Petrone L, Mannucci E, De Feo ML, et al (2012). A simple ultrasound score for the identification of candidates to fine needle aspiration of thyroid nodules. J Endocrinol Invest, 35, 720-4.
  17. Vinayak S, Sande JA (2012). Avoiding unnecessary fine-needle aspiration cytology by accurately predicting the benign nature of thyroid nodules using ultrasound. J Clin Imaging Sci, 2, 23. https://doi.org/10.4103/2156-7514.95446
  18. Wang Y, Li L, Wang YX, et al (2012). Ultrasound findings of papillary thyroid microcarcinoma: a review of 113 consecutive cases with histopathologic correlation. Ultrasound Med Boils, 38, 1681-8. https://doi.org/10.1016/j.ultrasmedbio.2012.05.019
  19. Xiang J, Wu Y, Li DS, et al (2010). New clinical features of thyroid cancer in eastern China. J Visc Surg, 147, e53-6. https://doi.org/10.1016/j.jviscsurg.2010.08.008
  20. Yang Y, Li Q, Guo L, et al (2011). A retrospective analysis of thyroid cancer in China. Asian Pac J Cancer Prev, 12, 2245-9.

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