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Positive predictive values of sonographic features of solid thyroid nodule

Authors
 Yoo Jin Hong  ;  Eun Ju Son  ;  Eun-Kyung Kim  ;  Jin Young Kwak  ;  Soon Won Hong  ;  Hang-Seok Chang 
Citation
 CLINICAL IMAGING, Vol.34(2) : 127-133, 2010 
Journal Title
 CLINICAL IMAGING 
ISSN
 0899-7071 
Issue Date
2010
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Observer Variation ; Reproducibility of Results ; Sensitivity and Specificity ; Thyroid Nodule/diagnostic imaging* ; Ultrasonography/methods* ; Young Adult
Keywords
Solid thyroid nodule ; Malignancy ; Ultrasonography
Abstract
AIM: The purpose of this study was to assess the positive predictive value of the suspicious sonographic features of solid nodules of the thyroid. MATERIALS AND METHODS: After approval by our institutional review board, we evaluated 594 sonographically detected nodules on which fine needle aspiration biopsy had been performed from January to December 2005. Among these, pure cystic lesions and inadequate pathologic results were excluded. The remaining 530 solid thyroid nodules were analyzed by two radiologists. Each lesion was classified based on four sonographic features that suggested malignancy: microcalcifications; an irregular or microlobulated margin; marked hypoechogenicity; and a shape that was taller than wide. The sensitivity, specificity, positive predictive value, and negative predictive value of the each sonographic feature were calculated. RESULTS: Final pathologic results showed that 97 (18.3%) of 530 nodules were malignant. The positive predictive values for malignancy in each sonographic feature were microcalcifications, 38.6% (39/101); an irregular or microlobulated margin, 28.2% (70/248); marked hypoechogenecity, 49.4% (38/77); taller than wide shape, 59.8% (49/82). In terms of relative risk, microcalcification [P<.01, relative risk (RR)=3.115, 95% CI: 1.724-5.628], hypoechogenecity (P<.01, RR=2.510, 95% CI: 1.290-4.881). The shape of nodule which was taller than wide (P<.01, RR=7.624, 95% CI: 4.156-13.986) revealed the highest predictive sonographic finding suggesting malignancy. However, margin is the least significant feature of detection of thyroid malignancy (P=.27, RR=1.395, 95% CI: 0.777-2.505). CONCLUSION: The three sonographic features of solid thyroid nodule, that is, microcalcifications, marked hypoechogenecity, and a taller than wide shape are meaningful findings in the diagnosis of thyroid malignancy. The shape that was taller than wide was the most reliable sonographic feature for predicting malignancy.
Full Text
http://www.sciencedirect.com/science/article/pii/S0899707109001259
DOI
10.1016/j.clinimag.2008.10.034
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Chang, Hang Seok(장항석) ORCID logo https://orcid.org/0000-0002-5162-103X
Hong, Soon Won(홍순원) ORCID logo https://orcid.org/0000-0002-0324-2414
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/102708
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