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Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study.

Authors
 Won-Jin Moon  ;  So Lyung Jung  ;  Jeong Hyun Lee  ;  Dong Gyu Na  ;  Jung-Hwan Baek  ;  Young Hen Lee  ;  Jinna Kim  ;  Hyun Sook Kim  ;  Jun Soo Byun  ;  Dong Hoon Lee 
Citation
 RADIOLOGY, Vol.247(3) : 762-770, 2008 
Journal Title
 RADIOLOGY 
ISSN
 0033-8419 
Issue Date
2008
MeSH
Chi-Square Distribution ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Regression Analysis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Nodule/diagnostic imaging* ; Ultrasonography
Keywords
Chi-Square Distribution ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Regression Analysis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Nodule/diagnostic imaging* ; Ultrasonography
Abstract
PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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.
Full Text
http://pubs.rsna.org/doi/abs/10.1148/radiol.2473070944
DOI
10.1148/radiol.2473070944
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jinna(김진아) ORCID logo https://orcid.org/0000-0002-9978-4356
Kim, Hyun Sook(김현숙)
Byun, Joon Soo(변준수)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107053
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