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New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid

 Eun Kyung Kim  ;  Cheong Soo Park  ;  Woung Youn Chung  ;  Ki Keun Oh  ;  Dong Ik Kim  ;  Jong Tae Lee  ;  Hyung Sik Yoo 
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.178(3) : 687-691, 2002 
Journal Title
Issue Date
Adult ; Aged ; Biopsy, Needle* ; Calcinosis/diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; ThyroidNeoplasms/diagnosis ; ThyroidNeoplasms/diagnostic imaging ; ThyroidNeoplasms/pathology ; ThyroidNodule/diagnosis ; ThyroidNodule/diagnostic imaging* ; ThyroidNodule/pathology ; Ultrasonography
OBJECTIVE. The purpose of our study was to provide new sonographic criteria for fine-needle aspiration biopsy of nonpalpable solid thyroid nodules.

MATERIALS AND METHODS. Sonographic scans of 155 nonpalpable thyroid nodules in 132 patients were prospectively classified as having positive or negative findings. Sonographic findings that suggested malignancy included microcalcifications, an irregular or microlobulated margin, marked hypoechogenicity, and a shape that was more tall than it was wide. If even one of these sonographic features was present, the nodule was classified as positive (malignant). If a nodule had none of the features described, it was classified as negative (benign). The final diagnosis of a lesion as benign (n = 106) or malignant (n = 49) was confirmed by fine-needle aspiration biopsy and follow-up (>6 months) in 83 benign nodules, by fine-needle aspiration biopsy and surgery in 44 malignant and 15 benign lesions, and by surgery alone in five malignant and eight benign lesions. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated on the basis of our proposed classification method.

RESULTS. Of 82 lesions classified as positive, 46 were malignant. Of 73 lesions classified as negative, three were malignant. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy based on our sonographic classification method were 93.8%, 66%, 56.1%, 95.9%, and 74.8%, respectively.

CONCLUSION. Considering the high level of sensitivity of our proposed sonographic classification, fine-needle aspiration biopsy should be performed on thyroid nodules classified as positive, regardless of palpability.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Park, Cheong Soo(박정수)
Yoo, Hyung Sik(유형식)
Lee, Jong Tae(이종태)
Chung, Woong Youn(정웅윤)
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