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Risk Stratification of Thyroid Nodules With Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance (AUS/FLUS) Cytology Using Ultrasonography Patterns Defined by the 2015 ATA Guidelines

 Ji Hye Lee  ;  Kyunghwa Han  ;  Eun-Kyung Kim  ;  Hee Jung Moon  ;  Jung Hyun Yoon  ;  Vivian Y. Park  ;  Jin Young Kwak 
 Annals of Otology, Rhinology & Laryngology, Vol.126(9) : 625-633, 2017 
Journal Title
 Annals of Otology, Rhinology & Laryngology 
Issue Date
Adenocarcinoma, Follicular/diagnostic imaging* ; Adenocarcinoma, Follicular/pathology ; Adenoma/diagnostic imaging* ; Adenoma/pathology ; Adult ; Biopsy, Fine-Needle ; Carcinoma/diagnostic imaging* ; Carcinoma/pathology ; Carcinoma, Neuroendocrine/diagnostic imaging* ; Carcinoma, Neuroendocrine/pathology ; Carcinoma, Papillary ; Female ; Humans ; Hyperplasia ; Male ; Middle Aged ; Practice Guidelines as Topic ; Retrospective Studies ; Risk Assessment ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/pathology ; Thyroid Nodule/diagnostic imaging* ; Thyroid Nodule/pathology ; Thyroiditis, Autoimmune/diagnostic imaging* ; Thyroiditis, Autoimmune/pathology ; Thyroiditis, Subacute/diagnostic imaging* ; Thyroiditis, Subacute/pathology ; Ultrasonography
AUS/FLUS ; BSRTC ; Bethesda System for Reporting Thyroid Cytopathology ; atypia of undetermined significance or follicular lesion of undetermined significance ; thyroid gland ; thyroid nodule ; ultrasonography
PURPOSE: The purpose of this study was to evaluate the predictive value of ultrasonography (US) patterns based on the 2015 American Thyroid Association (ATA) guidelines for malignancy in atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) nodules. METHODS: From January 2014 to August 2015, 133 thyroid nodules that were initially diagnosed as AUS/FLUS on fine needle aspiration (FNA) were included in this study. Each nodule was assigned a category with US patterns defined by the ATA guidelines. Clinical characteristics and US patterns were compared between the benign and malignant nodules, and malignancy rates were calculated according to the ATA guidelines. RESULTS: The malignancy rate in the very low suspicion group was 0.0% in AUS/FLUS nodules. When applying the ATA guidelines, significant differences existed for US patterns between the benign and malignant nodules in the AUS group ( P = .032) but not the FLUS group ( P = .168). CONCLUSIONS: Ultrasonography patterns by the 2015 ATA guidelines can provide risk stratification for nodules with AUS cytology but not for ones with FLUS cytology. For nodules with AUS/FLUS cytology with the very low suspicion pattern of the ATA guidelines, follow-up US might be recommended instead of repeat FNA.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
곽진영(Kwak, Jin Young) ORCID logo https://orcid.org/0000-0002-6212-1495
김은경(Kim, Eun-Kyung) ORCID logo https://orcid.org/0000-0002-3368-5013
문희정(Moon, Hee Jung) ORCID logo https://orcid.org/0000-0002-5643-5885
박영진(Park, Vivian Youngjean) ORCID logo https://orcid.org/0000-0002-5135-4058
윤정현(Yoon, Jung Hyun) ORCID logo https://orcid.org/0000-0002-2100-3513
이지혜(Lee, Ji Hye) ORCID logo https://orcid.org/0000-0002-1501-9105
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