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Validation of the 2015 American Thyroid Association Management Guidelines for Thyroid Nodules With Benign Cytologic Findings in the Era of the Bethesda System

 Yeun-Yoon Kim  ;  Kyunghwa Han  ;  Eun-Kyung Kim  ;  Hee Jung Moon  ;  Jung Hyun Yoon  ;  Vivian Y Park  ;  Jin Young Kwak 
 American Journal of Roentgenology, Vol.210(3) : 629-634, 2018 
Journal Title
 American Journal of Roentgenology 
Issue Date
cytology ; fine-needle aspiration ; thyroid nodule ; ultrasound
OBJECTIVE: The purpose of this study is to investigate follow-up strategies for cytologically benign thyroid nodules according to size and ultrasound (US) pattern according to the 2015 American Thyroid Association (ATA) guidelines in the era of the Bethesda system. MATERIALS AND METHODS: This retrospective study included 1208 patients with 1230 nodules that were cytologically benign at initial fine-needle aspiration performed from June 2012 to December 2014. False-negative rates (FNRs) were calculated by considering nodule size and US pattern according to the 2015 ATA guidelines and were compared between nodules with the high-suspicion US pattern and nodules with the high- or intermediate-suspicion US patterns according to size. RESULTS: Twenty-five of the 1230 nodules (2.0%) were malignant. The FNRs were 5.1% (8/158) for nodules with the high-suspicion US pattern and 1.6% (17/1072) for nodules with other US patterns. With regard to nodule size, the FNRs were 3.2% (9/277) for nodules 3 cm or larger and 5.2% (6/115) for nodules 4 cm or larger. The FNRs of nodules with the high-suspicion pattern were not significantly higher than those of nodules with the high- or intermediate-suspicion patterns among nodules 2 cm or larger (2.5% vs 1.9%; p = 0.208), 3 cm or larger (3.4% vs 2.9%; p = 0.498), and 4 cm or larger (5.4% vs 3.8%; p = 0.353). CONCLUSION: Thyroid nodules with initial benign cytologic findings had a low malignancy rate in the era of the Bethesda system, regardless of US pattern and size. Therefore, any immediate diagnostic intervention may be discouraged in cytologically benign nodules.
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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
김연윤(Kim, Yeun-Yoon) ORCID logo https://orcid.org/0000-0003-2018-5332
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
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