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Thyroid Nodules with Macrocalcification:Sonographic Findings Predictive of Malignancy

 Yun Joo Park  ;  Jeong-Ah Kim  ;  Eun Ju Son  ;  Ji Hyun Youk  ;  Eun-Kyung Kim  ;  Jin Young Kwak  ;  Cheong Soo Park 
 YONSEI MEDICAL JOURNAL, Vol.55(2) : 339-344, 2014 
Journal Title
Issue Date
Adult ; Biopsy, Fine-Needle ; Calcinosis/diagnostic imaging* ; Calcinosis/pathology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/pathology* ; Thyroid Nodule/diagnostic imaging* ; Thyroid Nodule/pathology* ; Ultrasonography
Sonography ; macrocalcification ; papillary thyroid cancer
PURPOSE: To analyze which sonographic features of thyroid nodules with macrocalcifications were predictable of thyroid malignancy.
MATERIALS AND METHODS: We reviewed sonographic findings of 854 macrocalcified thyroid nodules in patients who underwent fine needle aspiration biopsy between December 2009 and January 2011. There were 171 non-diagnostic aspirations, 34 nodules with category 3, 4, 5 based on Bethesda system, which were not confirmed by surgery, and these nodules were excluded from the analysis. Sonographic characteristics of the macrocalcifications including its thickness, interruption, and existence of soft tissue rim outside the macrocalcification were analyzed. Other sonographic characteristics of nodules such as shape, margin, composition, echo pattern, vascularity, and underlying parenchymal echogenicity were also evaluated. The correlation of sonographic features with cytopathologic results and the diagnostic performance of sonographic features for the prediction of malignancy were analyzed.
RESULTS: Among 649 nodules, 179 (27.6%) nodules were malignant and 470 (72.4%) nodules were benign. Among the features of the macrocalcification, interruption, irregular thickness, or the presence of soft tissue outside calcification rim were associated with malignancy (p<0.001). A high sensitivity and negative predictive values for the prediction of malignancy was found in sonographic characteristics of irregular thickness (92.2% and 91.0%, respectively) and the presence of soft tissue (88.5% and 88.8%, respectively).
CONCLUSION: Sonographic characteristics of macrocalcification such as interruption, irregular thickness and the presence of soft tissue rim were associated with malignancy in thyroid nodules with macrocalcifications.
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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
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
Kim, Jeong Ah(김정아) ORCID logo https://orcid.org/0000-0003-4949-4913
Park, Yun Joo(박연주)
Park, Cheong Soo(박정수)
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
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