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Malignancy Risk Stratification in Thyroid Nodules with Benign Results on Cytology: Combination of Thyroid Imaging Reporting and Data System and Bethesda System

Authors
 Hee Jung Moon  ;  Eun-Kyung Kim  ;  Jin Young Kwak 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.21(6) : 1898-1903, 2014 
Journal Title
ANNALS OF SURGICAL ONCOLOGY
ISSN
 1068-9265 
Issue Date
2014
MeSH
Adenocarcinoma, Follicular/classification ; Adenocarcinoma, Follicular/diagnostic imaging ; Adenocarcinoma, Follicular/pathology* ; Adult ; Biopsy, Fine-Needle ; Carcinoma, Medullary/classification ; Carcinoma, Medullary/diagnostic imaging ; Carcinoma, Medullary/pathology* ; Carcinoma, Papillary/classification ; Carcinoma, Papillary/diagnostic imaging ; Carcinoma, Papillary/pathology* ; Humans ; Image-Guided Biopsy ; Middle Aged ; Risk Assessment ; Thyroid Neoplasms/classification ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/pathology* ; Thyroid Nodule/classification ; Thyroid Nodule/diagnostic imaging* ; Thyroid Nodule/pathology* ; Tumor Burden ; Ultrasonography
Keywords
Thyroid Nodule ; Nodule Size ; Benign Nodule ; Irregular Margin ; Malignancy Risk
Abstract
BACKGROUND:
The indications of repeat fine-needle aspiration (FNA) for thyroid nodules with benign results of the Bethesda system were investigated.
METHODS:
A total of 1,398 nodules were classified according to the Thyroid Imaging Reporting and Data System (TIRADS). TIRADS category 3 included nodules without solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape on ultrasonography (US). Categories 4a, 4b, 4c, and 5 included nodules with one, two, three or four, or five suspicious US features, respectively. The malignancy risks, and odds ratio (OR) with 95 % confidence interval (CI) were calculated. Analyses were performed for all nodules, nodules >10 mm, and nodules ≤10 mm.
RESULTS:
Of 1.398 nodules, 43 (3.1 %) were malignanct. The malignancy risks of benign nodules with categories 3, 4a, and 4b were 0.7, 1.2, and 0.7 %, respectively, whereas those for nodules with categories 4c and 5 were 9.8 and 22.2 %, respectively. The ORs of nodules with categories 4c and 5 were 19.4 (95 % CI 5.0-76.2) and 50.6 (95 % CI 10.4-245.0), respectively. In nodules >10 mm, the malignancy risks of categories 4c and 5 were 2.7 and 20 %, respectively, and the ORs were 10.7 (95 % CI 1.2-93.7) and 236.1 (95 % CI 12.6-4426.4), respectively. In nodules ≤ 10 mm, the malignancy risks of categories 4c and 5 were 12.6 and 22.6 %, respectively, and the ORs were 10.1 (95 % CI 1.3-78.0) and 18.9 (95 % CI 2.1-168.9), respectively.
CONCLUSIONS:
Repeat US-guided FNA should be considered in benign thyroid nodules with three or more suspicious US features regardless of size.
Full Text
http://link.springer.com/article/10.1245%2Fs10434-014-3556-2
DOI
10.1245/s10434-014-3556-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 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
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98743
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