İlker ÖZGÜR
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)
Ahmet İŞCAN
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)
İsmail SORMAZ
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)
Fatih TUNCA
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)
ARTÜR SALMASLIOĞLU
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Radyoloji Anabilim Dalı, İstanbul, Türkiye)
Aysel BAYRAM
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Bölümü Patoloji, İstanbul, Türkiye)
Gülçin YEĞEN
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Bölümü Patoloji, İstanbul, Türkiye)
Yasemin Giles ŞENYÜREK
(İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye)
Yıl: 2020Cilt: 83Sayı: 4ISSN: 1305-6441Sayfa Aralığı: 378 - 383İngilizce

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THE PREDICTIVE VALUE OF ULTRASONOGRAPHY FOR POTENTIALLY MALIGNANT THYROID NODULES
Objective: In this study, we aimed to predict the malignancy potential of a thyroid nodule based on ultrasonography (US) features. Material and Method: The data of 726 nodules in 619 patients who underwent thyroidectomy between 2005 and 2012 at Istanbul University, Istanbul Medical Faculty were retrospectively analyzed. US features of nodules were recorded and matched with pathology reports and each US feature was evaluated for diagnostic value. Results: The study group consisted of mainly female patients (86.9%) and the mean age was 46,3 years. Thyroid cancer was detected in 374 (51.7%) nodules and the most common type was papillary thyroid cancer 97% (n=341). Microcalcifications (p=0.0001), irregular margin (p=0.001) and hypoechogenicity (p=0.038) were correlated with malignancy. The absence of any of these suspicious US features significantly predicted benign disease (p=0.0001). An increasing number of suspicious features predicted malign disease with increasing specificity, positive predictive value, and likelihood ratio. Microcalcifications and irregular borders had high specificity (>80%) to predict thyroid cancer. Conclusion: The presence of microcalcifications, irregular margin, and hypoechogenicity in a thyroid nodule significantly correlates with malignant disease. Microcalcifications and irregular borders had high specificity to predict thyroid cancer. The probability of thyroid cancer increases with an increasing number of suspicious US features.
DergiAraştırma MakalesiErişime Açık
  • 1. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et. al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016;26(1):1-133. [CrossRef]
  • 2. Cappelli C, Castellano M, Pirola I, Cumetti D, Agosti B, Gandossi E, et. al. The predictive value of ultrasound findings in the management of thyroid nodules. QJM 2007;100(1):29-35. [CrossRef]
  • 3. Hong YJ, Son EJ, Kim EK, Kwak JY, Hong SW, Chang HS. Positive predictive values of sonographic features of solid thyroid nodule. Clin Imaging 2010;34(2):127-33. [CrossRef]
  • 4. Carmeci C, Jeffrey RB, McDougall IR, Nowels KW, Weigel RJ. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses. Thyroid 1998;8(4):283-9. [CrossRef
  • 5. Tee YY, Lowe AJ, Brand CA, Judson RT. Fine-needle aspiration may miss a third of all malignancy in palpable thyroid nodules: a comprehensive literature review. Ann Surg 2007;246(5):714-20. [CrossRef]
  • 6. Peng Y, Wang HH. A meta-analysis of comparing fineneedle aspiration and frozen section for evaluating thyroid nodules. Diagn Cytopathol 2008;36(12):916-20. [CrossRef]
  • 7. Oertel YC, Miyahara-Felipe L, Mendoza MG, Yu K. Value of repeated fine needle aspirations of the thyroid: an analysis of over ten thousand FNAs. Thyroid 2007;17(11):1061-6. [CrossRef]
  • 8. Lewis CM, Chang KP, Pitman M, Faquin WC, Randolph GW. Thyroid fine-needle aspiration biopsy: variability in reporting. Thyroid 2009;19(7):717-23. [CrossRef]
  • 9. Yeh MW, Demircan O, Ituarte P, Clark OH. False-negative fine-needle aspiration cytology results delay treatment and adversely affect outcome in patients with thyroid carcinoma. Thyroid 2004;14(3):207-15. [CrossRef]
  • 10. Pinchot SN, Al-Wagih H, Schaefer S, Sippel R, Chen H. Accuracy of fine-needle aspiration biopsy for predicting neoplasm or carcinoma in thyroid nodules 4 cm or larger. Arch Surg 2009;144(7):649-55. [CrossRef]
  • 11. Yoon JH, Kwak JY, Moon HJ, Kim MJ, Kim EK. The diagnostic accuracy of ultrasound-guided fine-needle aspiration biopsy and the sonographic differences between benign and malignant thyroid nodules 3cm or larger. Thyroid 2011;21(9):993-1000. [CrossRef]
  • 12. Nguyen GK, Lee MW, Ginsberg J, Wragg T, Bilodeau D. Fine-needle aspiration of the thyroid: an overview. Cytojournal 2005;2(1):12. [CrossRef]
  • 13. Faquin WC. Diagnosis and reporting of follicular-patterned thyroid lesions by fine needle aspiration. Head Neck Pathol 2009;3(1):82-5. [CrossRef]
  • 14. Kesmodel SB, Terhune KP, Canter RJ, Mandel SJ, LiVolsi VA, Baloch ZW, et. al. The diagnostic dilemma of follicular variant of papillary thyroid carcinoma. Surgery 2003;134(6):1005-12. [CrossRef]
  • 15. Malhi H, Beland MD, Cen SY, Allgood E, Daley K, Martin SE, et. al. Echogenic foci in thyroid nodules: significance of posterior acoustic artifacts. AJR Am J Roentgenol 2014;203(6):1310-6. [CrossRef]
  • 16. Kwak JY, Han KH, Yoon JH, Moon HJ, Son EJ, Park SH, et. al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology 2011;260(3):892-9. [CrossRef]
  • 17. Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, et. al. AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocr Pract 2010;16(3):468- 75. [CrossRef]
  • 18. Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, et. al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab 2006;91(9):3411-7. [CrossRef]
  • 19. Nam-Goong IS, Kim HY, Gong G, Lee HK, Hong SJ, Kim WB, et. al. Ultrasonography-guided fine-needle aspiration of thyroid incidentaloma: correlation with pathological findings. Clin Endocrinol (Oxf) 2004;60(1):21-8. [CrossRef]
  • 20. Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA, et. al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol 2017;14(5):587-95. [CrossRef]
  • 21. Remonti LR, Kramer CK, Leitão CB, Pinto LC, Gross JL. Thyroid ultrasound features and risk of carcinoma: a systematic review and meta-analysis of observational studies. Thyroid 2015;25(5):538-50. [CrossRef]
  • 22. Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, et. al. Society of Radiologists in Ultrasound. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005;237(3):794-800. [CrossRef]
  • 23. Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults: The EU-TIRADS. Eur Thyroid J 2017;6(5):225-37. [CrossRef]
  • 24. Khoo ML, Asa SL, Witterick IJ, Freeman JL. Thyroid calcification and its association with thyroid carcinoma. Head Neck 2002;24(7):651-5. [CrossRef]
  • 25. Kim HG, Moon HJ, Kwak JY, Kim EK. Diagnostic accuracy of the ultrasonographic features for subcentimeter thyroid nodules suggested by the revised American Thyroid Association guidelines. Thyroid 2013;23(12):1583-9. [CrossRef]
  • 26. Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, et. al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 2002;87(5):1941-6. [CrossRef]
  • 27. Wienke JR, Chong WK, Fielding JR, Zou KH, Mittelstaedt CA. Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. J Ultrasound Med 2003;22(10):1027-31. [CrossRef]
  • 28. Park JY, Lee HJ, Jang HW, Kim HK, Yi JH, Lee W, et. al. A proposal for a thyroid imaging reporting and data system for ultrasound features of thyroid carcinoma. Thyroid 2009;19(11):1257-64. [CrossRef]
  • 29. Hoang JK, Lee WK, Lee M, Johnson D, Farrell S. US Features of thyroid malignancy: pearls and pitfalls. Radiographics 2007;27(3):847-60. [CrossRef]
  • 30. Horvath E, Majlis S, Rossi R, Franco C, Niedmann JP, Castro A, et. al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab 2009;94(5):1748-51. [CrossRef]

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