The role of ultrasound findings in the management of thyroid nodules with atypia or follicular lesions of undetermined significance. (30th October 2013)

• Record Type: Journal Article
• Authors: Yoo, Won Sang; Choi, Hoon Sung; Cho, Sun Wook; Moon, Jae Hoon; Kim, Kyung Won; Park, Hyo Jin; Park, So Yeon; Choi, Sang Il; Choi, Sung Hee; Lim, Soo; Yi, Ka Hee; Park, Do Joon; Jang, Hak Chul; Park, Young Joo
• Is Part Of: Clinical endocrinology. Volume 80:Number 5(2014:May)
• Page Start: 735
• Page End: 742
• Publication Date: 2013-10-30
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12348
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12348-abs-0001"> <title>Summary</title> <sec id="cen12348-sec-0001" sec-type="section"> <title>Background</title> <p>Atypia or follicular lesions of undetermined significance (AUS/FLUS) is a broad cytological category in the Bethesda system for classifying thyroid cytology. This study investigated the diagnostic accuracy of ultrasound (US) analysis of thyroid nodules with AUS/FLUS.</p> </sec> <sec id="cen12348-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p>Of 5062 subjects with nodules subjected to fine‐needle aspiration cytology (FNACs) at our institution from January 2010 through May 2012, 383 met the Bethesda criteria for AUS/FLUS. After excluding subjects who had a history of thyroid cancer, who only underwent repeat FNA or who underwent no further examinations, we selected 249 subjects who had subsequently undergone a core‐needle biopsy and/or surgery. Of these, 100 were found to have malignant nodules (40·2%), 122 had benign nodules (49%), and 27 had nodules with indeterminate status (10·8%). We compared specific US parameters, including size, location, content, shape, margin, echogenicity, echotexture and calcification across these subject groups.</p> </sec> <sec id="cen12348-sec-0003" sec-type="section"> <title>Results</title> <p>Multivariate analysis revealed that malignancy was associated with taller‐than‐wide shape (TDW) (OR = 8·43, <italic>P</italic> = 0·002), ill‐defined margin (OR = 3·23, <italic>P</italic> = 0·002) and marked hypoechogenicity. (OR = 3·61, <italic>P</italic> = 0·001). The specificity and positive predictive values of TDW were 98% and 90·6%, respectively. The specificity and positive predictive values of 'TDW and marked hypoechogenicity' were both 100%.</p> </sec> <sec id="cen12348-sec-0004" sec-type="section"> <title>Conclusion</title> <p>US findings play a complementary role in the diagnosis of thyroid nodules with AUS/FLUS. In case of highly suspicious US findings such as 'TDW and marked hypoechogenicity', could be very helpful in the diagnosis of malignancy.</p> </sec> </abstract>