American Thyroid Association ultrasound system for the initial assessment of thyroid nodules: Use in stratifying the risk of malignancy of indeterminate lesions. Issue 4 (16th December 2017)

• Record Type: Journal Article
• Authors: Trimboli, Pierpaolo; Deandrea, Maurilio; Mormile, Alberto; Ceriani, Luca; Garino, Francesca; Limone, Paolo P.; Giovanella, Luca
• Is Part Of: Head & neck. Volume 40:Issue 4(2018)
• Page Start: 722
• Page End: 727
• Publication Date: 2017-12-16
• Subjects: American Thyroid Association (ATA) guidelines -- fine‐needle aspiration cytology (FNAC) -- indeterminate -- thyroid -- ultrasonography; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.25038
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: The ultrasound risk stratification system of the American Thyroid Association (ATA) is frequently adopted in clinical practice. Here, we evaluated its performance in a series of nodules with indeterminate fine‐needle aspiration cytology (FNAC) report. Methods: Indeterminate thyroid nodules diagnosed at 2 medical centers were retrospectively screened, ultrasound images were reevaluated, and lesions were classified according to the ATA. Single ultrasound parameters were also analyzed. Results: One hundred seventy‐three indeterminate lesions were included with 24.8% of malignancy. The high suspicion class showed a cancer rate (75%) significantly ( P < .001) higher than that recorded in the other categories (16.8%). Between ultrasound parameters, halo and microcalcifications were the most sensitive and specific ones. The most accurate receiver operating characteristic (ROC)‐derived cutoff of nodule's diameter was >4.1 cm. At multivariate analysis, only the ATA class of high suspicion and size >4.1 cm were significantly associated with cancer (odds ratios [ORs] 19.4 and 5.4, respectively). Conclusion: The ATA ultrasound system is reliable in the risk stratification of indeterminate thyroid lesions.