title: Selection of patients with solitary thyroid nodules for operation.
abstract: OBJECTIVE
  To improve the preoperative selection for operation of patients with solitary thyroid nodules.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  University hospital, France.
  
  
  METHODS
  155 consecutive patients who presented with solitary thyroid nodules and were operated on.
  
  
  METHODS
  Clinical examination, ultrasound examination, fine needle aspiration biopsy, followed by total thyroid lobectomy with frozen section and final histological examination.
  
  
  METHODS
  Correct prediction of thyroid carcinoma or benign adenoma.
  
  
  RESULTS
  A logistic regression analysis indicated that absence of rim (p < 0.002), solid and hypoechoic feature (p < 0.003) and malignant or suspicious fine needle aspiration biopsy results (p < 0.0001) were significantly associated with malignancy. Selection for operation by the logistic model would save 40 of 73 patients from operation and 40 of 59 from unnecessarily radical operation. It would detect a similar number of cancers as a strategy based solely on fine needle aspiration cytology.
  
  
  CONCLUSIONS
  A combination of the available diagnostic methods provides substantial benefit in the preoperative selection of patients with an isolated thyroid nodule.
authors.affiliation: Quantitative Medical Imaging Research Unit INSERM U494, Hĵpital Pitié-Salpêtrière, Paris, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Leenhardt
authors.forename: Fabrice
authors.initials: F
authors.lastname: Menegaux
authors.forename: Brigitte
authors.initials: B
authors.lastname: Franc
authors.forename: Thierry
authors.initials: T
authors.lastname: Delbot
authors.forename: Georges
authors.initials: G
authors.lastname: Mansour
authors.forename: Catherine
authors.initials: C
authors.lastname: Hoang
authors.forename: Claudine
authors.initials: C
authors.lastname: Guillausseau
authors.forename: Helyett
authors.initials: H
authors.lastname: Aurengo
authors.forename: Danièle
authors.initials: D
authors.lastname: Le Guillouzic
authors.forename: Gérard
authors.initials: G
authors.lastname: Turpin
authors.forename: André
authors.initials: A
authors.lastname: Aurengo
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Chigot
authors.forename: Gilles
authors.initials: G
authors.lastname: Hejblum
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000328:Adult; D001707:Biopsy, Needle; D018276:Carcinoma, Medullary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D014463:Ultrasonography