Role of ultrasonography in predicting malignancy in patients with thyroid nodules.
The use of ultrasonography (USG) has become an essential part of endocrine surgical practice. We evaluated the value of USG in predicting malignancy of thyroid nodules. The accuracy of USG in 857 patients who underwent fine-needle aspiration (FNA) with or without surgery was analyzed in a prospective setting. The diagnostic accuracy of USG was compared to that of FNA and of combined models in 153 operated patients. The malignancy-predicting value of USG in follicular neoplasms and its relation to nodule size were also investigated. Sensitivity, specificity, and overall accuracy (OA) of USG were 84.9%, 95.5%, and 93.7%, respectively. In operated patients, USG had accuracy comparable to that of FNA and combined models (sensitivity 93.3%, specificity 90.6%, OA 92.0%) regardless of nodule size but showed a significant rate of indeterminate results (29.4%). For follicular neoplasms, the sensitivity, specificity, and OA of USG were 100%, 95.4%, and 96.1%, respectively, with indeterminate results for three malignant nodules (42.8%). This acceptable malignancy-predicting value of USG in thyroid nodules supports the potential role of USG for predicting malignancy in selected patients with thyroid nodules. However, the high rate of indeterminate results precludes it from being a standard independent diagnostic method for the present time.
Moon
Hyeong-Gon
HG
Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University, Gyeongsang National University Hospital, Gyeongnam Regional Cancer Center, 90 Chilam-dong, Jinju, Gyeongsangnam-do 660-702, South Korea. moonhgsurgi@hanmail.net
Jung
Eun-Jung
EJ
Park
Soon-Tae
ST
Ha
Woo-Song
WS
Choi
Sang-Kyung
SK
Hong
Soon-Chan
SC
Lee
Young-Joon
YJ
Joo
Young-Tae
YT
Jeong
Chi-Young
CY
Choi
Dae-Seob
DS
Ryoo
Jae-Wook
JW
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography