title: McGill Thyroid Nodule Score (MTNS): "rating the risk," a novel predictive scheme for cancer risk determination.
abstract: OBJECTIVE
  There are presently a great number of publications pertaining to the clinical risk factors associated with thyroid cancer. These studies deal mostly with a single feature from either patient demographics, physical examination, laboratory values, imaging, or cytology. We sought to create a novel scoring system that integrates the diagnostic indices of each of these clinical features for carcinoma.
  
  
  METHODS
  A retrospective analysis of 1047 consecutive thyroidectomy patients was performed. Each patient was assigned a cancer risk score according to a newly devised 22-variable scoring scheme termed the McGill Thyroid Nodule Score (MTNS). The MTNS was developed by a multidisciplinary team of endocrinologists, thyroid surgeons, and pathologists using already established evidence-based risk factors for thyroid cancer.
  
  
  RESULTS
  The exact incidence of malignancy was calculated for each MTNS score based on final pathology. The incidence for scores of 1 to 3 was 27%, of 4 to 7 was 32%, of 8 was 39%, of 9 to 11 was 63%, of 12 to 13 was 88%, and of 14 to 18 was 93%. All (130 of 130) patients with a score ≥ 19 had carcinoma. A score ≤ 8 correlated with a 32% (115 of 357) risk of thyroid cancer, whereas a score > 8 implied an 86% (417 of 487) risk.
  
  
  CONCLUSIONS
  Our data suggest that a combined scoring system, the MTNS, can serve as an accurate predictor of the risk for thyroid cancer in a specific thyroid nodule. This will help physicians better formulate management decisions accordingly.
authors: Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, QC.
authors: Noah B
authors: NB
authors: Sands
authors: Shawn
authors: S
authors: Karls
authors: Alexander
authors: A
authors: Amir
authors: Michael
authors: M
authors: Tamilia
authors: Olga
authors: O
authors: Gologan
authors: Louise
authors: L
authors: Rochon
authors: Martin J
authors: MJ
authors: Black
authors: Michael P
authors: MP
authors: Hier
authors: Richard J
authors: RJ
authors: Payne
mesh_terms: D044963:Biopsy, Fine-Needle; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery