title: Management of thyroid follicular proliferation: an ultrasound-based malignancy score to opt for surgical or conservative treatment.
abstract: This study was conducted to evaluate whether ultrasound characteristics of thyroid nodules with a known cytologic diagnosis of "follicular pattern" (indicative of follicular hyperplasia, follicular adenoma or follicular carcinoma) can be used to define a nodule malignancy score to limit surgery to selected, higher-risk cases. In pre-operative ultrasound results of patients diagnosed with a "follicular pattern" on cytology who subsequently underwent surgery, each nodule feature was given a score from 0 (most likely benign) to 2 (most likely malignant), resulting in a total score ranging from 0 to 11. The total nodule score (total malignancy score) was then compared with the definitive histologic diagnosis. According to our results, surgery is advisable in patients with score ≥4 (79% of carcinomas), ultrasound follow-up seems to be appropriate for patients with a score of 3 (21% of carcinomas) and no action is recommended for patients with score <3 (only benign nodules).
authors.affiliation: Radiologia Diagnostica ed Interventistica, Azienda Ospedaliera San Paolo, Milan, Italy. giovanni.pompili@fastwebnet.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pompili
authors.forename: Silvia
authors.initials: S
authors.lastname: Tresoldi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Primolevo
authors.forename: Loredana
authors.initials: L
authors.lastname: De Pasquale
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Leo
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Cornalba
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D013965:Thyroidectomy / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014463:Ultrasonography / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Cytodiagnosis; Diagnostic imaging; Fine-needle biopsy; Follicular thyroid carcinoma; Thyroid nodule; Ultrasound