title: The Mcgill thyroid nodule score - does it help with indeterminate thyroid nodules?
abstract: BACKGROUND
  Ultrasound guided fine-needle aspiration (USFNA) biopsy of thyroid nodules often gives a result of indeterminate pathology, placing thyroid specialists in difficult management situations. The aim of this study is to evaluate the incidence of malignancy in patients undergoing surgery and to correlate these results with the McGill Thyroid Nodule Score (MTNS).
  
  
  METHODS
  We performed a retrospective study comparing USFNA results, MTNS and histopathology of patients undergoing thyroid surgery between 2010 and 2012. Pre-operative USFNA results were divided into three subgroups: benign, indeterminate and suspicious for/malignant. The indeterminate USFNA subgroup comprised of Bethesda type III (atypia of undetermined significance) and Bethesda type IV (follicular neoplasms, including Hurthle cell neoplasms) lesions. Post-operative histopathology was divided into benign or malignant groups.
  
  
  RESULTS
  Of the 437 patient charts reviewed, 57.0% had an indeterminate USFNA biopsy. Within the indeterminate group, the malignancy rate was 39.8%. For indeterminate USFNA, the median MTNS was 7 (32% risk of malignancy) for benign nodules and 9 (63% risk of malignancy) for malignant nodules on post-operative histopathology (p < 0.05).
  
  
  CONCLUSIONS
  The rate of malignancy in operated patients with an indeterminate USFNA result was 39.8%. The MTNS can be of value to thyroid specialists in pre-operative decision-making when dealing with an indeterminate result of a thyroid nodule on USFNA.
authors: McGill University, Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, 687 Pine Ave. West, E3-37, Montreal, QC, H3A 1A1, Canada. rickul.varshney@gmail.com.
authors: Rickul
authors: R
authors: Varshney
authors: McGill University, Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, 687 Pine Ave. West, E3-37, Montreal, QC, H3A 1A1, Canada. viforest@yahoo.ca.
authors: Veronique-Isabelle
authors: VI
authors: Forest
authors: McGill University, Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, 687 Pine Ave. West, E3-37, Montreal, QC, H3A 1A1, Canada. m.mascarella@gmail.ca.
authors: Marco A
authors: MA
authors: Mascarella
authors: McGill University, Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, 687 Pine Ave. West, E3-37, Montreal, QC, H3A 1A1, Canada. faisalzawawi@gmail.com.|King Abdulaziz University, Jeddah, Saudi Arabia. faisalzawawi@gmail.com.
authors: Faisal
authors: F
authors: Zawawi
authors: Department of Pathology, Jewish General Hospital, McGill University, 3755 Côte-Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada. louise.rochon@mcgill.ca.
authors: Louise
authors: L
authors: Rochon
authors: McGill University, Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, 687 Pine Ave. West, E3-37, Montreal, QC, H3A 1A1, Canada. mhier@ent.jgh.mcgill.ca.
authors: Michael P
authors: MP
authors: Hier
authors: McGill University, Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, 687 Pine Ave. West, E3-37, Montreal, QC, H3A 1A1, Canada. alexmlynarek@hotmail.com.
authors: Alex
authors: A
authors: Mlynarek
authors: Department of Endocrinology and Metabolism, Jewish General Hospital, McGill University, 3755 Côte-Ste-Catherine Road, Montreal, Canada. mtamilia@end.jgh.mcgill.ca.
authors: Michael
authors: M
authors: Tamilia
authors: McGill University, Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, 687 Pine Ave. West, E3-37, Montreal, QC, H3A 1A1, Canada. rkpayne@sympatico.ca.
authors: Richard J
authors: RJ
authors: Payne
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D013223:Statistics as Topic; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D016606:Thyroid Nodule / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy; D018084:Ultrasonography, Interventional / Q000379:methods*
references: Cancer Cytopathol. 2013 May;121(5):223-4
references: 23670834
references: Saudi Med J. 2012 Feb;33(2):167-71
references: 22327757
references: Cancer. 2007 Dec 25;111(6):508-16
references: 17999413
references: Cancer. 2007 Oct 25;111(5):306-15
references: 17680588
references: N Engl J Med. 2012 Aug 23;367(8):705-15
references: 22731672
references: J Clin Endocrinol Metab. 2012 Jul;97(7):2354-61
references: 22535974
references: J Clin Endocrinol Metab. 2013 Apr;98(4):E761-8
references: 23476074
references: Endocr J. 2013;60(3):375-82
references: 23197046
references: Thyroid. 2012 Oct;22(10):996-1001
references: 22873825
references: J Korean Med Sci. 2012 Sep;27(9):1014-8
references: 22969246
references: Thyroid. 2009 Nov;19(11):1167-214
references: 19860577
references: Cir Cir. 2010 Nov-Dec;78(6):473-8
references: 21214982
references: J Otolaryngol Head Neck Surg. 2011 Feb;40 Suppl 1:S1-13
references: 21453655
references: J Clin Endocrinol Metab. 2011 Nov;96(11):E1719-26
references: 21865367
references: J Clin Endocrinol Metab. 2011 Nov;96(11):3390-7
references: 21880806
references: Endocrine. 2014 Feb;45(1):37-45
references: 23504651