title: Comparison of computed tomography features between follicular neoplasm and nodular hyperplasia.
abstract: BACKGROUND
  To date, appropriate management for Bethesda IV thyroid nodules is controversial, and no specific features of follicular neoplasm and nodular hyperplasia on ultrasonography, computed tomography (CT), or other imaging modalities have been reported. This study aimed to compare CT features of follicular neoplasm and nodular hyperplasia and to determine the specific CT features that could be used to distinguish follicular neoplasm from nodular hyperplasia.
  
  
  METHODS
  In 122 patients who underwent preoperative CT of the neck and thyroid surgery, 59 follicular neoplasms and 65 nodular hyperplasias were included. In each case, non-enhanced and contrast-enhanced CT images were obtained, and a single radiologist retrospectively analyzed CT images, including degree and pattern of attenuation, nodular configuration, margin, shape, pattern of calcification, degree and pattern of nodular enhancement, and CT halo sign. A univariate and multivariate logistic regression analyses were used to evaluate the predictive power of each variable and CT features with a high predictive power, respectively.
  
  
  RESULTS
  According to the univariate analysis, iso-attenuation, intraglandular configuration, smooth margin, ovoid shape, decreased enhancement, and absence of CT halo sign were more frequently observed in nodular hyperplasia (p < 0.05), whereas low attenuation, expansile configuration, lobulated margin, taller-than-wide shape, increased enhancement, and presence of computed tomography halo sign were more frequently observed in follicular neoplasm (p < 0.05). Multivariate analysis revealed significant differences in configuration (OR: 2.73, 1.13-6.57), degree of enhancement (OR: 2.14, 1.21-3.78), and presence of CT halo sign (OR: 7.97, 2.74-23.37) between follicular neoplasm and nodular hyperplasia (p < 0.05).
  
  
  CONCLUSIONS
  Neck CT may be helpful for distinguishing follicular neoplasm from nodular hyperplasia.
  
  
  BACKGROUND
  Rretrospectively registered.
authors.affiliation: Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, 48108, South Korea.|Department of Radiology, Newoori Namsan Hospital, Busan, 48305, South Korea.
authors.forename: Kwang Hwi
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, South Korea. dwultra@nate.com.
authors.forename: Dong Wook
authors.identifier: http://orcid.org/0000-0002-9826-1326
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, South Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Baek
authors.affiliation: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, South Korea.
authors.forename: Yoo Jin
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, South Korea.
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Choo
authors.affiliation: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, South Korea.
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Cho
authors.affiliation: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, South Korea.
authors.forename: Sun Joo
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, South Korea.
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Park
authors.affiliation: Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, 48108, South Korea.
authors.forename: Soo Jin
authors.initials: SJ
authors.lastname: Jung
authors.affiliation: Department of Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, 51476, South Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Follicular neoplasm; Nodular hyperplasia; Thyroid; Thyroid nodule