Diagnostic performance of ATA, BTA and TIRADS sonographic patterns in the prediction of malignancy in histologically proven thyroid nodules
- 1 November 2018
- journal article
- research article
- Published by Medknow in Singapore Medical Journal
- Vol. 59 (11), 578-583
- https://doi.org/10.11622/smedj.2018062
Abstract
INTRODUCTION We aimed to compare the malignancy risk stratification of histologically proven thyroid nodules using the 2015 American Thyroid Association (ATA) Management Guidelines, 2014 British Thyroid Association (BTA) Guidelines for the Management of Thyroid Cancer and the Thyroid Imaging Reporting and Data System (TIRADS). METHODS Thyroid nodules measuring > 1 cm resected over 5.5 years were retrospectively studied. Demographic information as well as cytology and histopathology results were collected. Static ultrasonography (US) images and radiologists' reports of each resected nodules were reviewed and classified based on the above risk classification systems. RESULTS A total of 167 thyroid nodules from 150 patients were examined. More malignant nodules were solid (78.4% vs. 62.5%; p = 0.049) or hypoechoic (70.6% vs. 28.6%; p < 0.001), and had irregular margins (35.3% vs. 8.0%; p < 0.001), taller-than-wide morphology (9.8% vs. 2.7%; p = 0.031), microcalcifications (33.3% vs. 8.0%; p < 0.001), disrupted rim calcifications (9.8% vs. 0.9%; p = 0.012) or associated abnormal cervical lymphadenopathy (13.7% vs. 0.9%; p = 0.001) compared with benign nodules. The guidelines' diagnostic performance was: ATA - sensitivity 98.0%, specificity 17.3%, positive predictive value (PPV) 35.0%, negative predictive value (NPV) 95.0%; BTA - sensitivity 90%, specificity 50.9%, PPV 45.5%, NPV 91.8%; and TIRADS - sensitivity 94.0%, specificity 28.2%, PPV 37.3%%, NPV 91.2%. CONCLUSION Sonographic patterns outlined by the three guidelines displayed high sensitivity and NPV. Although isolated suspicious US features cannot predict malignancy risk, they should be considered when risk stratifying nodules that do not fit into particular sonographic patterns based on current guidelines.Keywords
This publication has 32 references indexed in Scilit:
- 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid CancerThyroid®, 2016
- Malignancy Risk Stratification in Thyroid Nodules with Nondiagnostic Results at Cytologic Examination: Combination of Thyroid Imaging Reporting and Data System and the Bethesda SystemRadiology, 2015
- Value of sonographic features in predicting malignancy in thyroid nodules diagnosed as follicular neoplasm on cytologyClinical Endocrinology, 2014
- Guidelines for the management of thyroid cancerClinical Endocrinology, 2014
- Malignancy Risk Stratification in Thyroid Nodules with Benign Results on Cytology: Combination of Thyroid Imaging Reporting and Data System and Bethesda SystemAnnals of Surgical Oncology, 2014
- Thyroid Imaging Reporting and Data System for US Features of Nodules: A Step in Establishing Better Stratification of Cancer RiskRadiology, 2011
- Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid CancerThyroid®, 2009
- An Ultrasonogram Reporting System for Thyroid Nodules Stratifying Cancer Risk for Clinical ManagementJournal of Clinical Endocrinology & Metabolism, 2009
- Comparison of palpation-versus ultrasound-guided fine-needle aspiration biopsies in the evaluation of thyroid nodulesBMC Research Notes, 2008
- Comparison of Palpation-Guided Fine-Needle Aspiration Biopsy to Ultrasound-Guided Fine-Needle Aspiration Biopsy in the Evaluation of Thyroid NodulesThyroid®, 2006