Imaging-Detected Incidental Thyroid Nodules that Undergo Surgery: A Single-Center Experience Over 1 Year
Open Access
- 26 June 2014
- journal article
- research article
- Published by American Society of Neuroradiology (ASNR) in American Journal of Neuroradiology
- Vol. 35 (11), 2176-2180
- https://doi.org/10.3174/ajnr.a4004
Abstract
BACKGROUND AND PURPOSE: Incidental thyroid nodules are commonly seen on imaging, and their work-up can ultimately lead to surgery. We describe characteristics and pathology results of imaging-detected incidental thyroid nodules that underwent surgery. MATERIALS AND METHODS: A retrospective review was performed of 303 patients who underwent thyroid surgery over a 1-year period to identify patients who presented with incidental thyroid nodules on imaging. Medical records were reviewed for the types of imaging studies that led to detection, nodule characteristics, and surgical pathology. RESULTS: Of 303 patients, 208 patients (69%) had surgery for thyroid nodules. Forty-seven of 208 patients (23%) had incidental thyroid nodules detected on imaging. The most common technique leading to detection was CT (47%). All patients underwent biopsy before surgery. The cytology results were nondiagnostic (6%), benign (4%), atypia of undetermined significance or follicular neoplasm of undetermined significance (23%), follicular neoplasm or suspicious for follicular neoplasm (19%), suspicious for malignancy (17%), and diagnostic of malignancy (30%). Surgical pathology was benign in 24 of 47 (51%) cases of incidental thyroid nodules. In the 23 incidental cancers, the most common histologic type was papillary (87%), the mean size was 1.4 cm, and nodal metastases were present in 7 of 23 cases (30%). No incidental cancers on imaging had distant metastases. CONCLUSIONS: Imaging-detected incidental thyroid nodules led to nearly one-fourth of surgeries for thyroid nodules, and almost half were initially detected on CT. Despite indeterminate or suspicious cytology results that lead to surgery, more than half were benign on final pathology. Guidelines for work-up of incidental thyroid nodules detected on CT could help reduce unnecessary investigations and surgery.This publication has 22 references indexed in Scilit:
- Thyroid Cancers Incidentally Detected at Imaging in a 10-year Period: How Many Cancers Would Be Missed with Use of the Recommendations from the Society of Radiologists in Ultrasound?Radiology, 2014
- High Variability in Radiologists' Reporting Practices for Incidental Thyroid Nodules Detected on CT and MRIAmerican Journal of Neuroradiology, 2014
- JOURNAL CLUB: Incidental Thyroid Nodules Detected at Imaging: Can Diagnostic Workup Be Reduced by Use of the Society of Radiologists in Ultrasound Recommendations and the Three-Tiered System?American Journal of Roentgenology, 2014
- Risk of Thyroid Cancer Based on Thyroid Ultrasound Imaging CharacteristicsJAMA Internal Medicine, 2013
- Outcomes of incidentally discovered thyroid nodules referred to a high‐volume head and neck surgeonHead & Neck, 2013
- Incidentally discovered thyroid nodules: frequency in an adult population during Doppler ultrasonographic evaluation of cervical vesselsEndocrine, 2013
- Incidental Thyroid Nodules on CT: Evaluation of 2 Risk-Categorization Methods for Work-Up of NodulesAmerican Journal Of Neuroradiology, 2013
- The Impact of Thyroid Nodule Size on the Risk of Malignancy and Accuracy of Fine-Needle Aspiration: A 10-Year Study from a Single InstitutionThyroid®, 2012
- The Bethesda System for Reporting Thyroid Cytopathology: A Meta-AnalysisActa Cytologica, 2011
- The Prevalence and Significance of Incidental Thyroid Nodules Identified on Computed TomographyJournal of Computer Assisted Tomography, 2008