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Differentiation between Benign and Malignant Solid Thyroid Nodules Using an US Classification System

2011; Korean Society of Radiology; Volume: 12; Issue: 5 Linguagem: Inglês

10.3348/kjr.2011.12.5.559

2005-8330

Young Hun Lee, Dong Wook Kim, Hyun Sin In, Ji Sung Park, Sang Hyo Kim, Jae Wook Eom, Bomi Kim, Eun Joo Lee, Myung Ho Rho,

Head and Neck Anomalies

Objective: To evaluate the diagnostic accuracy of a new ultrasound (US) classification system for differentiating between benign and malignant solid thyroid nodules. Materials and Methods:In this study, we enrolled 191 consecutive patients who received real-time US and subsequent US diagnoses for solid thyroid nodules, and underwent US-guided fine-needle aspiration.Each thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by real-time US: "malignant," "suspicious for malignancy," "borderline," "probably benign," and "benign".We evaluated the diagnostic accuracy of thyroid US and the cut-off US criteria by comparing the US diagnoses of thyroid nodules with cytopathologic results.Results: Of the 191 solid nodules, 103 were subjected to thyroid surgery.US categories for these 191 nodules were malignant (n = 52), suspicious for malignancy (n = 16), borderline (n = 23), probably benign (n = 18), and benign (n = 82).A receiver-operating characteristic curve analysis revealed that the US diagnosis for solid thyroid nodules using the 5-category US classification system was very good.The sensitivity, specificity, positive and negative predictive values, and accuracy of US diagnosis were 86%, 95%, 91%, 92%, and 92%, respectively, when benign, probably benign, and borderline categories were collectively classified as benign (negative). Conclusion:The diagnostic accuracy of thyroid US for solid thyroid nodules is high when the above-mentioned US classification system is applied.