Nina Baier, Presenter: Nothing to Disclose

Peter F. Hahn MD, PhD, Abstract Co-Author: Nothing to Disclose

Debra Ann Gervais MD, Abstract Co-Author: Speakers Bureau, Covidien AG Research grant, Covidien AG

Anthony Edward Samir MBBCh, Abstract Co-Author: Nothing to Disclose

Peter Raff Mueller MD, Abstract Co-Author: Nothing to Disclose

Mukesh Gobind Harisinghani MD, Abstract Co-Author: Nothing to Disclose

To determine the likelihood for malignancy in thyroid nodules based on the ultrasonographic (US) assessment of size, morphology, presence of microcalcification and lymphadenopathy.

Between 2002 and 2007, 781 thyroid nodules (161 male; 621 female) were identified retrospectively who had undergone an ultrasound followed by histopathological assessment. Four sonographic features were recorded from previous reports: Longest dimension (<10mm, ≥10mm), morphology (solid, cystic, mixed), presence of microcalcifications, presence of lymphadenopathy. Final diagnosis of each nodule was classified as benign or malignant based on surgical pathology when available and on cytology otherwise. Individual US features, as well as combinations of them were analyzed for their correlation with benignity or malignancy.

The overall prevalence of malignancy was 15.6%. Younger age (mean age 50.1 for malignant vs. 55.9 yrs for benign nodules; Odds Ratio 0.979, p=0.002) and male gender (Odds Ratio 1.623, p=0.039) showed a significant correlation with malignancy. Intra-group comparison of US features among benign and malignant nodules resulted in the identification of solid morphology as the only statistically significant predictor for malignancy (83.7% sensitivity, 28.4% specificity, p=0.006). Neither size, presence of microcalcifications, presence of lymphadenopathy or all possible combinations of two to four US features showed any significant difference between benign and malignant nodules. Concomitant presence of all US features known as possible predictors for malignancy resulted in a 1.644 fold increased risk for malignancy, this risk still being lower than that of the feature solid morphology alone (Odds Ratio 2.067).

In our study the only statistically significant US predictor for malignancy was solid morphology, no other US feature could add additional information. Furthermore younger age and male gender were correlated with an increased risk for malignancy.

US assessment of morphology remains to be the most important predictor for malignancy in thyroid nodules, and adding additional US information does not increase this predictability.

Baier, N, Hahn, P, Gervais, D, Samir, A, Mueller, P, Harisinghani, M, Predictability of Malignancy in Thyroid Nodules Based on Individual or Combined Ultrasonographic Features.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6016568.html