Correlation of Hot Nodules and Cytopathology: Nine Years at an Academic Institution

Abstract

Background: Thyroid nodules are frequently diagnosed in everyday clinical practice. Strategies for the evaluation of their potential malignant risk and clinical management approaches have been widely developed by multiple endocrine and surgical societies. These guidelines are dynamically changing and the malignant potential of a hot thyroid nodule has become a matter of debate. Methods: All thyroid scans (n=137) performed at our institution over nine years (January 2003 to December 2012), for which a cytopathology result was available for review were retrospectively reanalyzed by an experienced nuclear medicine physician. 65 scans demonstrated clearly hot nodules and were correlated with cytopathology results. Results: Only one of sixty-five nodules (1.5%) was found to be malignant: a Hurthle cell carcinoma. An additional papillary thyroid carcinoma was found incidentally in another patient, however corresponding to a cold nodule in the contralateral lobe to the hot nodule. Conclusions: A hot nodule on a thyroid scan likely confers an overall low but non-negligible risk for malignancy. Further studies on larger datasets pooled from various centers would be valuable.