Prospective Evaluation of the McGill Thyroid Nodule Score

Abstract

Objective: 1) Familiarize the audience with the new McGill Thyroid Nodule Score (MTNS) scoring system for thyroid nodules. 2) Present the statistics on the MTNS and why we feel this is a great adjunct in the management of thyroid nodules. 3) Describe a new tool at the clinician’s disposal that will help better manage patients with thyroid nodules. Method: This is a prospective study. A total of 245 consecutive patients were enrolled between July 2009 and March 2011. McGill Thyroid Nodule Score (MTNS), age, gender, and extent of surgery were recorded preoperatively. Final pathology was recorded postthyroidectomy. The percentage of malignancy was calculated for each MTNS score. Using Fisher exact test, the risk of malignancy for each group was compared to that anticipated based on the MTNS. We then used linear regression to plot a best fit curve for both the retrospective and prospective data and compared the 2. Results: We found no statistically significant difference when comparing the risk of malignancy between the retrospective group originally used to create the MTNS and the prospective group used to validate this tool with P > .05 for all groups. Regression analysis revealed linear curves and also showed no significant difference between both groups ( P = .35). Conclusion: The MTNS system has been validated prospectively and is a unified and individualized tool to help clinicians with multiple aspects in the management of patients with thyroid nodules. This includes discussion with patients regarding the risk of their nodules harbouring malignancy, decisions regarding extent of surgery, and discussion between physicians.