THE PREDICTIVE VALUE OF ULTRASONOGRAPHY FOR POTENTIALLY MALIGNANT THYROID NODULES

Abstract

Objective: In this study, we aimed to predict the malignancy potential of a thyroid nodule based on ultrasonography (US) features. Material and Method: The data of 726 nodules in 619 patients who underwent thyroidectomy between 2005 and 2012 at Istanbul University, Istanbul Medical Faculty were retrospectively analyzed. US features of nodules were recorded and matched with pathology reports and each US feature was evaluated for diagnostic value. Results: The study group consisted of mainly female patients (86.9%) and the mean age was 46,3 years. Thyroid cancer was detected in 374 (51.7%) nodules and the most common type was papillary thyroid cancer 97% (n=341). Microcalcifications (p=0.0001), irregular margin (p=0.001) and hypoechogenicity (p=0.038) were correlated with malignancy. The absence of any of these suspicious US features significantly predicted benign disease (p=0.0001). An increasing number of suspicious features predicted malign disease with increasing specificity, positive predictive value, and likelihood ratio. Microcalcifications and irregular borders had high specificity (>80%) to predict thyroid cancer. Conclusion: The presence of microcalcifications, irregular margin, and hypoechogenicity in a thyroid nodule significantly correlates with malignant disease. Microcalcifications and irregular borders had high specificity to predict thyroid cancer. The probability of thyroid cancer increases with an increasing number of suspicious US features.