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KMID : 0880420110120040416
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Korean Journal of Radiology
2011 Volume.12 No. 4 p.416 ~ p.424
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Differentiation between Benign and Malignant Solid Thyroid Nodules Using an US Classification System
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Lee Young-Hun
Kim Dong-Wook
In Hyun-Sin
Park Ji-Sung
Kim Sang-Hyo
Eom Jae-Wook
Kim Bo-Mi
Lee Eun-Joo
Rho Myung-Ho
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Abstract
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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.
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KEYWORD
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Thyroid nodule, Solid, Ultrasound, Fine-needle aspiration, Classification, Malignancy
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