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KMID : 0361820110300030179
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Journal of the Korean Society of Medical Ultrasound
2011 Volume.30 No. 3 p.179 ~ p.185
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US Diagnosis for Thyroid Nodules with an Indeterminate Cytology
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Ha Jong-Geun
Kim Dong-Wook
Kang Tae-Woo
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Abstract
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Purpose: We wanted to assess the diagnostic efficacy of thyroid ultrasound (US) for evaluating thyroid nodules with indeterminate cytology.
Materials and Methods : Among 1865 nodules in 1278 patients who received a prospective US diagnosis of their thyroid nodule(s) and who subsequently underwent US-guided fine-needle aspiration, 130 nodules with indeterminate cytology were enrolled in the study. Each thyroid nodule was prospectively classified by a single radiologist into 1 of 5 diagnostic categories: “benign”, “probably benign”, “indeterminate”, “suspicious for malignancy” and “malignant.” The solid nodules were classified using all 5 categories and the partially cystic nodules classified using 4 categories (“indeterminate” was omitted). We calculated the diagnostic efficacy of thyroid US by comparing the US diagnoses with the pathology results.
Results: Of 130 nodules with indeterminate cytology (130/1865, 7.0%), 62 nodules were surgically removed. Nineteen nodules were assigned to the indeterminate category on US. The malignantly rate of the US-indeterminate category was 56.5% (35/62). The sensitivity, specificity and positive and negative predictive values were 81.0%, 81.8%, 81.0%, 81.8% and 81.4%, respectively, when US-indeterminate nodules were excluded. There was no significant difference of diagnostic efficacy when these nodules were reclassified as malignant, but there was a significant difference of diagnostic efficacy when these nodules were reclassified as benign.
Conclusion: Our US classification may be a feasible method for managing thyroid nodules with indeterminate cytology.
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KEYWORD
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Thyroid nodule, Ultrasound, Fine-needle aspiration, Indeterminate
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