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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2012; 22(01): 63-68
DOI: 10.4103/0971-3026.95407
Neuroradiology and Head & Neck Radiology

Utility of gray-scale ultrasound to differentiate benign from malignant thyroid nodules

Manju Bala Popli
Department of Radiological Imaging, Institute of Nuclear Medicine and Allied Sciences (INMAS), Delhi, India
,
Ashita Rastogi
Department of Radiological Imaging, Institute of Nuclear Medicine and Allied Sciences (INMAS), Delhi, India
,
PJS Bhalla
Department of Cytopathology, Institute of Nuclear Medicine and Allied Sciences (INMAS), Delhi, India
,
Yachna Solanki
Department of Radiological Imaging, Institute of Nuclear Medicine and Allied Sciences (INMAS), Delhi, India
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Abstract

Objective: The objective was to assess the utility of gray-scale USG to identify patterns of thyroid nodules and to correlate the characteristics of benign and malignant nodules with pathological diagnosis. Materials and Methods: From September 2009 to August 2010, a total of 203 patients (17 males and 186 females), with 240 nodules detected at USG, were included in this study. The characteristics of each nodule were determined. The results were then compared with fine needle aspiration (FNA)/histopathological diagnosis. Results: Of the 240 nodules examined, 44 (18.33%) were found to be malignant on cytopathology. The malignant nodules demonstrated solid or predominantly solid composition (sensitivity 88.6%, specificity 53.5%); presence of microcalcification (sensitivity 65.9%, specificity 97.9%); irregular or poorly defined margins (sensitivity 84%, specificity 88.7%); anteroposterior (AP) diameter > transverse diameter (sensitivity 77.2%, specificity 80.1%); absent or thick incomplete halo (sensitivity 70.4%, specificity 65.8%); and markedly hypoechoic character (sensitivity 65.9%, specificity 84.6%). Among males, malignant nodules were found in 36.8%, whereas in females the occurrence was 16.7%. Conclusion: Gray-scale USG features of thyroid nodules are useful to distinguish patients with clinically significant thyroid nodules from those with innocuous nodules despite the overlap of findings. From our study, it is apparent that the USG findings of poorly defined margins, marked hypoechogenicity, microcalcifications, and a taller-than-wider shape have a high diagnostic accuracy for identifying malignant thyroid nodules.

Keywords

Thyroid - nodule - ultrasonography


Publication History

Article published online:
30 July 2021

© 2012. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Solbiati L, Charboneau JW, Osti V, James EM, Hay ID. The Thyroid Gland. In: Wilson SR, Charboneau JW, Rumack CM, editors. Diagnostic Ultrasound. 3 rd ed. Missouri: Mosby, Elsevier Inc.; 2005. p. 735-70.
  • 2 Yeung MJ, Serpell JW. Management of the solitary thyroid nodule. Oncologist 2008;13:105-12.
  • 3 Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ. Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2009;19:1167-214.
  • 4 Mortenson J, Woolner L, Benneu W. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab 1955;15:1270-80.
  • 5 Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, et al. Management of Thyroid Nodules Detected at US: society of Radiologists in Ultrasound Consensus Conference Statement. Radiology 2005;237:794-800.
  • 6 Hoang JK, Lee WK, Lee M, Johnson D, Farrell S. US Features of Thyroid Malignancy: Pearls and Pitfalls. Radiographics 2007;27:847-65.
  • 7 Sipos JA. Advances in Ultrasound for the Diagnosis and Management of Thyroid Cancer. Thyroid 2009;19:1363-72.
  • 8 Kim MJ, Kim EK, Kwak JY, Park CS, Chung WY, Nam KH. Differentiation of thyroid nodules with macrocalcifications role of suspicious sonographic findings. J Ultrasound Med 2008;27:1179-84.
  • 9 Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, et al. Benign and malignant thyroid nodules: US differentiation - multicenter retrospective study. Radiology 2008;247:762-70.
  • 10 Samghabadi MA, Rahmani M, Saberi H, Behjati J, Firouznia K, Ghasemian A. Sonography and color doppler in the evaluation of cold thyroid nodules. Iran J Radiol 2004;2:12-17.
  • 11 Bonavita JA, Mayo J, Babb J, Bennett G, Oweity T, Macari M, et al. Pattern recognition of benign nodules at ultrasound of the thyroid: Which nodules can be left alone? AJR Am J Roentgenol 2009;193:207-13.
  • 12 Kim EK, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 2002;178:687-91.
  • 13 Cappelli C, Castellano M, Pirola I, Gandossi E, De Martino E, Cumetti D, et al. Thyroid nodule shape suggests malignancy. Eur J Endocrinol 2006;155:27-31.
  • 14 Popowicz B, Klencki M, Lewinski A, Slowinska-Klencka D. The usefullness of sonographic features in selection of thyroid nodules for biopsy in relation to the nodules′s size. Eur J Endocrinol 2009;161:103-11.
  • 15 Alexander EK, Marqusee E, Orcutt J, Benson CB, Frates MC, Doubilet PM, et al. Thyroid nodule shape and predicition of malignancy. Thyroid 2004;14:953-8.