Thyroid Nodules with Indeterminate Cytology: Utility of the American Thyroid Association Sonographic Patterns for Cancer Risk Stratification

Thyroid : Official Journal of the American Thyroid Association
Pablo ValderrabanoBryan McIver

Abstract

The 2015 American Thyroid Association (ATA) guidelines recommend using a classification based on sonographic patterns to set the size threshold for biopsies. Each pattern is associated with a distinct estimated rate of malignancy that it was hypothesized should stratify the risk of malignancy of cytologically indeterminate thyroid nodules (ITNs). Ultrasound images of 463 ITNs (38% atypia/follicular lesions of undetermined significance; 62% follicular neoplasms) with histological follow-up consecutively evaluated between October 2008 and June 2015 at the authors' academic cancer center were independently evaluated by three observers and classified into one of the five sonographic patterns proposed by the ATA. Nodules with sonographic patterns not defined in the classification were grouped into a non-ATA pattern category. Differences in clinical and histological findings between the sonographic patterns were assessed. The prevalence of malignancy and odds ratio for malignancy were calculated for each sonographic pattern (low and intermediate patterns were collapsed for the analysis). The distribution of size and cytological diagnosis was significantly different between sonographic patterns (p < 0.001). The overall rate of maligna...Continue Reading

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Citations

Aug 17, 2019·Journal of Clinical Ultrasound : JCU·Joel M Fradin
Jan 9, 2020·BMJ : British Medical Journal·Naykky Singh OspinaM Regina Castro
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Jun 15, 2021·Frontiers in Endocrinology·Yunhai LiGuosheng Ren

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Methods Mentioned

BETA
biopsy
biopsies

Software Mentioned

R
SAS

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