Risk Stratification of Thyroid Nodules Diagnosed as Bethesda Category III by Ultrasound, Size, and Cytology.

Autor:	Ahn HS; Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea., Na DG; Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.; Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Republic of Korea. nndgna@gmail.com., Kim JH; Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jazyk:	angličtina
Zdroj:	Korean journal of radiology [Korean J Radiol] 2024 Oct; Vol. 25 (10), pp. 924-933.
DOI:	10.3348/kjr.2024.0292
Abstrakt:	Objective: This study aimed to evaluate the performance of an integrated risk stratification system (RSS) based on ultrasound (US) RSSs, nodule size, and cytology subcategory for diagnosing malignancy in thyroid nodules initially identified as Bethesda category III on fine-needle aspiration. Materials and Methods: This retrospective study was conducted at two institutions and included consecutive patients with Bethesda category III nodules, and final diagnoses confirmed by repeat biopsy or surgery. A total of 320 Bethesda category III nodules (≥1 cm) from 309 patients (223 female and 86 male; mean age, 50.9 ± 12.0 years) were included. The malignancy risk of Bethesda category III nodules and predictors of malignancy were assessed according to US RSSs, nodule size, and cytology subcategory. The diagnostic performances of US-size cytology (USC) RSS and US RSS alone for malignancy were compared. Results: The intermediate or high suspicion US category independently increased the malignancy risk in all US RSSs ( P ≤ 0.001). Large nodule size (≥3 cm) independently increased the malignancy risk of low- or intermediate suspicion US category nodules. Additionally, the atypia of undetermined significance cytology subcategory independently increased the malignancy risk of low suspicion US category nodules in most US RSSs. The area under the receiver operating characteristic curve of the USC RSSs was greater than that of the US RSSs alone ( P < 0.048). Malignancy was not found in the very low risk category of USC RSS. Conclusion: The diagnostic performance of USC RSS for malignancy was superior to that of US RSS alone in Bethesda category III nodules. Malignancy can be ruled out in the very low-risk category of USC RSS. Competing Interests: The authors have no potential conflicts of interest to disclose. (Copyright © 2024 The Korean Society of Radiology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu