Echogenicity as a standalone nodule characteristic is not inferior to the TIRADS systems in the 10-20 mm nodule diameter range in patient selection for fine needle aspiration: a pilot study.

Autor:	Rucz K; Department of Endocrinology, Siofok Hospital, Siofok, Hungary., Hegedűs L; Department of Endocrinology, Odense University Hospital, Odense, Denmark., Bonnema SJ; Department of Endocrinology, Odense University Hospital, Odense, Denmark., Frasoldati A; Endocrinology Unit of Arcispedale S. Maria Nuova, Reggio Emilia, Italy., Jambor L; Institute of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Kovacs GL; 1st Department of Medicine, Flohr Ferenc Hospital, Kistarcsa, Hungary., Papini E; Regina Apostolorum Hospital in Albano, Rome, Italy., Russ G; Unité Thyroïde et Tumeurs Endocrines - Pr Leenhardt Hôpital La Pitie Salpetriere, Sorbonne Université, Paris, France., Karanyi Z; Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Nagy EV; Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary., Solymosi T; Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Jazyk:	angličtina
Zdroj:	European thyroid journal [Eur Thyroid J] 2024 Nov 06; Vol. 13 (6). Date of Electronic Publication: 2024 Nov 06 (Print Publication: 2024).
DOI:	10.1530/ETJ-24-0149
Abstrakt:	Objective: The ultrasound evaluation of thyroid nodules (TNs) in patient selection for fine needle aspiration (FNA) requires both uniformly accepted definitions of each nodule characteristic and extensive experience from the examiner. We hypothesized that nodule echogenicity alone may provide comparable performance to more complex approaches in patient selection for FNA. Patients and Methods: Seven highly experienced investigators from four countries evaluated, online, the ultrasound (US) video recordings of 123 histologically verified TN by answering 17 nodule characteristics-related questions. The diagnostic performances of five TN image reporting and data systems (TIRADS) were compared to making decisions based solely on the echogenicity of the nodule for indicating FNA in 110 nodules ≥10 mm. Results: In the 10-20 mm size range, the sensitivities and specificities of the five TIRADS systems in identifying malignant nodules were 80.5-91.0% and 31.4-50.9%, respectively. Had FNA been recommended for all hypoechoic nodules, disregarding other US characteristics, comparable sensitivity and specificity (87.5% and 43.4%, respectively) were obtained. Compared to nodules >20 mm, a higher proportion of cancers were hypoechoic in the 10-20 mm size range (87.2% vs 77.8%, P = 0.05). In the 10-20 mm size range, compared to hypoechoic nodules, a significantly lower proportion of isoechoic nodules demonstrated suspicious findings (70.7% vs 30.0%, P < 0.05). Conclusion: In contrast to >20 mm diameter nodules, the recommendation of FNA may rely on a single US feature, echogenicity, in the 10-20 mm size range. If independently confirmed in larger cohorts, this may simplify nodule evaluation in this size range.
Databáze:	MEDLINE
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