Classification and Regression Tree (CART) model of sonographic signs in predicting thyroid nodules malignancy
| Autor: | Gaelle Boustany, Zahra Charara, Georges Halaby, Ghassan Sleilaty, Tarek Smayra, Lina Menassa-Moussa |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Thyroid nodules
Cart lcsh:Medical physics. Medical radiology. Nuclear medicine medicine.medical_specialty endocrine system endocrine system diseases lcsh:R895-920 Biopsy Thyroid neoplasms Malignancy Article 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Fine needle aspiration cytology medicine Radiology Nuclear Medicine and imaging Thyroid nodule Ultrasonography medicine.diagnostic_test business.industry Thyroid Echogenicity Nodule (medicine) medicine.disease humanities Fine-needle medicine.anatomical_structure 030220 oncology & carcinogenesis Radiology medicine.symptom business human activities |
| Zdroj: | European Journal of Radiology Open European Journal of Radiology Open, Vol 6, Iss, Pp 343-349 (2019) |
| ISSN: | 2352-0477 |
| Popis: | Highlights • Taller-than-wide thyroid nodules are more likely to require surgery. • A taller-than-wide, solid and hypoechoic thyroid nodule is likely a Bethesda 4 or 5. • Taller-than-wide sonographic sign is the strongest in predicting thyroid malignancy. Purpose To develop a Classification and Regression Tree (CART) model in order to recognize the most suspicious sonographic features of thyroid nodules and efficiently guide their management. Methods 791 thyroid fine needle aspiration cytology (FNAC) performed under ultrasound guidance between January 2015 and January 2017 were reviewed. Retrieved data consisted in qualitative (patient’s gender, composition, echogenicity, shape, margins and echogenic foci of the nodule) and quantitative (patient’s age and maximal diameter of the nodule) variables as well as the Bethesda score. Results Patients were 48.5 ± 13.7 years old with female to male ratio of 8:2. The nodules had median size of 2.3 (1.5–3.5) cm with a majority of solid (62.5 %) and isoechoic (50.8 %) features. 700 nodules (88.5 %) had a wider-than-tall shape, 600 (75.9 %) smooth margins and 113 (14.3 %) ill-defined ones. Echogenic foci were absent in 388 nodules (49.1 %) and, when present, largely dominated by punctate foci (32.5 %). Bethesda classes 3, 4 and 5, which require surgery, represented only 10.6 % of cases. They were significantly correlated with the taller-than-wide shape and with solid or predominantly solid features. There was no significant correlation between echostructure and Bethesda scores but we did find more nodules classified Bethesda 4 and 5 in the categories hypoechoic and severely hypoechoic. In the CART model we developed, the sequence leading to most nodules classified Bethesda 4 and 5 is: taller-than-wide shape, solid composition and hypoechoic or severely hypoechoic feature. Conclusions Taller-than-wide, solid or predominantly solid, hypoechoic or severely hypoechoic nodules are likely to require surgery and might benefit from FNAC. |
| Databáze: | OpenAIRE |
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