Prediction of thyroid nodule histopathology by expert ultrasound evaluation
| Autor: | Henrik Stenestø Foshaug, Olav Inge Håskjold, Vegard Heimly Brun, Helga Charlotte Kjøren, Therese Benedikte Iversen |
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| Rok vydání: | 2021 |
| Předmět: |
Thyroid nodules
endocrine system medicine.medical_specialty Adenoma Endocrinology Diabetes and Metabolism Colloid nodule overdiagnosis Malignancy Diseases of the endocrine glands. Clinical endocrinology Thyroid carcinoma Endocrinology Internal Medicine medicine VDP::Medisinske Fag: 700 Thyroid cancer overtreatment accuracy ultrasound business.industry Research Thyroid Nodule (medicine) RC648-665 medicine.disease VDP::Medical disciplines: 700 medicine.anatomical_structure thyroid nodule cytology Radiology medicine.symptom business |
| Zdroj: | Endocrine Connections, Vol 10, Iss 7, Pp 776-781 (2021) Endocrine Connections |
| ISSN: | 2049-3614 |
| DOI: | 10.1530/ec-21-0192 |
| Popis: | Objective The basis of thyroid nodule diagnostics is ultrasound-guided fine needle biopsy with cytological evaluation (FNC) if ultrasound appearance is not clearly benign. The aim of this study was to investigate the predictive potential of dedicated, expert high-resolution ultrasound, to see if histopathological entities of thyroid nodules can be diagnosed without invasive FNC biopsies. Design Prospective case-cohort study. Methods 187 patients with 221 thyroid nodules were examined with ultrasound and prospectively assigned to the expected histopathological diagnosis: colloid nodule, adenomatoid colloid nodule, follicular adenoma, follicular carcinoma, follicular variant of papillary thyroid carcinoma, papillary thyroid carcinoma, or other thyroid cancer. In 101 of these, we later obtained histopathological reports for comparison. Results Overall accuracy for classification into discrete histopathological categories by expert ultrasound was 71.3% and Cohen’s Kappa was 0.62. The sensitivity and specificity for detecting malignancy were 97.3% and 78.1%. The diagnostic accuracy for malignancy was 85.1%. ACR-TIRADS scores for the same nodules had a sensitivity of 97.3%, specificity of 26.6%, and accuracy of 52.5%. Conclusion Dedicated expert high-resolution ultrasound without FNC can reliably distinguish benign vs malignant nodules, but also differentiate between several histopathological entities in thyroid nodules. There is potential for a reduction in the number of invasive FNC biopsies and diagnostic operations. |
| Databáze: | OpenAIRE |
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