Ultrasound Findings Suggestive of Malignancy in Thyroid Nodules Classified as Follicular Lesion of Undetermined Significance or Follicular Neoplasm based on the 2017 Bethesda System for Reporting Thyroid Cytopathology
Purpose To identify US findings suggestive of malignancy in thyroid nodules with follicular lesions of undetermined significance (FLUS) or follicular neoplasm (FN) on fine-needle aspiration cytology (FNAC) and evaluate the diagnostic performance. Materials and Methods Seventy FLUS (n = 57) or FN...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Korean Society of Radiology
2025-01-01
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| Series: | Journal of the Korean Society of Radiology |
| Subjects: | |
| Online Access: | https://doi.org/10.3348/jksr.2024.0016 |
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| Summary: | Purpose To identify US findings suggestive of malignancy in thyroid nodules with follicular
lesions of undetermined significance (FLUS) or follicular neoplasm (FN) on fine-needle aspiration
cytology (FNAC) and evaluate the diagnostic performance.
Materials and Methods Seventy FLUS (n = 57) or FN (n = 13) nodules on FNAC that underwent
surgical excision between February 2018 and November 2020 were selected. US findings
were retrospectively reviewed. Orientation, margin, echogenicity, calcification, additional
findings of the rim, echogenicity, heterogeneity of the solid portion, and the ratio of
anterior posterior diameter to lateral diameter (criteria) were assessed. The diagnostic performances
of US findings, criteria, and the Korean Society of Thyroid Radiology Thyroid Imaging
Reporting and Data System (K-TIRADS) were evaluated using logistic regression analysis. Results Microcalcification, homogeneous solid echotexture, and thickened rims were suggestive of
malignancy. Our criteria showed a highest area under the ROC curve (AUC) value of 0.771, sensitivity of
97.14%, accuracy of 77.14%, positive predictive value of 93.33%, negative predictive value of 95.24%,
and specificity of 97.14%. The criteria showed a significantly higher AUC value than K-TIRADS.
Conclusion US findings of homogenous solid portions, thick rims, and microcalcifications suggested
malignancy in nodules with FLUS or FN on FNAC. These additional US findings could improve the diagnostic
performance of K-TIRADS. |
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| ISSN: | 2951-0805 |