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: Heui Jin Jung, Na Lae Eun, Eun Ju Son, Jeong-Ah Kim, Ji Hyun Youk, Hye Sun Lee, Soyoung Jeon
Format: Article
Language:English
Published: The Korean Society of Radiology 2025-01-01
Series:Journal of the Korean Society of Radiology
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Online Access:https://doi.org/10.3348/jksr.2024.0016
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author Heui Jin Jung
Na Lae Eun
Eun Ju Son
Jeong-Ah Kim
Ji Hyun Youk
Hye Sun Lee
Soyoung Jeon
author_facet Heui Jin Jung
Na Lae Eun
Eun Ju Son
Jeong-Ah Kim
Ji Hyun Youk
Hye Sun Lee
Soyoung Jeon
author_sort Heui Jin Jung
collection DOAJ
description 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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spelling doaj-art-4bdabb9b165843718b71bf34a8dabfe32025-01-31T07:32:28ZengThe Korean Society of RadiologyJournal of the Korean Society of Radiology2951-08052025-01-01861114126https://doi.org/10.3348/jksr.2024.0016Ultrasound 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 CytopathologyHeui Jin JungNa Lae EunEun Ju SonJeong-Ah KimJi Hyun YoukHye Sun LeeSoyoung JeonPurpose 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.https://doi.org/10.3348/jksr.2024.0016thyroid neoplasmsthyroid noduleultrasonographybiopsyfine-needle
spellingShingle Heui Jin Jung
Na Lae Eun
Eun Ju Son
Jeong-Ah Kim
Ji Hyun Youk
Hye Sun Lee
Soyoung Jeon
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
Journal of the Korean Society of Radiology
thyroid neoplasms
thyroid nodule
ultrasonography
biopsy
fine-needle
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic thyroid neoplasms
thyroid nodule
ultrasonography
biopsy
fine-needle
url https://doi.org/10.3348/jksr.2024.0016
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