A nomogram for predicting malignancy in thyroid nodules diagnosed as atypia of undetermined significance/follicular lesions of undetermined significance on fine needle aspiration

Jung Hyun Yoon, Hye Sun Lee, Eunkyung Kim, Hee Jung Moon, jinyoung kwak

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background We hypothesized that a nomogram constructed of clinical and imaging variables could be applied to predicting the risk of malignancy in thyroid nodules diagnosed as atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS) on ultrasonographic fine-needle aspiration (US-FNA). Methods This retrospectively designed study included 393 thyroid nodules in 392 patients (mean age, 49 ± 12 years), which were diagnosed as AUS/FLUS with US-FNA during the study period. Medical records, US images, and cytopathology results were reviewed and analyzed. The 393 thyroid nodules were divided into training and validation sets. Logistic regression analysis was performed to predict the probability of malignancy, and nomograms were constructed using the training set and subsequently applied to the validation set. Results Three sets of nomograms were constructed separately using clinical factors and (1) individual US features; (2) final assessment of US; and (3) the number of suspicious US features. All 3 sets of nomograms built were proven accurate and discriminative, these nomograms had an area under the receiver operating characteristic curve (AUC) of 0.817 (95% confidence interval [CI], 0.757-0.877) when using clinical factors and individual US features, an AUC of 0.769 (95% CI, 0.705-0.833) wen using final assessment, and an AUC of 0.779 (95% CI, 0.718-0.840) when using the number of suspicious US features. The AUC of each validation set was 0.754 (95% CI, 0.659-0.850), 0.757 (95% CI, 0.661-0.853), and 0.721 (95% CI, 0.621-0.820), respectively. Conclusion Nomograms constructed in our study using US can be utilized in predicting the probability of malignancy in thyroid nodules diagnosed as AUS/FLUS on US-FNA, and may help in selecting patients who are at high risk for malignancy.

Original languageEnglish
Pages (from-to)1006-1013
Number of pages8
JournalSurgery (United States)
Volume155
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Nomograms
Thyroid Nodule
Fine Needle Biopsy
Confidence Intervals
Area Under Curve
Neoplasms
ROC Curve
Medical Records
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{3150ec9d9715461299d6b1f39f9ee22c,
title = "A nomogram for predicting malignancy in thyroid nodules diagnosed as atypia of undetermined significance/follicular lesions of undetermined significance on fine needle aspiration",
abstract = "Background We hypothesized that a nomogram constructed of clinical and imaging variables could be applied to predicting the risk of malignancy in thyroid nodules diagnosed as atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS) on ultrasonographic fine-needle aspiration (US-FNA). Methods This retrospectively designed study included 393 thyroid nodules in 392 patients (mean age, 49 ± 12 years), which were diagnosed as AUS/FLUS with US-FNA during the study period. Medical records, US images, and cytopathology results were reviewed and analyzed. The 393 thyroid nodules were divided into training and validation sets. Logistic regression analysis was performed to predict the probability of malignancy, and nomograms were constructed using the training set and subsequently applied to the validation set. Results Three sets of nomograms were constructed separately using clinical factors and (1) individual US features; (2) final assessment of US; and (3) the number of suspicious US features. All 3 sets of nomograms built were proven accurate and discriminative, these nomograms had an area under the receiver operating characteristic curve (AUC) of 0.817 (95{\%} confidence interval [CI], 0.757-0.877) when using clinical factors and individual US features, an AUC of 0.769 (95{\%} CI, 0.705-0.833) wen using final assessment, and an AUC of 0.779 (95{\%} CI, 0.718-0.840) when using the number of suspicious US features. The AUC of each validation set was 0.754 (95{\%} CI, 0.659-0.850), 0.757 (95{\%} CI, 0.661-0.853), and 0.721 (95{\%} CI, 0.621-0.820), respectively. Conclusion Nomograms constructed in our study using US can be utilized in predicting the probability of malignancy in thyroid nodules diagnosed as AUS/FLUS on US-FNA, and may help in selecting patients who are at high risk for malignancy.",
author = "Yoon, {Jung Hyun} and Lee, {Hye Sun} and Eunkyung Kim and Moon, {Hee Jung} and jinyoung kwak",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.surg.2013.12.035",
language = "English",
volume = "155",
pages = "1006--1013",
journal = "Surgery",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - A nomogram for predicting malignancy in thyroid nodules diagnosed as atypia of undetermined significance/follicular lesions of undetermined significance on fine needle aspiration

AU - Yoon, Jung Hyun

AU - Lee, Hye Sun

AU - Kim, Eunkyung

AU - Moon, Hee Jung

AU - kwak, jinyoung

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background We hypothesized that a nomogram constructed of clinical and imaging variables could be applied to predicting the risk of malignancy in thyroid nodules diagnosed as atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS) on ultrasonographic fine-needle aspiration (US-FNA). Methods This retrospectively designed study included 393 thyroid nodules in 392 patients (mean age, 49 ± 12 years), which were diagnosed as AUS/FLUS with US-FNA during the study period. Medical records, US images, and cytopathology results were reviewed and analyzed. The 393 thyroid nodules were divided into training and validation sets. Logistic regression analysis was performed to predict the probability of malignancy, and nomograms were constructed using the training set and subsequently applied to the validation set. Results Three sets of nomograms were constructed separately using clinical factors and (1) individual US features; (2) final assessment of US; and (3) the number of suspicious US features. All 3 sets of nomograms built were proven accurate and discriminative, these nomograms had an area under the receiver operating characteristic curve (AUC) of 0.817 (95% confidence interval [CI], 0.757-0.877) when using clinical factors and individual US features, an AUC of 0.769 (95% CI, 0.705-0.833) wen using final assessment, and an AUC of 0.779 (95% CI, 0.718-0.840) when using the number of suspicious US features. The AUC of each validation set was 0.754 (95% CI, 0.659-0.850), 0.757 (95% CI, 0.661-0.853), and 0.721 (95% CI, 0.621-0.820), respectively. Conclusion Nomograms constructed in our study using US can be utilized in predicting the probability of malignancy in thyroid nodules diagnosed as AUS/FLUS on US-FNA, and may help in selecting patients who are at high risk for malignancy.

AB - Background We hypothesized that a nomogram constructed of clinical and imaging variables could be applied to predicting the risk of malignancy in thyroid nodules diagnosed as atypia of undetermined significance/follicular lesions of undetermined significance (AUS/FLUS) on ultrasonographic fine-needle aspiration (US-FNA). Methods This retrospectively designed study included 393 thyroid nodules in 392 patients (mean age, 49 ± 12 years), which were diagnosed as AUS/FLUS with US-FNA during the study period. Medical records, US images, and cytopathology results were reviewed and analyzed. The 393 thyroid nodules were divided into training and validation sets. Logistic regression analysis was performed to predict the probability of malignancy, and nomograms were constructed using the training set and subsequently applied to the validation set. Results Three sets of nomograms were constructed separately using clinical factors and (1) individual US features; (2) final assessment of US; and (3) the number of suspicious US features. All 3 sets of nomograms built were proven accurate and discriminative, these nomograms had an area under the receiver operating characteristic curve (AUC) of 0.817 (95% confidence interval [CI], 0.757-0.877) when using clinical factors and individual US features, an AUC of 0.769 (95% CI, 0.705-0.833) wen using final assessment, and an AUC of 0.779 (95% CI, 0.718-0.840) when using the number of suspicious US features. The AUC of each validation set was 0.754 (95% CI, 0.659-0.850), 0.757 (95% CI, 0.661-0.853), and 0.721 (95% CI, 0.621-0.820), respectively. Conclusion Nomograms constructed in our study using US can be utilized in predicting the probability of malignancy in thyroid nodules diagnosed as AUS/FLUS on US-FNA, and may help in selecting patients who are at high risk for malignancy.

UR - http://www.scopus.com/inward/record.url?scp=84901625384&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901625384&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2013.12.035

DO - 10.1016/j.surg.2013.12.035

M3 - Article

C2 - 24630147

AN - SCOPUS:84901625384

VL - 155

SP - 1006

EP - 1013

JO - Surgery

JF - Surgery

SN - 0039-6060

IS - 6

ER -