Diagnosis and management of small thyroid nodules: A comparative study with six guidelines for thyroid nodules

Jung Hyun Yoon, Kyunghwa Han, Eun Kyung Kim, Hee Jung Moon, Jin Young Kwak

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: To investigate the diagnostic performances of six guidelines used to assess thyroid nodules and to determine whether any of these guidelines identify cancers of aggressive form in this population. Materials and Methods: From March 2007 to February 2010, 4696 thyroid nodules that were 1-2 cm in 4585 patients were diagnosed as benign or malignant on the basis of cytopathologic results. Ultrasonographic examinations of the thyroid nodules were retrospectively reviewed and categorized according to the categories defined by six previously published guidelines for thyroid nodules. Diagnostic performances of each guideline for diagnosing thyroid cancer were calculated and compared by using the generalized estimating equation method for logistic regression. Multivariate regression analysis was used to analyze predictors for distant metastasis and recurrence and persistence in patients with small thyroid cancer. Results: Of the 4696 thyroid nodules, 3652 (77.8%) were benign and 1044 (22.2%) were malignant. Followed were 873 patients who were diagnosed with small thyroid cancer, of whom 12 had distant metastasis and 66 had recurrence or persistence of disease. Specificity, positive predictive value, and accuracy were highest with criteria developed by Kim et al (83.1%, 59.6%, and 84.0%, respectively), while sensitivity and negative predictive value were highest with Thyroid Imaging Reporting and Data System developed by Kwak et al (98.8% and 98.6%, respectively; P <.001). Positive findings that indicated fine-needle aspiration in the guidelines did not show significant association with distant metastasis or recurrence or persistence (P >.05), but the study power was low to detect a difference. Conclusion: With its high specificity and accuracy, criteria from Kim et al may be an effective guideline to use in the management of small thyroid nodules.

Original languageEnglish
Pages (from-to)560-569
Number of pages10
JournalRadiology
Volume283
Issue number2
DOIs
Publication statusPublished - 2017 May

Fingerprint

Thyroid Nodule
Guidelines
Thyroid Neoplasms
Neoplasm Metastasis
Recurrence
Information Systems
Thyroid Gland
Multivariate Analysis
Logistic Models
Regression Analysis
Population
Neoplasms

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{0b660b871cee437dad403505c959f66b,
title = "Diagnosis and management of small thyroid nodules: A comparative study with six guidelines for thyroid nodules",
abstract = "Purpose: To investigate the diagnostic performances of six guidelines used to assess thyroid nodules and to determine whether any of these guidelines identify cancers of aggressive form in this population. Materials and Methods: From March 2007 to February 2010, 4696 thyroid nodules that were 1-2 cm in 4585 patients were diagnosed as benign or malignant on the basis of cytopathologic results. Ultrasonographic examinations of the thyroid nodules were retrospectively reviewed and categorized according to the categories defined by six previously published guidelines for thyroid nodules. Diagnostic performances of each guideline for diagnosing thyroid cancer were calculated and compared by using the generalized estimating equation method for logistic regression. Multivariate regression analysis was used to analyze predictors for distant metastasis and recurrence and persistence in patients with small thyroid cancer. Results: Of the 4696 thyroid nodules, 3652 (77.8{\%}) were benign and 1044 (22.2{\%}) were malignant. Followed were 873 patients who were diagnosed with small thyroid cancer, of whom 12 had distant metastasis and 66 had recurrence or persistence of disease. Specificity, positive predictive value, and accuracy were highest with criteria developed by Kim et al (83.1{\%}, 59.6{\%}, and 84.0{\%}, respectively), while sensitivity and negative predictive value were highest with Thyroid Imaging Reporting and Data System developed by Kwak et al (98.8{\%} and 98.6{\%}, respectively; P <.001). Positive findings that indicated fine-needle aspiration in the guidelines did not show significant association with distant metastasis or recurrence or persistence (P >.05), but the study power was low to detect a difference. Conclusion: With its high specificity and accuracy, criteria from Kim et al may be an effective guideline to use in the management of small thyroid nodules.",
author = "Yoon, {Jung Hyun} and Kyunghwa Han and Kim, {Eun Kyung} and Moon, {Hee Jung} and Kwak, {Jin Young}",
year = "2017",
month = "5",
doi = "10.1148/radiol.2016160641",
language = "English",
volume = "283",
pages = "560--569",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

Diagnosis and management of small thyroid nodules : A comparative study with six guidelines for thyroid nodules. / Yoon, Jung Hyun; Han, Kyunghwa; Kim, Eun Kyung; Moon, Hee Jung; Kwak, Jin Young.

In: Radiology, Vol. 283, No. 2, 05.2017, p. 560-569.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Diagnosis and management of small thyroid nodules

T2 - A comparative study with six guidelines for thyroid nodules

AU - Yoon, Jung Hyun

AU - Han, Kyunghwa

AU - Kim, Eun Kyung

AU - Moon, Hee Jung

AU - Kwak, Jin Young

PY - 2017/5

Y1 - 2017/5

N2 - Purpose: To investigate the diagnostic performances of six guidelines used to assess thyroid nodules and to determine whether any of these guidelines identify cancers of aggressive form in this population. Materials and Methods: From March 2007 to February 2010, 4696 thyroid nodules that were 1-2 cm in 4585 patients were diagnosed as benign or malignant on the basis of cytopathologic results. Ultrasonographic examinations of the thyroid nodules were retrospectively reviewed and categorized according to the categories defined by six previously published guidelines for thyroid nodules. Diagnostic performances of each guideline for diagnosing thyroid cancer were calculated and compared by using the generalized estimating equation method for logistic regression. Multivariate regression analysis was used to analyze predictors for distant metastasis and recurrence and persistence in patients with small thyroid cancer. Results: Of the 4696 thyroid nodules, 3652 (77.8%) were benign and 1044 (22.2%) were malignant. Followed were 873 patients who were diagnosed with small thyroid cancer, of whom 12 had distant metastasis and 66 had recurrence or persistence of disease. Specificity, positive predictive value, and accuracy were highest with criteria developed by Kim et al (83.1%, 59.6%, and 84.0%, respectively), while sensitivity and negative predictive value were highest with Thyroid Imaging Reporting and Data System developed by Kwak et al (98.8% and 98.6%, respectively; P <.001). Positive findings that indicated fine-needle aspiration in the guidelines did not show significant association with distant metastasis or recurrence or persistence (P >.05), but the study power was low to detect a difference. Conclusion: With its high specificity and accuracy, criteria from Kim et al may be an effective guideline to use in the management of small thyroid nodules.

AB - Purpose: To investigate the diagnostic performances of six guidelines used to assess thyroid nodules and to determine whether any of these guidelines identify cancers of aggressive form in this population. Materials and Methods: From March 2007 to February 2010, 4696 thyroid nodules that were 1-2 cm in 4585 patients were diagnosed as benign or malignant on the basis of cytopathologic results. Ultrasonographic examinations of the thyroid nodules were retrospectively reviewed and categorized according to the categories defined by six previously published guidelines for thyroid nodules. Diagnostic performances of each guideline for diagnosing thyroid cancer were calculated and compared by using the generalized estimating equation method for logistic regression. Multivariate regression analysis was used to analyze predictors for distant metastasis and recurrence and persistence in patients with small thyroid cancer. Results: Of the 4696 thyroid nodules, 3652 (77.8%) were benign and 1044 (22.2%) were malignant. Followed were 873 patients who were diagnosed with small thyroid cancer, of whom 12 had distant metastasis and 66 had recurrence or persistence of disease. Specificity, positive predictive value, and accuracy were highest with criteria developed by Kim et al (83.1%, 59.6%, and 84.0%, respectively), while sensitivity and negative predictive value were highest with Thyroid Imaging Reporting and Data System developed by Kwak et al (98.8% and 98.6%, respectively; P <.001). Positive findings that indicated fine-needle aspiration in the guidelines did not show significant association with distant metastasis or recurrence or persistence (P >.05), but the study power was low to detect a difference. Conclusion: With its high specificity and accuracy, criteria from Kim et al may be an effective guideline to use in the management of small thyroid nodules.

UR - http://www.scopus.com/inward/record.url?scp=85018509150&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018509150&partnerID=8YFLogxK

U2 - 10.1148/radiol.2016160641

DO - 10.1148/radiol.2016160641

M3 - Article

C2 - 27805843

AN - SCOPUS:85018509150

VL - 283

SP - 560

EP - 569

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -