Large (≥3cm) thyroid nodules with benign cytology: Can Thyroid Imaging Reporting and Data System (TIRADS) help predict false-negative cytology?

Se Jin Nam, Jin Young Kwak, Hee Jung Moon, Jung Hyun Yoon, Eun Kyung Kim, Ja Seung Koo

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: There is controversy about the accuracy of the fine-needle aspiration (FNA) cytology results in large sized thyroid nodules. Our aim was to evaluate the false-negative rate of FNA for large thyroid nodules and the usefulness of the Thyroid Imaging Reporting and Data System (TIRADS) in predicting false-negative cytology for large thyroid nodules with benign cytology. Methods: 632 thyroid nodules larger than or equal to 3cm in size with subsequent benign cytology on US-guided FNA were included. US features of internal composition, echogenicity, margin, calcifications, and shape were evaluated, and nodules were classified according to TIRADS. TIRADS category 3 included nodules without any of the following suspicious features:solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape. Category 4a, 4b, 4c, and 5 were assigned to nodules showing one, two, three or four, or five suspicious US features, respectively. US features associated with malignancy for these lesions were analyzed and malignancy risk according to TIRADS was calculated. Results: Of the 632 lesions, 23 lesions(3.6%) were malignant and 609(96.4%) were benign, suggesting a 3.6% false-negative rate for FNA cytology. Of the 23 malignant lesions, final pathology was mainly follicular carcinoma minimally invasive(65.2%, 15/23) and the follicular variant of papillary carcinoma(26.1%, 6/23). The malignancy risks of categories 3, 4a, 4b, and 4c nodules were 0.9%, 4.6%, 10.0%, and 11.8%, respectively. Conclusion: Large thyroid nodules with benign cytology had a relatively high false-negative risk of 3.6% and TIRADS was helpful in predicting false-negative cytology for these lesions.

Original languageEnglish
Article numbere0186242
JournalPloS one
Volume12
Issue number10
DOIs
Publication statusPublished - 2017 Oct

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Cytology
Thyroid Nodule
Information Systems
cell biology
Cell Biology
Thyroid Gland
image analysis
Imaging techniques
Fine Needle Biopsy
Needles
carcinoma
Carcinoma, Papillary, Follicular
Calcinosis
Neoplasms
calcification
Pathology
Carcinoma

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

@article{8ecd3f0514cc44baaf71204882a4a081,
title = "Large (≥3cm) thyroid nodules with benign cytology: Can Thyroid Imaging Reporting and Data System (TIRADS) help predict false-negative cytology?",
abstract = "Background: There is controversy about the accuracy of the fine-needle aspiration (FNA) cytology results in large sized thyroid nodules. Our aim was to evaluate the false-negative rate of FNA for large thyroid nodules and the usefulness of the Thyroid Imaging Reporting and Data System (TIRADS) in predicting false-negative cytology for large thyroid nodules with benign cytology. Methods: 632 thyroid nodules larger than or equal to 3cm in size with subsequent benign cytology on US-guided FNA were included. US features of internal composition, echogenicity, margin, calcifications, and shape were evaluated, and nodules were classified according to TIRADS. TIRADS category 3 included nodules without any of the following suspicious features:solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape. Category 4a, 4b, 4c, and 5 were assigned to nodules showing one, two, three or four, or five suspicious US features, respectively. US features associated with malignancy for these lesions were analyzed and malignancy risk according to TIRADS was calculated. Results: Of the 632 lesions, 23 lesions(3.6{\%}) were malignant and 609(96.4{\%}) were benign, suggesting a 3.6{\%} false-negative rate for FNA cytology. Of the 23 malignant lesions, final pathology was mainly follicular carcinoma minimally invasive(65.2{\%}, 15/23) and the follicular variant of papillary carcinoma(26.1{\%}, 6/23). The malignancy risks of categories 3, 4a, 4b, and 4c nodules were 0.9{\%}, 4.6{\%}, 10.0{\%}, and 11.8{\%}, respectively. Conclusion: Large thyroid nodules with benign cytology had a relatively high false-negative risk of 3.6{\%} and TIRADS was helpful in predicting false-negative cytology for these lesions.",
author = "Nam, {Se Jin} and Kwak, {Jin Young} and Moon, {Hee Jung} and Yoon, {Jung Hyun} and Kim, {Eun Kyung} and Koo, {Ja Seung}",
year = "2017",
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language = "English",
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journal = "PLoS One",
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Large (≥3cm) thyroid nodules with benign cytology : Can Thyroid Imaging Reporting and Data System (TIRADS) help predict false-negative cytology? / Nam, Se Jin; Kwak, Jin Young; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Eun Kyung; Koo, Ja Seung.

In: PloS one, Vol. 12, No. 10, e0186242, 10.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Large (≥3cm) thyroid nodules with benign cytology

T2 - Can Thyroid Imaging Reporting and Data System (TIRADS) help predict false-negative cytology?

AU - Nam, Se Jin

AU - Kwak, Jin Young

AU - Moon, Hee Jung

AU - Yoon, Jung Hyun

AU - Kim, Eun Kyung

AU - Koo, Ja Seung

PY - 2017/10

Y1 - 2017/10

N2 - Background: There is controversy about the accuracy of the fine-needle aspiration (FNA) cytology results in large sized thyroid nodules. Our aim was to evaluate the false-negative rate of FNA for large thyroid nodules and the usefulness of the Thyroid Imaging Reporting and Data System (TIRADS) in predicting false-negative cytology for large thyroid nodules with benign cytology. Methods: 632 thyroid nodules larger than or equal to 3cm in size with subsequent benign cytology on US-guided FNA were included. US features of internal composition, echogenicity, margin, calcifications, and shape were evaluated, and nodules were classified according to TIRADS. TIRADS category 3 included nodules without any of the following suspicious features:solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape. Category 4a, 4b, 4c, and 5 were assigned to nodules showing one, two, three or four, or five suspicious US features, respectively. US features associated with malignancy for these lesions were analyzed and malignancy risk according to TIRADS was calculated. Results: Of the 632 lesions, 23 lesions(3.6%) were malignant and 609(96.4%) were benign, suggesting a 3.6% false-negative rate for FNA cytology. Of the 23 malignant lesions, final pathology was mainly follicular carcinoma minimally invasive(65.2%, 15/23) and the follicular variant of papillary carcinoma(26.1%, 6/23). The malignancy risks of categories 3, 4a, 4b, and 4c nodules were 0.9%, 4.6%, 10.0%, and 11.8%, respectively. Conclusion: Large thyroid nodules with benign cytology had a relatively high false-negative risk of 3.6% and TIRADS was helpful in predicting false-negative cytology for these lesions.

AB - Background: There is controversy about the accuracy of the fine-needle aspiration (FNA) cytology results in large sized thyroid nodules. Our aim was to evaluate the false-negative rate of FNA for large thyroid nodules and the usefulness of the Thyroid Imaging Reporting and Data System (TIRADS) in predicting false-negative cytology for large thyroid nodules with benign cytology. Methods: 632 thyroid nodules larger than or equal to 3cm in size with subsequent benign cytology on US-guided FNA were included. US features of internal composition, echogenicity, margin, calcifications, and shape were evaluated, and nodules were classified according to TIRADS. TIRADS category 3 included nodules without any of the following suspicious features:solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape. Category 4a, 4b, 4c, and 5 were assigned to nodules showing one, two, three or four, or five suspicious US features, respectively. US features associated with malignancy for these lesions were analyzed and malignancy risk according to TIRADS was calculated. Results: Of the 632 lesions, 23 lesions(3.6%) were malignant and 609(96.4%) were benign, suggesting a 3.6% false-negative rate for FNA cytology. Of the 23 malignant lesions, final pathology was mainly follicular carcinoma minimally invasive(65.2%, 15/23) and the follicular variant of papillary carcinoma(26.1%, 6/23). The malignancy risks of categories 3, 4a, 4b, and 4c nodules were 0.9%, 4.6%, 10.0%, and 11.8%, respectively. Conclusion: Large thyroid nodules with benign cytology had a relatively high false-negative risk of 3.6% and TIRADS was helpful in predicting false-negative cytology for these lesions.

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