New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid

Eun Kyung Kim, Soo Park Cheong, Youn Chung Woung, Keun Oh Ki, Ik Kim Dong, Tae Lee Jong, Sik Yoo Hyung

Research output: Contribution to journalArticle

746 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of our study was to provide new sonographic criteria for fine-needle aspiration biopsy of nonpalpable solid thyroid nodules. MATERIALS AND METHODS. Sonographic scans of 155 nonpalpable thyroid nodules in 132 patients were prospectively classified as having positive or negative findings. Sonographic findings that suggested malignancy included microcalcifications, an irregular or microlobulated margin, marked hypoechogenicity, and a shape that was more tall than it was wide. If even one of these sonographic features was present, the nodule was classified as positive (malignant). If a nodule had none of the features described, it was classified as negative (benign). The final diagnosis of a lesion as benign (n = 106) or malignant (n = 49) was confirmed by fine-needle aspiration biopsy and follow-up (>6 months) in 83 benign nodules, by fine-needle aspiration biopsy and surgery in 44 malignant and 15 benign lesions, and by surgery alone in five malignant and eight benign lesions. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated on the basis of our proposed classification method. RESULTS. Of 82 lesions classified as positive, 46 were malignant. Of 73 lesions classified as negative, three were malignant. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy based on our sonographic classification method were 93.8%, 66%, 56.1%, 95.9%, and 74.8%, respectively. CONCLUSION. Considering the high level of sensitivity of our proposed sonographic classification, fine-needle aspiration biopsy should be performed on thyroid nodules classified as positive, regardless of palpability.

Original languageEnglish
Pages (from-to)687-691
Number of pages5
JournalAmerican Journal of Roentgenology
Volume178
Issue number3
DOIs
Publication statusPublished - 2002 Jan 1

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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