ACR TI-RADS and ATA US scores are helpful for the management of thyroid nodules with indeterminate cytology.
Background: Cytologically indeterminate thyroid nodules currently present a challenge for clinical decision-making. The main aim of our study was to determine whether the classifications, American College of Radiology (ACR) TI-RADS and 2015 American Thyroid Association (ATA) guidelines, in associati...
| Publicado en: | BMC Endocrine Disorders Vol. 19; no. 1 |
|---|---|
| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
10/29/2019
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139390020&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139390020 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14726823 1CHL jtl: BMC Endocrine Disorders issn: 14726823 maglogo: N pubinfo: dt: 10/29/2019 vid: 19 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 139390020 139390020 139390020 10.1186/s12902-019-0429-5 139390020 ppct: 1 formats: tig: atl: ACR TI-RADS and ATA US scores are helpful for the management of thyroid nodules with indeterminate cytology. aug: au: Barbosa, Thayse Lozovoy Madsen Junior, Cleo Otaviano Mesa Graf, Hans Cavalvanti, Teresa Trippia, Marcus Adriano da Silveira Ugino, Ricardo Torres de Oliveira, Gabriel Lucca Granella, Victor Hugo de Carvalho, Gisah Amaral affil: Department of Endocrinology and Metabology, Federal University of Paraná– Brazil, Av. Agostinho Leão Júnior, 285, Alto da Glória, 80.030-110, Curitiba, PR, Brazil sug: subj: Thyroid Nodule Classification Cytology Practice Guidelines Risk Assessment Human Retrospective Design Decision Making, Clinical Thyroid Neoplasms Diagnosis Biopsy, Needle Ultrasonography Methods Descriptive Statistics Odds Ratio ab: Background: Cytologically indeterminate thyroid nodules currently present a challenge for clinical decision-making. The main aim of our study was to determine whether the classifications, American College of Radiology (ACR) TI-RADS and 2015 American Thyroid Association (ATA) guidelines, in association with The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), could be used to stratify the malignancy risk of indeterminate thyroid nodules and guide their clinical management. Methods: The institutional review board approved this retrospective study of a cohort of 140 thyroid nodules in 139 patients who were referred to ultrasound-guided fine-needle aspiration cytology (FNAC) from January 2012 to June 2016 with indeterminate cytological results (44 Bethesda III, 52 Bethesda IV and 44 Bethesda V) and in whom pre-FNAC thyroid US images and histological results after surgery were available. Each included nodule was classified by one radiologist blinded to the cytological and histological diagnoses according to the ACR TIRADS scores and the US patterns as recommended in the 2015 ATA guidelines. The risk of malignancy was estimated for Bethesda, TI-RADS scores, ATA US patterns and their combination. Results: Of the 140 indeterminate thyroid nodules examined, 74 (52.9%) were histologically benign. A different rate of malignancy (p < 0.001) among Bethesda III, IV and V was observed. The rate of malignancy increased according to the US suspicion categories (p < 0.001) in both US classifications (TI-RADS and ATA). Thyroid nodules classified as Bethesda III and the lowest risk US categories (very low, low and intermediate suspicion by ATA and 2, 3 and 4a by TI-RADS) displayed a sensitivity of 95.3% for both classifications and a negative predictive value of 94.3 and 94.1%, respectively. The highest risk US categories (high suspicion by ATA and 4b,4c and 5 by TI-RADS) were significantly associated with cancer (odds ratios [ORs] 14.7 and 9.8, respectively). Conclusions: Ultrasound classifications, ACR TI-RADS and ATA guidelines, may help guide the management of indeterminate thyroid nodules, suggesting a conservative approach to nodules with low-risk US suspicion and Bethesda III, while molecular testing and surgery should be considered for nodules with high-risk US suspicion and Bethesda IV or V. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|