Sonographic Characteristics Suggesting Papillary Thyroid Carcinoma According to Nodule Size
- 603 Downloads
To determine differences in ultrasonography (US) features suggesting papillary thyroid carcinoma (PTC) between nodules larger than 10 mm (large lesions) and nodules ≤10 mm in diameter (small lesions).
We included 1,238 nodules in 1,173 patients that were confirmed through cytology or histopathology between February 2007 and June 2007 in the study. Nodules were divided into large lesions (571 lesions) and small lesions (667 lesions). Sonographic features were defined as composition, echogenicity, margin, calcifications, shape, and vascularity. Logistic regression analyses were performed to determine the odds ratios (OR) of each feature to predict PTC.
On multivariate analysis, irregular margin (OR = 37.788, P < 0.001), microcalcifications (OR = 17.799, P < 0.001), microlobulated margin (OR = 10.385, P < 0.001), and no vascularity (OR = 5.975, P < 0.001) were independent factors for PTC in the large lesions and irregular margin (OR = 7.185, P < 0.001), microlobulated margin (OR = 5.952, P < 0.001), microcalcifications (OR = 3.722, P < 0.001), marked hypoechogenicity (OR = 2.873, P = 0.004), and taller than wide shape (OR = 2.698, P < 0.001) were independent factors for PTC in the small lesions.
The OR of each US finding for predicting PTC is different between large and small lesions. Therefore, it would be helpful to weight certain US features according to nodule size when reporting thyroid nodules with different risks of PTC.
KeywordsPapillary Thyroid Carcinoma Thyroid Nodule Small Lesion Large Lesion Nodule Size
Conflict of interest
None of the authors has any conflicts of interest to disclose.
- 3.Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedus L, Vitti P. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr Pract. 2010;16(Suppl 1):1–43.PubMedCrossRefGoogle Scholar
- 9.Hoang JK, Lee WK, Lee M, Johnson D, Farrell S. US Features of thyroid malignancy: pearls and pitfalls. Radiographics. 2007;27:847–60; discussion 61–5.Google Scholar
- 27.Frates MC, Benson CB, Doubilet PM, Cibas ES, Marqusee E. Can color Doppler sonography aid in the prediction of malignancy of thyroid nodules? J Ultrasound Med. 2003;22:127–31; quiz 32–4.Google Scholar