We also considered solitary and solid nodules with homogeneous internal echo to be follicular neoplasms.įor preoperative US diagnosis, the overall sensitivity was 81.8% and the overall specificity was 90.6%. With signs of invasion to adjacent organs, nodules were malignant regardless of the other characteristics. Preoperatively, we considered ill-defined or irregular nodules with heterogeneous internal echo or hypoechogenicity to be malignant. Margin (well defined or ill defined), shape (regular or irregular), halo sign (present or absent), echo structure (solid, mixed, or cystic), internal echo (homogeneous or heterogeneous), echogenicity (hyperechoic or isoechoic, hypoechoic, or hypoisoechoic), calcification (fine, other, or absent), and invasion to adjacent organs (present or absent) were assessed to make a US diagnosis of either malignant or benign disease. The spatial resolution for this system is about 2 mm. The US examination was performed with a US scanner (Logiq TM500MD GE Yokogawa Medical Systems, Tokyo, Japan) equipped with a 6- to 13-MHz linear probe (LA 39 GE Yokogawa Medical Systems). For follicular neoplasms, ultrasonographic diagnosis was unreliable, even when multiple logistic regression analysis was applied.Ĭonclusion We can predict malignancy of nonfollicular neoplasms of the thyroid by using multiple logistic regression analysis based on only 5 features: margin, shape, echo structure, echogenicity, and calcification. The probability of malignancy at this point is greater than 0.2. According to a receiver operating characteristic curve constructed from this multiple logistic regression analysis, the best point not to overlook malignancy is the point at which sensitivity is 94% and specificity is 87%. According to multiple logistic regression analysis, margin, shape, echo structure, echogenicity, and calcification were reliable indication of malignancy in nonfollicular neoplasms. The specificity was 92.3% and 88.7%, respectively. Results The sensitivity of preoperative US diagnosis was 86.5% for nonfollicular neoplasms and 18.2% for follicular neoplasms. Main Outcome Measure The US characteristics to predict malignancy for both follicular and nonfollicular neoplasms by means of multiple logistic regression analysis. Patients Between January 1 and June 30, 1999, 309 patients were examined by US before thyroidectomy. Setting A center for the treatment of thyroid diseases where about 1400 thyroid operations are performed per year. Hypothesis Ultrasonography is useful for predicting malignancy of thyroid nodules.ĭesign A retrospective study of 329 thyroid nodules (≥5 mm) in 309 patients comparing US characteristics and pathological results. Shared Decision Making and Communicationīackground High-resolution real-time ultrasonography (US) can detect characteristics of thyroid nodules, but the US differentiation between malignant nodules and benign nodules is not well described.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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