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Does a three-degree hypoechogenicity grading improve ultrasound thyroid nodule risk stratification and affect the TI-RADS 4 category? A retrospective observational study.
Delfim, Ricardo Luiz Costantin; Assumpção, Lia Roque; Lopes, Flávia Paiva Proença Lobo; de Fátima Dos Santos Teixeira, Patrícia.
Afiliación
  • Delfim RLC; DASA, Departamento de Radiologia, Rio de Janeiro, RJ, Brasil, dr.ricardodelfim@gmail.com.
  • Assumpção LR; Universidade do Estado do Rio de Janeiro, Departamento de Cirurgia, Rio de Janeiro, RJ, Brasil.
  • Lopes FPPL; DASA, Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Rio de Janeiro, RJ, Brasil.
  • de Fátima Dos Santos Teixeira P; Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Programa de Pós-graduação em Endocrinologia, Rio de Janeiro, RJ, Brasil.
Arch Endocrinol Metab ; 67(4): e000608, 2023 May 12.
Article en En | MEDLINE | ID: mdl-37252697
Objective: The aim of this study was to determine whether classifying hypoechogenicity in three degrees (mild, moderate, and marked) could improve the distinction between benign and malignant nodules and whether such an approach could influence Category 4 of the Thyroid Imaging Reporting and Data System (TI-RADS). Materials and methods: In total, 2,574 nodules submitted to fine needle aspiration, classified by the Bethesda System, were retrospectively assessed. Further, a subanalysis considering solid nodules without any additional suspicious findings (n = 565) was performed with the purpose of evaluating mainly TI-RADS 4 nodules. Results: Mild hypoechogenicity was significantly less related to malignancy (odds ratio [OR]: 1.409; CI: 1.086-1.829; p = 0.01), compared to moderate (OR: 4.775; CI: 3.700-6.163; p < 0.001) and marked hypoechogenicity (OR: 8.540; CI: 6.355-11.445; p < 0.001). In addition, mild hypoechogenicity (20.7%) and iso-hyperechogenicity (20.5%) presented a similar rate in the malignant sample. Regarding the subanalysis, no significant association was found between mildly hypoechoic solid nodules and cancer. Conclusion: Stratifying hypoechogenicity into three degrees influences the confidence in the assessment of the rate of malignancy, indicating that mild hypoechogenicity has a unique low-risk biological behavior that resembles iso-hyperechogenicity, but with minor malignant potential when compared to moderate and marked hypoechogenicity, with special influence on the TI-RADS 4 category.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Tiroides / Nódulo Tiroideo Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Arch Endocrinol Metab Año: 2023 Tipo del documento: Article Pais de publicación: Brasil
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Tiroides / Nódulo Tiroideo Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Arch Endocrinol Metab Año: 2023 Tipo del documento: Article Pais de publicación: Brasil