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• W3204659144 abstract "Background. The classification of nodules by Thyroid Imaging Reporting and Data Systems (TIRADS) is important in guiding management. Whether sensitivity in identifying thyroid cancers varies with thyroid cancer phenotype remains unclarified. Methods. The ultrasound (US) characteristics of nodules of 26,908 nodular goiter patients were recorded. Fine-needle aspiration cytology (FNA) was performed in all nodules >1 cm irrespective of US findings (n = 25,025) and in nodules between 5 mm and 10 mm with suspicious US characteristics (n = 1,883). Of the 3281 operated cases, 221, 30, and 23 were papillary (PTC), follicular (FTC), and medullary (MTC) cancers, respectively. The US-based indication of FNA, as defined by EU-TIRADS scores, combined with lesion size, was calculated. This study design is unique in avoiding the common selection bias when TIRADS’ sensitivity is tested in a cohort selected for FNA and surgery based on the same US characteristics on which TIRADS is based. Results. The EU-TIRADS score influences decision of FNA in the 10–20 mm range. In such nodules (n = 118), the number of suspicious features (marked hypoechogenicity, microcalcifications, irregular shape, and irregular border) per lesion was lower in FTC (0.7 ± 0.6) than in PTC (1.7 ± 1.0) or MTC (1.8 ± 0.7; <math xmlns=http://www.w3.org/1998/Math/MathML id=M1> <mi>p</mi> <mo><</mo> <mn>0.02</mn> </math> ), resulting in EU-TIRADS scores of 4.1 ± 0.6, 4.8 ± 0.3, and 4.9 ± 0.2, respectively ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M2> <mi>p</mi> <mo><</mo> <mn>0.01</mn> </math> ). The EU-TIRADS-based FNA indication rate was lower in FTC (55.5%) compared to PTC (85.0%) and MTC (88.9%) ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M3> <mi>p</mi> <mo>=</mo> <mn>0.02</mn> </math> ). Conclusions. EU-TIRADS-defined suspicious US features are less common in FTC than in PTC and MTC. Therefore, a substantial number of FTCs in the 10–20 mm range escape surgery." @default.
• W3204659144 created "2021-10-11" @default.
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• W3204659144 date "2021-09-27" @default.
• W3204659144 modified "2023-10-18" @default.
• W3204659144 title "EU-TIRADS-Based Omission of Fine-Needle Aspiration and Cytology from Thyroid Nodules Overlooks a Substantial Number of Follicular Thyroid Cancers" @default.
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• W3204659144 doi "https://doi.org/10.1155/2021/9924041" @default.
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