Endocrine Abstracts (2011) 26 P474

Diagnostic performance and concordance analysis between ultrasonographic findings suggestive of malignancy and fine-needle aspiration (FNA) in eufunctional thyroid nodule

H Vargas-Uricoechea1,2, I Meza Cabrera1,2 & C Gómez Astaiza1,2


1University of Cauca, Popayán-Cauca, Colombia; 2Hospital Universitario San José, Popayán-Cauca, Colombia.


Introduction: In population, thyroid nodule incidence is 1 to 30%; malignancy incidence is 1–20% up to different series, which make us to realize diagnostic methods with variable sensibility and specificity, taking as point of reference, the cytological analysis.

Materials and methods: Fifty consecutive patients (44 women, 6 men) with thyroid nodule, performed neck ultrasonography (ALOKA SSD3500 equipment); material of FNA was processed according to international protocols (Koss-Papanicolau), the evaluated ultrasonographic findings were: solitary nodule, microcalcifications, solid structure, hiperechogenicity, irregular margins, perinodular halo and intranodular vascular spots; it was analyzed Sensibility (S), Specificity (E), Predictive Values (PPV, NPV), Likelihood Ratio (LR+) and concordance (kappa index), with cytological report as gold standard which was categorized as positive or negative for malignancy, for the samples reported as ‘unsatisfactory or undetermined’, the FNA was performed until the result was positive or negative (3× maximum).

Results: The mayor performance for malignancy diagnostic was the presence of microcalcifications, S: 85.7% (95% CI: 42.01–99.25); E: 91.7% (95% CI: 71.53–98.54%); PPV: 75%; NPV: 95.7%; LR(+):10.29%, kappa:0.737. The presence of solitary nodule showed S: 100%; E: 66.67% (95% CI: 44.69–83.57%), NPV: 100%; PPV: 46.7% (95% CI: 22.28–72.58%); LR(+):3.0; kappa: 0.475. When unite this ultrasonographic variables: uninodular, solid structure, hiperechogenic, microcalcifications, irregular margins, perinodular halo, intranodular vascular spots, all together show S: 100%, E: 70.83% (95%CI: 48.75–86.56%); PPV: 50% (95% CI: 24.04–75.96%), NPV: 100%, LR(+): 3.43, kappa: 0.737.

Conclusion: Ultrasonographic findings such as microcalcifications and solitary nodule have the most diagnostic performance for malignancy in thyroid nodule, however with other findings like solid structure, hiperechogenic, irregular margins, perinodular halo, intranodular vascular spots, all together increase the diagnostic performance for malignancy in patients with thyroid nodules.

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