ECE2021 Audio Eposter Presentations Thyroid (157 abstracts)
Efficacy of multidisciplinary approach in thyroid nodules: analysis of factors used for predicting malignancy
Savas Volkan Kisioglu 1 , 2 , Huseyin Atacan 3 , Emel Cakir 4 , Sukru Oguz 5 , Serdar Karakullukcu 6 & Halil Onder Ersoz 2
1Health Sciences University Kanuni Training and Research Hospital, Department of Endocrinology, Turkey; 2Karadeniz Technical University, Department of Endocrinology, Turkey; 3Karadeniz Technical University, Internal Medicine, Turkey; 4Karadeniz Technical University, Department of Pathology, Turkey; 5Karadeniz Technical University, Department of Radiology, Turkey; 6Bayburt Community Health Center, Community Health Center, Turkey
Background
To date, numerous molecular tests have been developed for preoperative evaluation of thyroid nodules. Nevertheless, these tests cannot be administered in many centers due to their imprecise diagnoses and high costs. The present study aimed to investigate the effect of making surgical decisions in a council through a multidisciplinary approach after clinical, ultrasonographic, and pathological evaluation of nodules on the accuracy of the decisions.
Materials and methods
The retrospective study included patients with thyroid nodules who underwent preoperative ultrasonography (USG) followed by FNAB, which was confirmed by postoperative pathological examinations between January 2017 and January 2019. Relationship between USG features of nodules and malignancy was analyzed. A comparison was performed between patients that were referred for surgery through the multidisciplinary versus non-multidisciplinary approach.
Results
A total of 255 nodules in 211 patients were evaluated in the study. The prevalence of malignancy was 100% in nodules with hypoechogenicity + microcalcification + margin irregularity (P<0.001). The likelihood of malignancy was significantly higher in dual combinations of these three adverse conditions (P<0.001 for all) (Table 1). Margin irregularity was found to be the most predictive model for malignancy (CI: 1.9–13.8, OR: 5.249, P<0.001). The multidisciplinary approach was superior to the non-multidisciplinary approach in the detection of malignancy (P = 0.008)(Table 2).
| Us Features | Beta Coefficient | Odds Ratio | 95% Confidence Interval | P Value |
| Hypoechogenicity | 1.336 ± 0.329 | 3.804 | 1.996, 7.250 | <0.001 |
| Irregüler margin | 1.658 ± 0.495 | 5.249 | 1.989, 13.856 | 0.001 |
| Microcalcifications | 0.998 ± 0.358 | 2.713 | 1.344, 5.476 | 0.005 |
| Macrocalcifications | –0.268 ± 0.470 | 0.671 | 0.335, 1.343 | 0.569 |
| Type III vascularity | –0.399 ± 0.354 | 0.765 | 0.305, 1.923 | 0.260 |
| Multidisciplinary approach | Non-Multidisciplinary approach | |||
| Benign Histology |
Malignant Histology | Benign Histology | Malignant Histology |
|
| No. % | No. % | No. % | No. % | |
| Non-diagnostik I | – | 1 (100.0) | 31 (86.5) | 5 (13.5) |
| Benign II | 8 (88.9) | 1 (11.1) | 64 (92.8) | 5 (7.2) |
| AUS/FLUS III | 7 (43.8) | 9 (56.2) | 37 (72.5) | 14 (27.5) |
| Follicular neoplasm IV | 2 (66.6) | 1 (33.3) | 5 (62.5) | 3 (37.5) |
| Suspicious of malignancy V | – | 8 (100.0) | 2 (10.0) | 18 (90.0) |
| Malignancy VI | – | 4 (100.0) | – | 30 (100.0) |
Conclusion
Margin irregularity had the highest predictive value for the detection of malignancy. Employing the multidisciplinary approach in preoperative evaluation of thyroid nodules can be highly effective in detecting malignancy and preventing unnecessary surgery.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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