ECE2023 Poster Presentations Thyroid (163 abstracts)
Sonographic pattern and risk factors and malignancy in indeterminate thyroid nodules
Maria Riestra 1,2 , Marta Dieguez Felechosa 1,2 , Carmen Gandara Gutiérrez 1 , Pablo Gonzalvo Rodríguez 3 , Diana Rodriguez Villar 3 , Lorena Mendez López 3 , Raquel Fernandez Morais 4 , Mario Sánchez Canteli 4 & Nuria Valdés Gallego 1,2
1Hospital Universitario de Cabueñes, Endocrinology and Nutrition, Gijon, Spain; 2Instituto Investigación Sanitaria Principado de Asturias, Oviedo, Spain; 3Hospital Universitario de Cabueñes, Pathological Anatomy, Gijon, Spain; 4Hospital Universitario de Cabueñes, Otorhinolaryngology, Gijon, Spain
Introduction: Fine-needle biopsy with cytologic evaluation remains the diagnostic test of choice to distinguish benign from malignant thyroid nodules, but fails to classify thyroid nodules in 15% to 30% of cases (indeterminate thyroid nodules-ITN). ‘Rule out’ molecular testing improves the diagnostic accuracy, with high sensitivity and negative predictive value, ranging from 86 to 96%. However, these tests are not widely available, and notably increase costs.
Objective : To determine if sonographic patterns of the nodule and risk factors of thyroid cancer are as useful as molecular testing.
Methods: We evaluate sonographic patterns and clinical characteristics of ITN with histologic diagnosis. We define EUTIRADS 2 and 3 as low risk (LR), EUTIRADS 4 as moderate risk (MR) and EUTIRADS 5 as high risk (HR). Sociodemographic variables and thyroid cancer risk factors (cervical radiotherapy, familiar history or PET-positive) were collected, and we calculate sensitivity (S), specificity (E), positive predictive value (PPV) and negative predictive value (NPV) for globally low risk patients (sonographic and clinical). Statistical study was carried out using SPSS v21
Results : From 2017 to 2021, 112 ITN with histologic diagnosis were included, 80.2% women, mean age 55.03 ±15.5. 11.7% has at least one thyroid cancer risk factors. 29.7% had LR sonographic pattern, 40.5% MR and 29.7% HR. Nodule mean size was 30.2 mm ± 18 The overall malignancy rate was 24.4%. For LR ultrasound and no risk factors (28.5% of all patients) overall S, E, PPV and NPV were 97.1, 40.8, 43.03 and 96.8 respectively.
Conclusions : Sonographic patterns and thyroid cancer risk factors has as high NPV as a ‘rule out’ molecular test, and it should be a first step prior to consider it use.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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