Nomogram for selecting thyroid nodules for ultrasound-guided fine-needle aspiration biopsy based on a quantification of risk of malignancy Journal Article


Authors: Nixon, I. J.; Ganly, I.; Hann, L. E.; Yu, C.; Palmer, F. L.; Whitcher, M. M.; Shah, J. P.; Shaha, A.; Kattan, M. W.; Patel, S. G.
Article Title: Nomogram for selecting thyroid nodules for ultrasound-guided fine-needle aspiration biopsy based on a quantification of risk of malignancy
Abstract: Background Our aim through this study was to develop a statistical tool to quantify risk of malignancy in thyroid nodules based on clinical, biochemical, and ultrasound features, which could be used to select which nodules require ultrasound-guided fine-needle aspiration. Methods Clinical records, biochemical profiles, pathology reports, and ultrasound images were reviewed. Multivariate logistic regression was used to rank variables in their ability to predict malignancy. Results In all, 190 nodules were reviewed. The final diagnoses were papillary carcinoma in 105 patients (66%), other carcinoma in 8 patients (5%), and benign thyroid pathology in 45 patients (29%). After exclusions, 182 nodules remained for analysis on a per nodule basis. The 8 variables with highest predictive value were: age; thyroid-stimulating hormone; and ultrasound size, shape, echo texture, calcification, margin, and vascularity. The nomogram had a concordance index of 75%. Conclusion We produced a nomogram able to accurately predict the need to perform ultrasound-guided fine-needle aspiration on a thyroid nodule based on biochemical, clinical, and ultrasound features. Copyright © 2012 Wiley Periodicals, Inc.
Keywords: adolescent; adult; controlled study; human tissue; aged; major clinical study; histopathology; cancer risk; tumor volume; medical record review; prediction; biopsy; age; risk assessment; echography; thyroid carcinoma; benign tumor; thyroid nodule; tumor vascularization; thyroid papillary carcinoma; thyroid; nomogram; predictive value; calcification; thyrotropin; thyroid follicular carcinoma; thyroid medullary carcinoma; thyrotropin blood level; diagnostic test accuracy study; thyroid metastasis; poorly differentiated thyroid cancer; nodule; ultrasound transducer; endoscopic ultrasound guided fine needle biopsy; echograph; limit of quantitation
Journal Title: Head & Neck
Volume: 35
Issue: 7
ISSN: 1043-3074
Publisher: John Wiley & Sons, Inc.  
Date Published: 2013-07-01
Start Page: 1022
End Page: 1025
Language: English
DOI: 10.1002/hed.23075
PROVIDER: scopus
PUBMED: 22730228
DOI/URL:
Notes: --- - Cited By (since 1996):1 - "Export Date: 1 August 2013" - "CODEN: HEANE" - "Source: Scopus"
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MSK Authors
  1. Ashok R Shaha
    699 Shaha
  2. Snehal G Patel
    414 Patel
  3. Iain James Nixon
    60 Nixon
  4. Ian Ganly
    432 Ganly
  5. Lucy E Hann
    69 Hann
  6. Jatin P Shah
    724 Shah
  7. Frank Palmer
    82 Palmer
  8. Michael W Kattan
    218 Kattan