goal
Assess the risk of developing thyroid cancer (thyroid cancer) from the nodal structures found during an ultrasound examination of the thyroid gland.
Methods
A retrospective case-control study included 8806 patients who underwent thyroid ultrasound from January 1, 2000 to March 30, 2005 in California (USA). The development of thyroid cancer was evaluated using the California Cancer Registry.
results
Of the 8806 patients who underwent thyroid ultrasound, 105 were subsequently diagnosed with thyroid cancer. Nodules in the thyroid gland were found both in patients with diagnosed cancer (96.9) and without it (56.4%). Ultrasound characteristics of the nodes: microcalcifications (OR = 8.1; 95% CI, 3.8-17.3), sizes greater than 2 cm (OR = 3.6; 95% CI, 1.7-7.6), high density (OR = 4.0; 95% CI, 1.7 -9.2) —was the only findings associated with thyroid cancer. If only one of the above characteristics was used for biopsy, then the majority of thyroid cancer was detected (sensitivity, 0.88; 95% CI, 0.80-0.94), while the number of false-positive results was high (0.44; 95% CI, 0.43-0.45 ) In the presence of 2 signs: the number of false-positive results was lower (0.07, 95% CI 0.07-0.08),
Conclusion
Ultrasound imaging of the thyroid gland can be used to detect patients with a low risk of developing thyroid cancer in whom a biopsy is currently not required.
It is necessary to perform a biopsy of nodes that have not only dimensions of more than 5 mm, but also more than 2 of the above symptoms, then it will be possible to reduce the number of unnecessary biopsies by 90%.
The results of this study should be confirmed in wider population CIs.