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Ultrasound features and estimated risk of malignancy in thyroid nodules
Aseel O Doubi1, Nouf H Alshammari2, Reenad Hussain Bedaiwi3, Ali Mohammad Alshdokhi4, Dana Aljomah2, Ahmad Albosaily5, Saleh Aldhahri6
1 Department of Otolaryngology Head and Neck Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia
2 Department of Otolaryngology Head and Neck Surgery, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
3 Department of Otolaryngology Head and Neck Surgery, Taibah University, Medina, Kingdom of Saudi Arabia
4 Department of Otolaryngology Head and Neck Surgery, King Khaled Hospital, Hail, Kingdom of Saudi Arabia
5 Department of Otolaryngology Head and Neck Surgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Kingdom of Saudi Arabia
6 Department of Otolaryngology Head and Neck Surgery, King Saud University, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
Correspondence Address:
Dr. Aseel O Doubi
King Saud Medical City, Riyadh, Kingdom of Saudi Arabia
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/sjoh.sjoh_8_22
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Introduction: A significant uncertainty surrounding the diagnostic accuracy of ultrasound (US) and the risk features in thyroid nodules exist to date which impacts clinical practice and guidelines. Methods: This retrospective descriptive observational study included patients with thyroid nodules with US reports over 10 years and either had a fine-needle aspiration (FNA) cytology result, a pathology report or both. Results: A total of 483 patients were included. Most of the patients were <55 years old (67.3%) and the majority of them were females (91.3%). The FNA cytology results indicated that 311 (64.4%) of the thyroid nodules were benign and 32 (6.6%) were malignant. Overall, only 181 (37.5%) of the patients had a final histopathologic assessment; of these, 80 (44.2%) had malignant thyroid nodules, 78 (43.1%) had benign nodules, and 23 (12.7%) had microcarcinoma. multivariate logistic regression analysis revealed that having US features of hypoechogenicity (adjusted odd ratio 3.37; 95% confidence interval [CI] 1.03–11.00) and a microlobulated or irregular margin (aOR 3.65; 95% [CI] 1.13–11.79) were the only sonographic characteristics that had a statistically significant association with thyroid cancer based on final pathology. Conclusion: Thyroid nodules showing hypoechogenic echogenicity and microlobulated or irregular margin on US need to be closely followed and given the appropriate management based on their risk criteria.
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