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Ultrasound Predictors of Thyroid Cancer

Cholatip Wiratkapun MD*, Rapeechai Jaiyen MD*, Panuwat Lertsithichai MD, MSc**, Banjongsak Wedsart MD*, Janjira Jatchavala MD*, Suphaneewan Jaovisidha MD*, Prakasit Chirappapha MD**, Atcharaporn Pongtippan MD***, Rangsima Aroonroch MD***

Affiliation : * Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand *** Department of Pathology and Cytology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand


Objective : To identify ultrasound (US) features associated with cancer in thyroid nodules. Material and Method: During a two and a half-year period, medical charts, US images, and pathological findings in 629 consecutive patients with thyroid nodules who underwent US examination as well as fine needle aspiration biopsy (FNAB) or surgical excision or both were retrospectively reviewed. Clinical and US findings associated with thyroid cancer were identified using statistical models.
Results : Unequivocal cytological or pathological findings were available for 578 patients. Forty-eight patients (8%) had thyroid cancer. Independent clinical and US features associated with thyroid cancer included younger age, symptoms other than palpable mass, solid nodules, fewer number of nodules, presence of calcifications, and enlarged cervical lymph nodes. The combination of all these features was most specific for the diagnosis of thyroid cancer. The absence of all these features could rule out all thyroid cancers.
Conclusion : The risk of the thyroid cancer in patients with thyroid nodules could be estimated by using relevant clinical and US features.

Keywords : Thyroid, Thyroid nodule, Ultrasound, Predictor, Cancer


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