Cancer Risk in Thyroid Nodules: An Analysis of Over 1000 Consecutive FNA Biopsies Performed in a Single Canadian Institution
<b>Objective:</b> To determine the cancer risk in thyroid nodules using ACR TI-RADS. <b>Methods:</b> A retrospective analysis of all thyroid biopsies was performed over a 3-year period (2021 to 2023). Variables including gender, age, history of thyroid cancer or neck irradiat...
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MDPI AG
2024-12-01
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| author | Elsabe J. Smit Sana Samadi Mitchell P. Wilson Gavin Low |
| author_facet | Elsabe J. Smit Sana Samadi Mitchell P. Wilson Gavin Low |
| author_sort | Elsabe J. Smit |
| collection | DOAJ |
| description | <b>Objective:</b> To determine the cancer risk in thyroid nodules using ACR TI-RADS. <b>Methods:</b> A retrospective analysis of all thyroid biopsies was performed over a 3-year period (2021 to 2023). Variables including gender, age, history of thyroid cancer or neck irradiation, nodule size and location, TR level, and sonographic features such as punctate echogenic foci (PEF), a very hypoechoic appearance, taller-than-wide shape, and suspected extrathyroidal extension were analyzed. <b>Results:</b> A total of 1140 nodules were assessed in 993 patients, including 740 females (74.5%) and 253 males (25.5%). The mean patient age was 57.1 ± 15.4 years. Variables significantly associated with nodule malignancy included (1) younger age, (2) a prior history of thyroid cancer or neck irradiation, (3) a higher TR level, (4) a taller-than-wide shape in nodules <1 cm, (5) PEF, (6) a very hypoechoic appearance, and (5) suspected extrathyroidal extension (<i>p</i> < 0.05). Gender, nodule location and size were not associated with a higher cancer risk (<i>p</i> > 0.05). Malignancy was found in 40.7% of TR5, 4.8% of TR4, 0.3% of TR3, and 0% of TR1 and 2 nodules. The odds ratios (ORs) for cancer were as follows: TR4 or 5, OR = 19; PEF, OR = 11; a very hypoechoic appearance, OR = 13.3; and suspected extrathyroidal extension, OR = 27.2 (<i>p</i> < 0.01). <b>Conclusions:</b> Higher TR levels, PEF, a very hypoechoic appearance, and suspected extrathyroidal extension are important features for predicting cancer risk. These findings affirm the effectiveness of ACR TI-RADS in nodule risk stratification. |
| format | Article |
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| institution | DOAJ |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-b8c5fe3a753e456bb38f8df9b3f4c2d02025-08-20T02:57:07ZengMDPI AGDiagnostics2075-44182024-12-011424277510.3390/diagnostics14242775Cancer Risk in Thyroid Nodules: An Analysis of Over 1000 Consecutive FNA Biopsies Performed in a Single Canadian InstitutionElsabe J. Smit0Sana Samadi1Mitchell P. Wilson2Gavin Low3Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB T6G2B7, CanadaDepartment of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB T6G2B7, CanadaDepartment of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB T6G2B7, CanadaDepartment of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB T6G2B7, Canada<b>Objective:</b> To determine the cancer risk in thyroid nodules using ACR TI-RADS. <b>Methods:</b> A retrospective analysis of all thyroid biopsies was performed over a 3-year period (2021 to 2023). Variables including gender, age, history of thyroid cancer or neck irradiation, nodule size and location, TR level, and sonographic features such as punctate echogenic foci (PEF), a very hypoechoic appearance, taller-than-wide shape, and suspected extrathyroidal extension were analyzed. <b>Results:</b> A total of 1140 nodules were assessed in 993 patients, including 740 females (74.5%) and 253 males (25.5%). The mean patient age was 57.1 ± 15.4 years. Variables significantly associated with nodule malignancy included (1) younger age, (2) a prior history of thyroid cancer or neck irradiation, (3) a higher TR level, (4) a taller-than-wide shape in nodules <1 cm, (5) PEF, (6) a very hypoechoic appearance, and (5) suspected extrathyroidal extension (<i>p</i> < 0.05). Gender, nodule location and size were not associated with a higher cancer risk (<i>p</i> > 0.05). Malignancy was found in 40.7% of TR5, 4.8% of TR4, 0.3% of TR3, and 0% of TR1 and 2 nodules. The odds ratios (ORs) for cancer were as follows: TR4 or 5, OR = 19; PEF, OR = 11; a very hypoechoic appearance, OR = 13.3; and suspected extrathyroidal extension, OR = 27.2 (<i>p</i> < 0.01). <b>Conclusions:</b> Higher TR levels, PEF, a very hypoechoic appearance, and suspected extrathyroidal extension are important features for predicting cancer risk. These findings affirm the effectiveness of ACR TI-RADS in nodule risk stratification.https://www.mdpi.com/2075-4418/14/24/2775thyroidthyroid nodulethyroid cancerultrasoundTI-RADSACR TI-RADS |
| spellingShingle | Elsabe J. Smit Sana Samadi Mitchell P. Wilson Gavin Low Cancer Risk in Thyroid Nodules: An Analysis of Over 1000 Consecutive FNA Biopsies Performed in a Single Canadian Institution Diagnostics thyroid thyroid nodule thyroid cancer ultrasound TI-RADS ACR TI-RADS |
| title | Cancer Risk in Thyroid Nodules: An Analysis of Over 1000 Consecutive FNA Biopsies Performed in a Single Canadian Institution |
| title_full | Cancer Risk in Thyroid Nodules: An Analysis of Over 1000 Consecutive FNA Biopsies Performed in a Single Canadian Institution |
| title_fullStr | Cancer Risk in Thyroid Nodules: An Analysis of Over 1000 Consecutive FNA Biopsies Performed in a Single Canadian Institution |
| title_full_unstemmed | Cancer Risk in Thyroid Nodules: An Analysis of Over 1000 Consecutive FNA Biopsies Performed in a Single Canadian Institution |
| title_short | Cancer Risk in Thyroid Nodules: An Analysis of Over 1000 Consecutive FNA Biopsies Performed in a Single Canadian Institution |
| title_sort | cancer risk in thyroid nodules an analysis of over 1000 consecutive fna biopsies performed in a single canadian institution |
| topic | thyroid thyroid nodule thyroid cancer ultrasound TI-RADS ACR TI-RADS |
| url | https://www.mdpi.com/2075-4418/14/24/2775 |
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