Endocrine Abstracts

Aim: The aim of this retrospective study was to evaluate the diagnostic significance of presurgical thyroid ultrasound in comparison with FNAC of thyroid nodules and their contribution in detecting thyroid cancer.

Patients and methods: We retrospectively studied the files of 118 thyroid cancer patients, 18 men (15.2%) and 100 women (84.8%), who underwent thyroidectomy from January 2013 until December 2016, in the Department of Surgical Oncology of Theagenio Cancer Hospital, Thessaloniki, Greece. All patients were diagnosed and followed up by the Section of Endocrinology and were operated upon by the same surgical team. The mean patient age was 55 years (±12.26). We evaluated the suspicious ultrasound findings according to the ATA Guidelines of 2015 (hypogenicity, microcalcifications, taller than wide shape, irregular margins, extrathyroidal extension) and the results of FNAC (in accordance to Bethesda Score), in association with the pathology report. All ultrasounds were scored based on the suspicious characteristics.

Results: Mean tumor size was 7.1 mm (±8.73 mm), multifocallity was found in 69 patients (58.5%). The Bethesda score was positive for malignancy in 45% of the cases. On the other hand, the suspicious ultrasound findings were in accordance with the pathology report in 78.8% of the cases. Almost all patients with Bethesda II or III presented at least one or more suspicious ultrasound characteristics and those with Bethesda VI at least three or more suspicious for cancer ultrasonographic findings. Based on our statistical analysis, ultrasound as a diagnostic tool is more significant (P<0.05) and has a more positive predictive value in detecting thyroid cancer compared to FNAC.

Conclusions: Ultrasound characteristics and clinical suspicion are considered more valuable in the diagnosis of papillary thyroid carcinoma, especially for small lesions (<10 mm) and multinodular goiter. Therefore, an ultrasound scoring system should be adopted by the clinicians coping with thyroid cancer.