ECE2022 Poster Presentations Thyroid (136 abstracts)
1La Rabta University Hospital, Department of Endocrinology, Tunis, Tunisia; 2 La Rabta University Hospital, Department of Oto-Rhino-Laryngology, Tunis, Tunisia; 3 La Rabta University Hospital, Department of Radiology, Tunis, Tunisia; 4 La Rabta University Hospital, Department of Pathology, Tunis, Tunisia
Introduction: Thyroid cancer remains a relatively rare entity. Radiological scoring systems aim to stratify the risk of malignancy based on morphological criteria.The objective of this study was to develop a new score based on ultrasound criteria to predict thyroid nodule malignancy risk.
Patients and methods: This was a retrospective study including 200 thyroid nodules (100 malignant nodules and 100 benign nodules). The report of the thyroid ultrasound and the result of the final histological examination were collected for each nodule. Odds ratios (OR) of ultrasound criteria were calculated. The new score represents the sum of the ORs of the ultrasound criteria for each nodule.
Results: Ultrasound criteria associated with nodule malignancy risk were: solid composition (OR=7.81; P<10-3), very hypoechoic character (OR=12.49; P<10-3), moderately hypoechoic character (OR=6.2: P<10-3), irregular contours (OR=7.47; P<10-3), taller-than-wide shape (OR=3.58;P=0.02), microcalcifications (OR=3.02;P=0.006) and the presence of cervical lymph nodes (OR=5.5; P<10-3). The mean ultrasound score was 16.7 ± 7.5 for malignant nodules vs 5.65 ± 6.5 for benign nodules (P<10-3). A score ≥ 10 was significantly associated with malignancy (OR=17.9; P<10-3). The threshold of 10 had a sensitivity of 85% and a specificity of 76%. A score ≥ 25 was predictive of malignancy in 100% of cases. The area under the ROC curve was 0.85 for this new score, 0.81 for the EU-TIRADS classification, and 0.82 for the ACR-TIRADS classification.
Conclusion: Our new ultrasound score seems to be effective in predicting thyroid nodule malignancy risk. However, it needs to be validated by prospective multicenter studies.