Ting-Chun Kuo1, Ming-Hsun Wu2, Kuen-Yuan Chen2, Min-Shu Hsieh3, Argon Chen4, Chiung-Nien Chen5. 1. Department of Surgery, National Taiwan University Hospital, Taiwan, ROC; Department of Traumatology, National Taiwan University Hospital, Taiwan, ROC. 2. Department of Surgery, National Taiwan University Hospital, Taiwan, ROC. 3. Department of Pathology, National Taiwan University Hospital, Taiwan, ROC. 4. Graduate Institute of Industrial Engineering, National Taiwan University, Taiwan, ROC. 5. Department of Surgery, National Taiwan University Hospital, Taiwan, ROC. Electronic address: cnchen@ntu.edu.tw.
Abstract
BACKGROUND: Preoperative differentiation of follicular thyroid carcinoma (FTC) from follicular adenoma (FA) remains an unsolved puzzle. Patients sometimes undergo unnecessary lobectomy for histology confirmation inevitably. OBJECTIVE: In this retrospective study, we propose new gray-scale ultrasonographic (US) features that may help to differentiate FTC from FA. METHOD: Medical charts and US images of follicular thyroid neoplasms were collected prospectively. Gray-scale US features including conventional parameters adding tubercle-in-nodule and trabecular formation were recorded. RESULTS: The histopathologic diagnosis was FA in 139 and FTC in 49 patients. In patients with FTC, minimally invasive follicular carcinoma (MIFC) was seen in 36 patients and widely invasive follicular carcinoma (WIFC) in 13. The incidences of calcifications (p < 0.0001), tubercle-in-nodule signs (p < 0.0001), spiculated margins (p = 0.014), and trabecular formations (p = 0.03) were significantly higher in FTC. Tubercle-in-nodule (p < 0.01) and calcification (p < 0.001) were independent factors in the differentiation of FTC in multivariate analysis (area under the curve = 0.689). CONCLUSIONS: US characteristics of tubercle-in-nodule in combination with calcification help to differentiate FTC from FA.
BACKGROUND: Preoperative differentiation of follicular thyroid carcinoma (FTC) from follicular adenoma (FA) remains an unsolved puzzle. Patients sometimes undergo unnecessary lobectomy for histology confirmation inevitably. OBJECTIVE: In this retrospective study, we propose new gray-scale ultrasonographic (US) features that may help to differentiate FTC from FA. METHOD: Medical charts and US images of follicular thyroid neoplasms were collected prospectively. Gray-scale US features including conventional parameters adding tubercle-in-nodule and trabecular formation were recorded. RESULTS: The histopathologic diagnosis was FA in 139 and FTC in 49 patients. In patients with FTC, minimally invasive follicular carcinoma (MIFC) was seen in 36 patients and widely invasive follicular carcinoma (WIFC) in 13. The incidences of calcifications (p < 0.0001), tubercle-in-nodule signs (p < 0.0001), spiculated margins (p = 0.014), and trabecular formations (p = 0.03) were significantly higher in FTC. Tubercle-in-nodule (p < 0.01) and calcification (p < 0.001) were independent factors in the differentiation of FTC in multivariate analysis (area under the curve = 0.689). CONCLUSIONS: US characteristics of tubercle-in-nodule in combination with calcification help to differentiate FTC from FA.
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