Sina Jasim1, Thomas J Baranski1, Sharlene A Teefey2, William D Middleton2. 1. Division of Endocrinology, Metabolism and Lipid Research, Department of Internal Medicine; School of Medicine, St. Louis, Missouri. 2. Mallinckrodt Institute of Radiology; Washington University in St. Louis, School of Medicine, St. Louis, Missouri.
Abstract
Background: Thyroid nodules are routinely evaluated with ultrasound. Our aim was to determine if thyroid nodule location was a useful feature to predict thyroid cancer. Materials and Methods: Retrospective review of patients with thyroid nodules from six referral centers from 2006 to 2010. A total of 3313 adult patients with thyroid nodules and confirmed benign or malignant thyroid diagnoses were included. Results: Mean patient age was 54.2 (18-97) years, and the majority were women (n = 2635, 79.8%). A total of 3241 nodules were analyzed, 335 (10.3%) of which were malignant. Thyroid nodule location was an independent risk factor in predicting thyroid cancer (p = 0.005). Thyroid cancer odds were highest in the isthmus (odds ratio [OR] = 2.4, 95% confidence interval [CI] 1.6-3.6, p < 0.0001). In a multivariate regression model adjusting for age, sex, family history of thyroid cancer, radiation exposure, nodule size, and American College of Radiology (ACR) TI-RADS (Thyroid Imaging Reporting and Data System) score, the isthmus nodules had the highest risk of malignancy (OR = 2.4 [CI 1.5-3.9], p = 0.0007), followed by upper thyroid nodules (OR = 1.8 [CI 1.2-2.7], p = 0.005) and then middle thyroid nodules (OR = 1.5 [CI 1.1-2.0], p = 0.01) compared with lower thyroid nodules. Isthmus nodules were significantly smaller in size compared with middle (p < 0.0001) and lower (p = 0.0004), but not upper nodules (p = 0.25), with a mean size of 15.5 mm (±10.7). Conclusions: Thyroid nodule location is an independent risk factor in predicting the risk of thyroid cancer. Isthmic nodules carry the highest risk of cancer diagnosis and lower lobe nodules carry the lowest risk.
Background: Thyroid nodules are routinely evaluated with ultrasound. Our aim was to determine if thyroid nodule location was a useful feature to predict thyroid cancer. Materials and Methods: Retrospective review of patients with thyroid nodules from six referral centers from 2006 to 2010. A total of 3313 adult patients with thyroid nodules and confirmed benign or malignant thyroid diagnoses were included. Results: Mean patient age was 54.2 (18-97) years, and the majority were women (n = 2635, 79.8%). A total of 3241 nodules were analyzed, 335 (10.3%) of which were malignant. Thyroid nodule location was an independent risk factor in predicting thyroid cancer (p = 0.005). Thyroid cancer odds were highest in the isthmus (odds ratio [OR] = 2.4, 95% confidence interval [CI] 1.6-3.6, p < 0.0001). In a multivariate regression model adjusting for age, sex, family history of thyroid cancer, radiation exposure, nodule size, and American College of Radiology (ACR) TI-RADS (Thyroid Imaging Reporting and Data System) score, the isthmus nodules had the highest risk of malignancy (OR = 2.4 [CI 1.5-3.9], p = 0.0007), followed by upper thyroid nodules (OR = 1.8 [CI 1.2-2.7], p = 0.005) and then middle thyroid nodules (OR = 1.5 [CI 1.1-2.0], p = 0.01) compared with lower thyroid nodules. Isthmus nodules were significantly smaller in size compared with middle (p < 0.0001) and lower (p = 0.0004), but not upper nodules (p = 0.25), with a mean size of 15.5 mm (±10.7). Conclusions: Thyroid nodule location is an independent risk factor in predicting the risk of thyroid cancer. Isthmic nodules carry the highest risk of cancer diagnosis and lower lobe nodules carry the lowest risk.
Authors: Bryan R Haugen; Erik K Alexander; Keith C Bible; Gerard M Doherty; Susan J Mandel; Yuri E Nikiforov; Furio Pacini; Gregory W Randolph; Anna M Sawka; Martin Schlumberger; Kathryn G Schuff; Steven I Sherman; Julie Ann Sosa; David L Steward; R Michael Tuttle; Leonard Wartofsky Journal: Thyroid Date: 2016-01 Impact factor: 6.568
Authors: Jin Young Kwak; Kyung Hwa Han; Jung Hyun Yoon; Hee Jung Moon; Eun Ju Son; So Hee Park; Hyun Kyung Jung; Ji Soo Choi; Bo Mi Kim; Eun-Kyung Kim Journal: Radiology Date: 2011-07-19 Impact factor: 11.105
Authors: Valeria Ramundo; Livia Lamartina; Rosa Falcone; Laura Ciotti; Cristiano Lomonaco; Marco Biffoni; Laura Giacomelli; Marianna Maranghi; Cosimo Durante; Giorgio Grani Journal: Ultrasonography Date: 2018-11-06
Authors: Sara Ahmadi; Theodora Pappa; Alex S Kang; Alexandra K Coleman; Iñigo Landa; Ellen Marqusee; Matthew Kim; Trevor E Angell; Erik K Alexander Journal: Front Endocrinol (Lausanne) Date: 2022-02-11 Impact factor: 5.555