RT Journal Article
SR Electronic
T1 Role of Sonographic Diagnosis in Managing Bethesda Class III Nodules
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 2136
OP 2141
DO 10.3174/ajnr.A2686
VO 32
IS 11
A1 Kim, D.W.
A1 Lee, E.J.
A1 Jung, S.J.
A1 Ryu, J.H.
A1 Kim, Y.M.
YR 2011
UL http://www.ajnr.org/content/32/11/2136.abstract
AB BACKGROUND AND PURPOSE: Bethesda class III cytology is an important limitation of the US-FNA in assessing thyroid nodules. This study aimed to assess the diagnostic efficacy of US in evaluating thyroid nodules with Bethesda class III cytology. MATERIALS AND METHODS: From January 2008 to December 2009, 1036 patients with 1289 thyroid nodules diagnosed by US and subsequent US-FNA biopsy were enrolled in the study. On the basis of US features, each thyroid nodule was prospectively classified by a single radiologist into 1 of 5 diagnostic categories: benign, probably benign, borderline, possibly malignant, and malignant. Solid nodules were classified by using all 5 categories, whereas partially cystic nodules were classified by using 4 (borderline was omitted). We calculated the diagnostic efficacy of thyroid US by comparing the US diagnoses with the histopathology results of Bethesda class III nodules. RESULTS: Of the 51 Bethesda class III nodules, 35 were surgically confirmed and 8 were histologically diagnosed, and a malignancy rate of 46.5% (20/43) was determined. From the 43 nodules, the sensitivity, specificity, positive and negative predictive values, and accuracy were calculated with 9 borderline nodules excluded (100%, 94.7%, 93.3%, 100%, and 97.0%, respectively) and with the 9 when reclassified as benign (63.6%, 95.2%, 93.3%, 71.4%, and 79.1%, respectively) and malignant (100%, 85.7%, 88.0%, 100%, and 93.0%, respectively). The values obtained with exclusion and malignancy reclassification of 9 borderline nodules were not significantly different (P = .250). CONCLUSIONS: US diagnosis by using the present US classification system can be helpful for managing Bethesda class III nodules. CNBcore-needle biopsyFNAfine-needle aspirationPCTNpartially cystic thyroid noduleUSsonography