Observational studyEuropean radiology2015
Ultrasound-Based Risk Stratification for Malignancy in Thyroid Nodules: A Four-Tier Categorization System.
Observational study in European radiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- 2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules: the C-TIRADS.Endocrine · 2020Guideline
- Conventional ultrasound combined with contrast-enhanced ultrasound for differentiating benign and malignant thyroid nodules.Quantitative imaging in medicine and surgery · 2026Article
- A Mixed Model of Clinical Characteristics, Strain Elastography and ACR-TIRADS Predicts Malignancy in Small Thyroid Nodules: A Prospective Single-Center Study.Medicina (Kaunas, Lithuania) · 2025Article
- The value of non-punctate echogenic foci in the ultrasonic diagnosis of thyroid nodules.Endocrine · 2025Article
- Challenges in Risk Stratification of Solid Atypical Mixed Echogenicity Thyroid Nodules.TouchREVIEWS in endocrinology · 2024Article
- Distinguishing benign and malignant thyroid nodules using plasma trimethylamine N-oxide, carnitine, choline and betaine.Journal of cancer research and clinical oncology · 2024Article
- Deep learning approaches for differentiating thyroid nodules with calcification: a two-center study.BMC cancer · 2023Article
- Differentiating benign and malignant thyroid nodules: A cross-sectional study on the comparison of diagnostic value of ultrasound elastography and fine needle aspiration biopsy.Health science reports · 2023Article
- Malignancy risk of thyroid nodules with minimal cystic changes: a multicenter retrospective study.Ultrasonography (Seoul, Korea) · 2022Article
- Assessing Detection Accuracy of Computerized Sonographic Features and Computer-Assisted Reading Performance in Differentiating Thyroid Cancers.Biomedicines · 2022Article
- Review
- Review
- Deep learning for the diagnosis of suspicious thyroid nodules based on multimodal ultrasound images.Frontiers in oncology · 2022Article
- Comparison of Conventional Smear and Liquid-Based Cytology in Adequacy of Thyroid Fine-Needle Aspiration Biopsies without an Accompanying Cytopathologist.Sisli Etfal Hastanesi tip bulteni · 2022Article
- 2021 Korean Thyroid Imaging Reporting and Data System and Imaging-Based Management of Thyroid Nodules: Korean Society of Thyroid Radiology Consensus Statement and Recommendations.Korean journal of radiology · 2021Review
- Malignancy Risk Stratification of Thyroid Nodules with Macrocalcification and Rim Calcification Based on Ultrasound Patterns.Korean journal of radiology · 2021Article
- Fine needle aspiration biopsy indications for thyroid nodules: compare a point-based risk stratification system with a pattern-based risk stratification system.European radiology · 2019Article
- Diagnostic pitfalls and therapeutic outcomes of the macrofollicular variant of papillary thyroid carcinoma.Biomedical journal · 2019Article
- Comparison of Different Risk-Stratification Systems for the Diagnosis of Benign and Malignant Thyroid Nodules.Frontiers in oncology · 2019Article
- Observational
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe purpose of this study was to stratify the malignancy risk of US features, with an emphasis on nodule echogenicity.
methodsA total of 1,058 nodules of 824 consecutive patients (236 malignant and 822 benign) were included in this study. Malignancy risk of each nodule was analyzed according to US features, with an emphasis on nodule echogenecity, and was stratified into 4-tier categories.
resultsIn multivariate analysis, isoechogenicity, indistinct margin, non-solid internal content, and parallel orientation were predictive of benign nodules (P < 0.002), while hypoechogenicity, marked hypoechogenicity, spiculated/microlobulated margin, solid content, nonparallel orientation (taller than wide), microcalcification, and macrocalcification were predictive of malignancy (P ≤ 0.037). Although the presence of US features associated with malignancy was significantly predictive of malignancy in hypoechoic and markedly hypoechoic nodules (P ≤ 0.004), it was not associated with malignancy in isoechoic or hyperechoic nodules. Thyroid nodules could be stratified into four categories according to the malignancy risk: benign (risk 0%), probably benign (risk ≤ 5%), indeterminate (risk > 5 and < 50%), and suspicion of malignancy (risk > 50%).
conclusionsThe US-based four-tier categorization system will be useful for predicting the risk of malignancy and decisions regarding FNA for thyroid nodules. KEY POINTS: • No US feature was predictive of malignancy in isoechoic nodules. • Isoechoic nodules without calcification can be included in the probably benign category. • We suggest a four-tier categorization stratified primarily by nodule echogenecity. • The four-tier categorization of thyroid nodules will be useful for FNA decisions.
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