ArticleCancer medicine2021
The gray zone of thyroid nodules: Using a nomogram to provide malignancy risk assessment and guide patient management.
Article in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Integrated intraoperative predictive model for malignancy risk assessment of thyroid nodules with atypia of undetermined significance cytology.Scientific reports · 2025Article
- Optimizing thyroid AUS nodules malignancy prediction: a comprehensive study of logistic regression and machine learning models.Frontiers in endocrinology · 2024Article
- The Role of "Critical" Ultrasound Reassessment in the Decision-Making of Bethesda III Thyroid Nodules.Medicina (Kaunas, Lithuania) · 2023Article
- The diagnostic value of a nomogram based on multimodal ultrasonography for thyroid-nodule differentiation: A multicenter study.Frontiers in oncology · 2022Article
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Authors and funding
3 authors.
Funding
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Abstract
backgroundThyroid nodules have a low prevalence of malignancy and most proven cancers do not behave aggressively. Thus, risk-stratification of nodules is a critical step to avoid surgical overtreatment. We hypothesized that a risk management system superior to those currently in use could be created to reduce the number of clinically indeterminate nodules (i.e., the "gray zone") by concurrently considering the malignancy risks conferred by clinical, ultrasonographic, and cytologic variables.
methodsThyroidectomy cases were reviewed from three institutions. Their benign versus malignant outcome was used to evaluate the variables for correlation. A binary logistic regression model was trained and, using indeterminate nodules with Bethesda III and IV results, validated. A scoring nomogram was designed to demonstrate the application of the model in clinical practice.
resultsOne hundred thirty thyroidectomies (28% malignant) met inclusion criteria. The final logistic regression model included difficulty in swallowing, hypothyroidism, echogenicity, hypervascularity, margins, calcification, and cytology diagnosis as input parameters. The model was highly successful in determining the outcome (p value: 0.001) with a R
conclusionsWe report a model for risk assessment of thyroid nodules that has the potential to significantly reduce indeterminates and surgical overtreatment. We illustrate its application via a straightforward nomogram, which integrates clinical, ultrasonographic, and cytologic data, and can be used to create clear, evidence-based management plans for patients.
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