ArticleThe Journal of clinical endocrinology and metabolism2022
Thyroid Nodule Shape Independently Predicts Risk of Malignancy.
Article in The Journal of clinical endocrinology and metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Sociodemographic and clinical predictors of malignancy in thyroid nodules: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Diagnostic performance of C-TIRADS in malignancy risk stratification of thyroid nodules: A systematic review and meta-analysis.Frontiers in endocrinology · 2022Pooled it
- Bisphenol A and its analogues in thyroid diseases: Evidence from dysfunction, autoimmunity, and cancer.iScience · 2026Review
- Surgical outcomes of Bethesda System for Reporting Thyroid Cytopathology diagnostic category class I, II, and III thyroid nodules.Frontiers in endocrinology · 2026Article
- A "calcification"-enhanced deep learning approach for precise differentiation of thyroid nodules.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Article
- Thyroid Nodule Sphericity Metrics Discriminate Benign and Malignant Follicular and Oncocytic Neoplasms.Thyroid : official journal of the American Thyroid Association · 2025Article
- A deep learning based ultrasound diagnostic tool driven by 3D visualization of thyroid nodules.NPJ digital medicine · 2025Article
- The diagnostic value of a new ultrasonographic method for the measurement of a taller-than-wide shape of benign and malignant thyroid nodules.Endocrine · 2023Article
- Global scientific trends on thyroid disease in early 21st century: a bibliometric and visualized analysis.Frontiers in endocrinology · 2023Article
- Should we reconsider high-risk features in thyroid ultrasonography?Revista da Associacao Medica Brasileira (1992) · 2023Article
Corrections and comments
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Authors and funding
16 authors at 1 institution in 1 country.
Funding
Abstract
contextPredictive models of thyroid nodule cancer risk are presently based upon nodule composition, echogenicity, margins, and the presence of microcalcifications. Nodule shape has shown promise to be an additive factor helping determine the need for nodule biopsy.
objectiveWe sought to determine if calculation of a nodule's spherical shape independently associates with cancer risk.
methodsThis prospective cohort study, conducted at a single large academic healthcare system in the United States, included patients with 1 or 2 clinically relevant thyroid nodules (predominantly solid and over 1 cm) presenting for diagnostic evaluation. Thyroid ultrasound, cytological evaluation with fine-needle biopsy, and/or histopathological examination on occasion of thyroid surgery were performed. We calculated the nodule's long to short ratio (spherical shape), and its association with tissue proven benign or malignant endpoints.
resultsThe long to short nodule ratio was significantly lower in malignant compared to benign nodules indicating greater risk of malignancy in more spherical nodules (1.63 ± 0.38 for malignant nodules vs 1.74 ± 0.47 for benign, P < 0.0001). The risk of malignancy continually increased as the long to short ratio approached a purely spherical ratio of 1.0 (ratio > 2.00, 14.6% cancer; ratio 1.51-2.00, 19.7%; ratio 1.00-1.50, 25.5%, P < 0.0001). In multiple regression analysis, younger age, male sex, and nodule's spherical shape were each independently associated with cancer risk.
conclusionThe more a thyroid nodule is spherically shaped, as indicated by a long to short ratio approaching 1.0, the greater its risk of malignancy. This was independent of age, sex, and nodule size. Incorporating a nodule's sphericity in the risk stratification systems may improve individualized clinical decision making.
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