ArticleUltrasonography (Seoul, Korea)2026
Ultrasound-based follow-up of low-suspicion thyroid nodules with cytopathologic confirmation: is nodule growth associated with malignancy?
Article in Ultrasonography (Seoul, Korea), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aimed to evaluate the clinical utility of different ultrasound-based methods for assessing growth in low-suspicion thyroid nodules and to determine whether significant nodule growth (SNG) is associated with malignancy or thyroid neoplasm, as well as its implications for follow-up intervals.
methodsIn this retrospective study, 309 patients with 334 low-suspicion thyroid nodules were analyzed. All nodules underwent at least three ultrasound examinations over ≥1 year and had cytopathologic confirmation. SNG was defined using three criteria: diameter-based criterion (DBC; ≥20% increase in at least two diameters with a minimum increase of ≥2 mm), volume-based criterion (VBC; ≥50% increase in volume), and change in the longest diameter alone (≥20% and ≥2 mm increase). Statistical associations between SNG and malignancy or thyroid neoplasm were evaluated using odds ratios (ORs).
resultsNodule growth was common, occurring in 57.8% of nodules according to DBC or VBC and in 51.5% based on the longest diameter, with substantial concordance between methods (κ=0.68). The median time to SNG was 2.9 years for DBC or VBC and 2.6 years for the longest diameter. SNG was not significantly associated with malignancy (OR, 1.19; 95% confidence interval [CI], 0.69 to 2.06) or thyroid neoplasm (OR, 1.05; 95% CI, 0.59 to 1.88).
conclusionAmong cytopathologically confirmed low-suspicion thyroid nodules, SNG was not associated with malignancy or thyroid neoplasm. Measurement of the longest diameter alone provided a practical alternative to more complex growth assessment methods. Given that the median time to SNG exceeded 2.6 years, current ultrasound follow-up intervals for low-suspicion nodules may warrant cautious reconsideration.
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