Ultrasound characterization for thyroid nodules with indeterminate cytology: inter-observer agreement and impact of combining pattern-based and scoring-based classifications in risk stratification

被引:15
作者
Lam, Cesar A. [1 ]
McGettigan, Melissa J. [1 ]
Thompson, Zachary J. [2 ]
Khazai, Laila [3 ]
Chung, Christine H. [4 ]
Centeno, Barbara A. [3 ]
McIver, Bryan [4 ]
Valderrabano, Pablo [4 ,5 ]
机构
[1] H Lee Moffitt Canc Ctr & Res Inst, Dept Diagnost Imaging, 12902 Magnolia Dr, Tampa, FL 33612 USA
[2] H Lee Moffitt Canc Ctr & Res Inst, Dept Biostat & Bioinformat, 12902 Magnolia Dr, Tampa, FL 33612 USA
[3] H Lee Moffitt Canc Ctr & Res Inst, Dept Anat Pathol, 12902 Magnolia Dr, Tampa, FL 33612 USA
[4] H Lee Moffitt Canc Ctr & Res Inst, Dept Head & Neck Endocrine Oncol, 12902 Magnolia Dr, Tampa, FL 33612 USA
[5] IRYCIS, Hosp Univ Ramon & Cajal, Dept Endocrinol & Nutr, Ctra Colmenar Viejo Km 9,100, Madrid 28034, Spain
关键词
Thyroid ultrasound; Thyroid cytology; Thyroid nodules; Thyroid cancer; Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP); ASSOCIATION MANAGEMENT GUIDELINES; FINE-NEEDLE ASPIRATIONS; CANCER EPIDEMIC; MALIGNANCY; OPERATIONS; CARCINOMA; DIAGNOSES; INCREASES; FEATURES;
D O I
10.1007/s12020-019-02000-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The American Thyroid Association (ATA) sonographic patterns stratify the risk of malignancy of cytologically indeterminate thyroid nodules (ITNs). This study aimed to (1) assess inter-observer agreement for sonographic features and patterns; (2) identify potential sources of disagreement; and (3) evaluate whether the number of suspicious features riskstratifies non-ATA and high-suspicion patterns. Methods Three observers independently reviewed the ultrasound images of 463 ITNs with histological follow-up consecutively evaluated between October 2008 and June 2015 at an academic cancer center. Each observer evaluated individual sonographic features. ATA sonographic patterns were derived from the interpretation of sonographic features. Nodules not fitting into any of the proposed patterns were clustered into a non-ATA pattern. Results The inter-observer agreement for ATA sonographic patterns and echogenicity was fair, moderate for margins, good for composition and echogenic foci, and very good for extrathyroidal extension and lymph node metastasis. The interpretation of each sonographic feature was significantly different between observers, and there was complete disagreement in at least one of the features in 104 (22%) nodules. A total of 169 nodules (37%) were classified into the non-ATA pattern. The number of suspicious features allowed risk stratifying nodules with non-ATA and high-suspicion sonographic patterns. Most Non-invasive Follicular Thyroid Neoplasms with Papillary-like Nuclear Features had 0-1 suspicious features and none had >2. Conclusions Echogenicity interpretation was the greatest source of disagreement. The number of suspicious features riskstratifies ITNs with non-ATA or high-suspicion patterns. Future studies attempting to objectivize the interpretation of echogenicity and heterogeneity are needed.
引用
收藏
页码:278 / 287
页数:10
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