Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-22T14:41:33.279Z Has data issue: false hasContentIssue false
  • English
  • Français

Is sonographic intra-nodular vascularity a reliable predictor of thyroid malignancy? A UK tertiary centre study

Published online by Cambridge University Press:  21 May 2021

E Omakobia ,
S McClean ,
J England  and
A Walden
E Omakobia*
Affiliation:
Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
S McClean
Affiliation:
Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
J England
Affiliation:
Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
A Walden
Affiliation:
Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
*
Author for correspondence: Mr Eugene Omakobia, Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, HullHU16 5JQ, UK E-mail: [email protected] Fax: +44 (0)1274 366 549
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

British Thyroid Association 2014 guidelines emphasised ultrasound assessment of nodules. One ultrasonographic differentiator of debatable relevance is intra-nodular vascularity. This is the first UK study conducted to address this question.

Methods

Ultrasound reports for thyroid surgery patients over 10 years were retrospectively reviewed. Reports documenting ‘intra-nodular vascularity or flow’ were analysed. Reports identifying peripheral vascularity only or no intra-nodular flow formed the control group. Concordance with final histology was used to determine the odds ratio for malignancy.

Results

A total of 306 patients were included, and 119 (38.9 per cent) nodules demonstrated intra-nodular vascularity. Of these, 60 (50.4 per cent) were malignant compared with 42 per cent in the control group. Intra-nodular vascularity was not a statistically significant predictor of malignancy with an odds ratio of 1.39 (p = 0.18, 95 per cent confidence interval, 0.86–2.23).

Conclusion

Intra-nodular vascularity in isolation was not a reliable predictor of malignancy. This supports other world literature studies. Although intra-nodular flow should not be relied upon in isolation, interpretation in conjunction with other suspicious findings enhances the predictive value.

Keywords

UltrasoundThyroid GlandNeoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 7 , July 2021 , pp. 599 - 601
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr E Omakobia takes responsibility for the integrity of the content of the paper

Presented as a poster at the British Association of Endocrine and Thyroid Surgeons meeting, 3–4 October 2019, Barcelona, Spain, and at the North of England Otolaryngology Society, 23 October 2019, Wakefield, UK.

References

Cancer Research UK. Thyroid cancer incidence statistics. In: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/thyroid-cancer/incidence. [20 November 2019]Google Scholar
Mitchell, AL, Gandhi, A, Scott-Coombes, D, Perros, P. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130:S150–6010.1017/S0022215116000578CrossRefGoogle ScholarPubMed
Davies, L, Welch, HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA 2006;295:2164–710.1001/jama.295.18.2164CrossRefGoogle ScholarPubMed
Pattison, DA, Bozin, M, Gorelik, A, Hofman, MS, Hicks, RJ, Skandarajah, A. 18 F-FDG-avid thyroid incidentalomas: the importance of contextual interpretation. J Nucl Med 2018;59:749–5510.2967/jnumed.117.198085CrossRefGoogle ScholarPubMed
Zafon, C, Baena, JA, Castellví, J, Obiols, G, Gonzalez, O, Fort, JM et al. Evolution of differentiated thyroid cancer: a decade of thyroidectomies in a single institution. Eur Thyroid J 2014;3:197–20110.1159/000365416CrossRefGoogle ScholarPubMed
Perros, P, Boelaert, K, Colley, S, Evans, C, Evans, RM, Gerrard, G et al. British Thyroid Association. Guidelines for the management of thyroid cancer. Clin Endocrinol (Oxf) 2014;81:1–12210.1111/cen.12515CrossRefGoogle ScholarPubMed
Yang, GC, Fried, KO. Most thyroid cancers detected by sonography lack intranodular vascularity on colour Doppler imaging: review of the literature and sonographic-pathologic correlations for 698 thyroid neoplasms. J Ultrasound Med 2017;36:89–9410.7863/ultra.16.03043CrossRefGoogle ScholarPubMed
Remonti, LR, Kramer, CK, Leitao, CB, Pinto, LCF, Gross, JL. Thyroid ultrasound features and risk of carcinoma: a systematic review and meta-analysis of observational studies. Thyroid 2015;25:538–5010.1089/thy.2014.0353CrossRefGoogle ScholarPubMed
Khadra, H, Bakeer, M, Hauch, A, Hu, T, Kandil, E. Is vascular flow a predictor of malignant thyroid nodules? A meta-analysis. Gland Surg 2016;5:576–82CrossRefGoogle ScholarPubMed
Alexander, V, Rudd, J, Walker, D, Wong, G, Lunt, A, Hamakarim, Z et al. Thy 3F and 3a malignancy rate, a multisite regional retrospective case series. Ann R Coll Surg Engl 2018;100:545–5010.1308/rcsann.2018.0103CrossRefGoogle ScholarPubMed
Chng, CL, Kurzawinski, TR, Beale, T. Value of sonographic features in predicting malignancy in thyroid nodules diagnosed as follicular neoplasm on cytology. Clin Endocrinol 2015;83:711–1610.1111/cen.12692CrossRefGoogle ScholarPubMed
Rago, T, Vitti, P, Chiovato, L, Mazzeo, S, De Liperi, A, Miccoli, P et al. Role of conventional ultrasonography and colour flow-Doppler sonography in predicting malignancy in ‘cold’ thyroid nodules. Eur J Endocrinol 1998;138:41–610.1530/eje.0.1380041CrossRefGoogle ScholarPubMed
Sebag, F, Vaillant-Lombard, J, Berbis, J, Griset, V, Henry, JF, Petit, P et al. Shear wave elastography: a new ultrasound imaging mode for the differential diagnosis of benign and malignant thyroid nodules. J Clin Endocrinol Metab 2010;95:5281–810.1210/jc.2010-0766CrossRefGoogle ScholarPubMed
Tessler, FN, Middleton, WD, Grant, EG, Hoang, JK, Berland, LL, Teefey, SA et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol 2017;14:587–9510.1016/j.jacr.2017.01.046CrossRefGoogle ScholarPubMed
Rosario, PW, Silva, AL, Borges, MA, Calsolari, MR. Is Doppler ultrasound of additional value to gray-scale ultrasound in differentiating malignant and benign thyroid nodules? Arch Endocrinol Metab 2015;59:79–83CrossRefGoogle ScholarPubMed