Sonographic Risk Stratification Systems for Thyroid Nodules as Rule-Out Tests in Older Adults

Cancers

卷:12

Pierpaolo Trimboli¹  Rosa Falcone²  Cosimo Durante²  Piernatale Lucia²  Sebastiano Filetti²  Valeria Ramundo²  Marianna Maranghi²  Giorgio Grani²  Gabriela Brenta³ 

[1] Clinic of Endocrinology, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland;

[2] Department of Translational and Precision Medicine, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy;

[3] Endocrinology Department, Cesar Milstein Hospital, Buenos Aires CABA C1221ACI, Argentina;

关键词: ultrasonography;    ultrasound;    thyroid nodule;    reproducibility of results;    sensitivity and specificity;    aged adults;   

DOI  :  10.3390/cancers12092458

来源: DOAJ

【 摘 要 】

Ultrasonographic risk-stratification systems (RSS), including various Thyroid Imaging Reporting and Data Systems (TIRADS), were proposed to improve reporting and reduce the number of fine-needle aspiration biopsies. However, age might be a confounder since some suspicious ultrasonographic features lack specificity in elderly patients. We aimed to investigate whether the diagnostic performance of the RSS varied between age groups. All patients consecutively referred for thyroid biopsy between November 1, 2015, and March 10, 2020, were included. The malignancy risk of each nodule was estimated according to five RSS: the American Association of Clinical Endocrinologists/American College of Endocrinology/Associazione Medici Endocrinologi guidelines, the American College of Radiology (ACR) TIRADS, the American Thyroid Association guidelines, the European TIRADS, and the Korean TIRADS. Overall, 818 nodules (57 malignant) were evaluated. The malignancy rate was higher in patients ≤ 65 years (8.1%) than in patients > 65 years (3.8%; p = 0.02). All RSS confirmed a significant discriminative performance in both age groups, with a negative predictive value of 100% in patients > 65 years, although specificity was lower in older patients. The ACR TIRADS was the best performing in both age groups. RSS could avoid a sizable number of biopsies when applied as rule-out tests in elderly patients.

【 授权许可】

Unknown