Malignancy (FNA) Based Prognostic Characteristics

In recent years, thyroid nodules have become one of the common endocrine problems in the United States. The vast majority of thyroid nodules detected during physical examination are benign; however, 5-10% of palpable nodules prove to be malignant on biopsy (1, 2). On palpation, a solid thyroid nodule has a higher chance of being malignant (3,4). The American Thyroid Association and the American Society of Radiologists in the United States have defined various ultrasound (US) based prognostic characteristics to predict malignancy, such as irregular margins, hypo-echogenicity, absent halo sign, internal vascularity, microcalcification, and taller-than-wide shape (2,5). Though the efficacy of conventional US varies according to current literature it does provide information to differentiate benign and malignant nodules. …show more content…
However, the rate of indeterminate cytology varies widely ranging from 15-32% that require further ancillary tests or surgical resection for a definitive diagnosis [7,9-12]. Only 10-30% of such surgically resected thyroid nodules will harbor malignancy (4,11,13). These diagnostic operations, accompanying risks and financial burden, may be avoided if adjunctive non-invasive tests could reliably establish a preoperative diagnosis of a non-neoplastic nodule. In addition, an indeterminate preoperative diagnosis does not always lead to a complete initial surgical intervention for thyroid cancer, requiring subsequent operations. Therefore, both unnecessary and multiple surgeries can potentially be avoided with a more accurate preoperative diagnosis of cancer in thyroid