Journal
KOREAN JOURNAL OF RADIOLOGY
Volume 23, Issue 7, Pages 763-772Publisher
KOREAN SOCIETY OF RADIOLOGY
DOI: 10.3348/kjr.2022.0079
Keywords
Thyroid nodules; Thyroid cancer; Follicular neoplasm; Ultrasonography; Machine learning
Funding
- Korean Thyroid Association Clinical Research Award
Ask authors/readers for more resources
This multicenter cohort study analyzed the clinicoradiological characteristics of different histological types of follicular-patterned lesions in thyroid nodules. The study found that distinguishing features for these lesions compared to benign follicular nodules included patient age, lesion diameter, composition, echogenicity, and presence of halo. The study also identified specific features that distinguished follicular carcinoma and follicular variant of papillary thyroid carcinoma from follicular adenoma. The most important distinguishing features were lesion diameter, composition, echogenicity, orientation, and patient age.
Objective: Preoperative differential diagnosis of follicular-patterned lesions is challenging. This multicenter cohort study investigated the clinicoradiological characteristics relevant to the differential diagnosis of such lesions. Materials and Methods: From June to September 2015, 4787 thyroid nodules (>= 1.0 cm) with a final diagnosis of benign follicular nodule (BN, n = 4461), follicular adenoma (FA, n = 136), follicular carcinoma (FC, n = 62), or follicular variant of papillary thyroid carcinoma (FVPTC, n = 128) collected from 26 institutions were analyzed. The clinicoradiological characteristics of the lesions were compared among the different histological types using multivariable logistic regression analyses. The relative importance of the characteristics that distinguished histological types was determined using a random forest algorithm. Results: Compared to BN (as the control group), the distinguishing features of follicular-patterned neoplasms (FA, FC, and FVPTC) were patient's age (odds ratio [OR], 0.969 per 1-year increase), lesion diameter (OR, 1.054 per 1-mm increase), presence of solid composition (OR, 2.255), presence of hypoechogenicity (OR, 2.181), and presence of halo (OR, 1.761) (all p < 0.05). Compared to FA (as the control), FC differed with respect to lesion diameter (OR, 1.040 per 1-mm increase) and rim calcifications (OR, 17.054), while FVPTC differed with respect to patient age (OR, 0.966 per 1-year increase), lesion diameter (OR, 0.975 per 1-mm increase), macrocalcifications (OR, 3.647), and non-smooth margins (OR, 2.538) (all p < 0.05). The five important features for the differential diagnosis of follicular-patterned neoplasms (FA, FC, and FVPTC) from BN are maximal lesion diameter, composition, echogenicity, orientation, and patient's age. The most important features distinguishing FC and FVPTC from FA are rim calcifications and macrocalcifications, respectively. Conclusion: Although follicular-patterned lesions have overlapping clinical and radiological features, the distinguishing features identified in our large clinical cohort may provide valuable information for preoperative distinction between them and decision-making regarding their management.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available