JOURNAL CLUB: Retrospective Evaluation of Ultrasound Features of Thyroid Nodules to Assess Malignancy Risk: A Step Toward TIRADS.
JOURNAL CLUB: Retrospective Evaluation of Ultrasound Features of Thyroid Nodules to Assess Malignancy Risk: A Step Toward TIRADS.
复制标题
期刊俱乐部：甲状腺结节超声特征的回顾性评估以评估恶性肿瘤风险：迈向 TIRADS 的一步。
DOI：
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
K. Berbaum
中科院分区：
文献类型：
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作者：
A. Zayadeen;M. Abu;K. Berbaum
目的
本回顾性研究的目的是开发一种甲状腺结节恶性潜能评分系统，以便更好地选择结节进行超声（US）引导下细针穿刺（FNA）。
材料和方法
对连续患者的2375个甲状腺结节进行了超声引导下FNA。2002年病变的细胞病理学或组织病理学确认显示148例为恶性。我们开发了一个扩展的评分系统，通过包括弱（大钙化、蛋壳样钙化、低回声、实性）以及恶性肿瘤的强指标（微钙化、低回声、分叶状或边界不清、形状高于宽度、可疑淋巴结），并包括禁忌症（强回声、彗星尾伪影、完全晕、囊性或微囊性）。使用ROC分析来比较使用扩展评分的五个主要特征的标准评分所产生的检测准确性和决策阈值。
结果
虽然准确性优势被发现的扩展评分标准评分，我们折扣这一发现，因为我们的评分涉及初步分析。然而，扩展评分为恶性肿瘤的确定性提供了更多的报告选项：标准评分提供了4个潜在的报告阈值;扩展评分提供了9个。最有用的额外阈值捕获了近88%的恶性肿瘤，但仅导致28%的非恶性肿瘤患者接受活检。
结论
我们扩展的甲状腺成像报告和数据系统评分提供了更多的操作点，以支持治疗决策。一个简化的决策规则活检每个结节至少有两个弱功能或一个强功能，保留了最有用的新的决策阈值从扩展评分。
OBJECTIVE
The aim of this retrospective study was to develop a thyroid nodule scoring system for malignancy potential to better select nodules for ultrasound (US)-guided fine needle aspiration (FNA).
MATERIALS AND METHODS
US-guided FNA was performed on 2375 thyroid nodules in successive patients. Cytologic or histopathologic confirmation of disease state in 2002 lesions showed that 148 were malignant. We developed an extended scoring system to provide more decision levels than standard scoring by including weak (macrocalcification, eggshell calcification, hypoechogenicity, solid consistency) as well as strong indicators of malignancy (microcalcification, hypoechogenicity, lobulated or ill-defined margins, taller-than-wide shape, suspicious lymph nodes) and by including contraindications (hyperechogenicity, comet-tail artifact, complete halo, cystic or microcystic). ROC analysis was used to compare detection accuracy and decision thresholds resulting from standard scoring using five major features with extended scoring.
RESULTS
Although an accuracy advantage was found for the extended scoring over standard scoring, we discount this finding because our scoring involved a preliminary analysis. However, the extended scoring offers more reporting options for certainty of malignancy: standard scoring gave four potential thresholds for reporting; extended scoring gave nine. The most useful of the additional thresholds captured nearly 88% of malignancies but resulted in only 28% of patients without malignancy undergoing biopsy.
CONCLUSION
Our extended Thyroid Imaging Reporting and Data System scoring provides more operating points to support treatment decisions. A simplified decision rule-biopsy every nodule with at least two weak features or one strong feature-preserves the most useful of the new decision thresholds from extended scoring.
影响因子：
39
作者：
Smith-Bindman, Rebecca;Lebda, Paulette;Feldstein, Vickie A.;Sellami, Dorra;Goldstein, Ruth B.;Brasic, Natasha;Jin, Chengshi;Kornak, John
通讯作者：
Kornak, John
影响因子：
6.7
作者：
DORFMAN, DD;BERBAUM, KS;METZ, CE
通讯作者：
METZ, CE