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Research ArticleOriginal Article
Open Access

Clinical and ultrasonographic features in cancer risk stratification of indeterminate thyroid nodules

Saad M. Alqahtani, Sultan F. Alanesi, Waqas S. Mahmood, Yassin M. Moustafa, Laila M. Moharram, Nawaf F. Alharthi, Attiya M. Alzahrani and Yousef S. Alalawi
Saudi Medical Journal May 2022, 43 (5) 473-478; DOI: https://doi.org/10.15537/smj.2022.43.5.20220045
Saad M. Alqahtani
From the Department of Surgery (Alqahtani), from ther Department of Community Medicine and Public Health (Mahmood), College of Medicine, Majmaah University, Al-Majmaah; from the Department of Surgery (Alanesi, Alharthi, Alzahrani, Alalawi), from the Department of Radiodiagnostics and Medical Imaging (Moustafa), from the Department of Pathology (Moharram), King Salman Armed Forces Hospital Northwestern Region, Tabuk, Kingdom of Saudi Arabia, and from Azra Naheed Medical College (Mahmood), Superior University, Lahore, Pakistan.
MD
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  • For correspondence: [email protected] [email protected]
Sultan F. Alanesi
From the Department of Surgery (Alqahtani), from ther Department of Community Medicine and Public Health (Mahmood), College of Medicine, Majmaah University, Al-Majmaah; from the Department of Surgery (Alanesi, Alharthi, Alzahrani, Alalawi), from the Department of Radiodiagnostics and Medical Imaging (Moustafa), from the Department of Pathology (Moharram), King Salman Armed Forces Hospital Northwestern Region, Tabuk, Kingdom of Saudi Arabia, and from Azra Naheed Medical College (Mahmood), Superior University, Lahore, Pakistan.
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Waqas S. Mahmood
From the Department of Surgery (Alqahtani), from ther Department of Community Medicine and Public Health (Mahmood), College of Medicine, Majmaah University, Al-Majmaah; from the Department of Surgery (Alanesi, Alharthi, Alzahrani, Alalawi), from the Department of Radiodiagnostics and Medical Imaging (Moustafa), from the Department of Pathology (Moharram), King Salman Armed Forces Hospital Northwestern Region, Tabuk, Kingdom of Saudi Arabia, and from Azra Naheed Medical College (Mahmood), Superior University, Lahore, Pakistan.
PhD
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Yassin M. Moustafa
From the Department of Surgery (Alqahtani), from ther Department of Community Medicine and Public Health (Mahmood), College of Medicine, Majmaah University, Al-Majmaah; from the Department of Surgery (Alanesi, Alharthi, Alzahrani, Alalawi), from the Department of Radiodiagnostics and Medical Imaging (Moustafa), from the Department of Pathology (Moharram), King Salman Armed Forces Hospital Northwestern Region, Tabuk, Kingdom of Saudi Arabia, and from Azra Naheed Medical College (Mahmood), Superior University, Lahore, Pakistan.
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Laila M. Moharram
From the Department of Surgery (Alqahtani), from ther Department of Community Medicine and Public Health (Mahmood), College of Medicine, Majmaah University, Al-Majmaah; from the Department of Surgery (Alanesi, Alharthi, Alzahrani, Alalawi), from the Department of Radiodiagnostics and Medical Imaging (Moustafa), from the Department of Pathology (Moharram), King Salman Armed Forces Hospital Northwestern Region, Tabuk, Kingdom of Saudi Arabia, and from Azra Naheed Medical College (Mahmood), Superior University, Lahore, Pakistan.
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Nawaf F. Alharthi
From the Department of Surgery (Alqahtani), from ther Department of Community Medicine and Public Health (Mahmood), College of Medicine, Majmaah University, Al-Majmaah; from the Department of Surgery (Alanesi, Alharthi, Alzahrani, Alalawi), from the Department of Radiodiagnostics and Medical Imaging (Moustafa), from the Department of Pathology (Moharram), King Salman Armed Forces Hospital Northwestern Region, Tabuk, Kingdom of Saudi Arabia, and from Azra Naheed Medical College (Mahmood), Superior University, Lahore, Pakistan.
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Attiya M. Alzahrani
From the Department of Surgery (Alqahtani), from ther Department of Community Medicine and Public Health (Mahmood), College of Medicine, Majmaah University, Al-Majmaah; from the Department of Surgery (Alanesi, Alharthi, Alzahrani, Alalawi), from the Department of Radiodiagnostics and Medical Imaging (Moustafa), from the Department of Pathology (Moharram), King Salman Armed Forces Hospital Northwestern Region, Tabuk, Kingdom of Saudi Arabia, and from Azra Naheed Medical College (Mahmood), Superior University, Lahore, Pakistan.
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Yousef S. Alalawi
From the Department of Surgery (Alqahtani), from ther Department of Community Medicine and Public Health (Mahmood), College of Medicine, Majmaah University, Al-Majmaah; from the Department of Surgery (Alanesi, Alharthi, Alzahrani, Alalawi), from the Department of Radiodiagnostics and Medical Imaging (Moustafa), from the Department of Pathology (Moharram), King Salman Armed Forces Hospital Northwestern Region, Tabuk, Kingdom of Saudi Arabia, and from Azra Naheed Medical College (Mahmood), Superior University, Lahore, Pakistan.
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Article Figures & Data

Tables

    • View popup
    Table 1

    - Patient demographics and ultrasound-based morphologic features of thyroid nodules (N=50).

    VariableDistribution
    Gender
    Male8 (16.0)
    Female42 (84.0)
    Age (years)46.26±2.08
    Pathology
    Benign31 (62.0)
    Malignant19 (38.0)
    Biopsy method
    US-guided24 (48.0)
    Non-US-guided26 (52.0)
    Composition
    Mixed cystic and solid15 (30.0)
    Solid35 (70.0)
    Echogenicity
    Hyperechoic or isoechoic23 (46.0)
    Hypoechoic27 (54.0)
    Shape
    Wider-than-tall50 (100)
    Margin
    Ill-defined3 (6.0)
    Smooth47 (94.0)
    Echogenic foci
    Punctate echogenic foci6 (12.0)
    Macrocalcifications4 (8.0)
    None40 (80.0)
    Thyroid Imaging Reporting and Data System
    TR26 (12.0)
    TR323 (46.0)
    TR417 (34.0)
    TR54 (8.0)

    Distribution reported as frequency (%), except for age, which is reported as mean±standard error of the mean. US: ultrasound

      • View popup
      Table 2

      - Association between different categories of Bethesda and TI-RADS classification system with the final pathology.

      PathologyTI-RADSBethesda category, n (%)Significance
      IIIIVP-value
      BenignTR21 (25.0)3 (75.0)0.039*
      TR311 (78.6)3 (21.4)
      TR44 (36.4)7 (63.6)
      TR50 (0.00)2 (100)
      MalignantTR21 (50.0)1 (50.0)0.739
      TR36 (66.7)3 (33.3)
      TR44 (66.7)2 (33.3)
      TR52 (100)0 (0.0)

      * Statistically significant at p<0.05. TI-RADS: Thyroid Imaging Reporting and Data System

        • View popup
        Table 3

        - Association between various parameters and pathology (N=50).

        VariablesPathology, n (%)Significance
        BenignMalignantP-value
        Gender
        Female26 (83.9)16 (84.2)0.649
        Male5 (16.1)3 (15.8)
        Biopsy method
        Non US-guided14 (45.2)12 (63.2)0.216
        US guided17 (54.8)7 (36.8)
        Bethesda
        III16 (55.2)13 (44.8)0.242
        IV15 (71.4)6 (28.6)
        TI-RADS
        TR24 (66.7)2 (33.3)0.947
        TR314 (60.9)9 (39.1)
        TR411 (64.7)6 (35.3)
        TR52 (50.0)2 (50.0)
        Composition
        Mixed cystic and solid11 (73.3)4 (26.7)0.280
        Solid20 (57.1)15 (42.9)
        Echogenicity
        Hyperechoic or isoechoic13 (56.5)10 (43.5)0.461
        Hypoechoic18 (66.7)9 (33.3)
        Margin
        Ill-defined2 (66.7)1 (33.3)0.680
        Smooth29 (61.7)18 (38.3)
        Echogenic foci
        Punctate echogenic foci4 (66.7)2 (33.3)0.282
        Macrocalcifications1 (25.0)3 (75.0)
        None26 (65.0)14 (35.0)

        US: ultrasound, TI-RADS: Thyroid Imaging Reporting and Data System

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        Saudi Medical Journal: 43 (5)
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        1 May 2022
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        Clinical and ultrasonographic features in cancer risk stratification of indeterminate thyroid nodules
        Saad M. Alqahtani, Sultan F. Alanesi, Waqas S. Mahmood, Yassin M. Moustafa, Laila M. Moharram, Nawaf F. Alharthi, Attiya M. Alzahrani, Yousef S. Alalawi
        Saudi Medical Journal May 2022, 43 (5) 473-478; DOI: 10.15537/smj.2022.43.5.20220045

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        Clinical and ultrasonographic features in cancer risk stratification of indeterminate thyroid nodules
        Saad M. Alqahtani, Sultan F. Alanesi, Waqas S. Mahmood, Yassin M. Moustafa, Laila M. Moharram, Nawaf F. Alharthi, Attiya M. Alzahrani, Yousef S. Alalawi
        Saudi Medical Journal May 2022, 43 (5) 473-478; DOI: 10.15537/smj.2022.43.5.20220045
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        Keywords

        • cytologically indeterminate thyroid nodules
        • Bethesda categories III and IV
        • American College of Radiology Thyroid Imaging Reporting and Data System

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