A Scoring System for Assessing the Risk of Malignant Partially Cystic Thyroid Nodules Based on Ultrasound Features
ObjectiveTo assess the ultrasound (US) features of partially cystic thyroid nodules (PCTNs) and to establish a scoring system to further improve the diagnostic accuracy.MethodsA total of 262 consecutive nodules from September 2017 to March 2020 were included in a primary cohort to construct a scorin...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.731779/full |
| _version_ | 1818734921152200704 |
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| author | Yuwei Xin Yuwei Xin Feifei Liu Yan Shi Xiaohui Yan Liping Liu Jiaan Zhu |
| author_facet | Yuwei Xin Yuwei Xin Feifei Liu Yan Shi Xiaohui Yan Liping Liu Jiaan Zhu |
| author_sort | Yuwei Xin |
| collection | DOAJ |
| description | ObjectiveTo assess the ultrasound (US) features of partially cystic thyroid nodules (PCTNs) and to establish a scoring system to further improve the diagnostic accuracy.MethodsA total of 262 consecutive nodules from September 2017 to March 2020 were included in a primary cohort to construct a scoring system. Moreover, 83 consecutive nodules were enrolled as an validation cohort from May 2018 to August 2020. All nodules were determined to be benign or malignant according to the pathological results after surgery or ultrasound-guided fine-needle aspiration (US-FNA). The US images and demographic characteristics of the patients were analyzed. The ultrasound features of PCTNs were extracted from primary cohort by two experienced radiologists. The features extracted were used to develop a scoring system using logistic regression analysis. Receiver operating characteristic (ROC) curves were applied to evaluate the diagnostic efficacy of the scoring system in both the primary cohort and validation cohort. In addition, the radiologists evaluated the benign and malignant PCTNs of the validation cohort according to the ACR TI-RADS guidelines and clinical experience, and the accuracy of their diagnosis were compared with that of the scoring system.ResultsBased on the eight features of PCTNs, the scoring system showed good differentiation and reproducibility in both cohorts. The scoring system was based on eight features of PCTNs and showed good performance. The area under the curve (AUC) was 0.876 (95% CI, 0.830 - 0.913) in the primary cohort and 0.829(95% CI, 0.730 - 0.903) in the validation cohort. The optimal cutoff value of the scoring system for the diagnosis of malignant PCTNs was 4 points, with a good sensitivity of 71.05% and specificity of 87.63%. The scoring system (AUC=0.829) was superior to radiologists (AUC= 0.736) in diagnosing PCTNs and is a promising method for clinical application.ConclusionsThe scoring system described herein is a convenient and clinically valuable method that can diagnose PCTNs with relatively high accuracy. The use of this method to diagnose PCTNs, which have been previously underestimated, will allow PCTNs to receive reasonable attention, and assist radiologist to confidently diagnose the benignity or malignancy. |
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| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-18T00:13:02Z |
| publishDate | 2021-10-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-d5f344df9970484ca13e6d7107c8a5ed2022-12-21T21:27:37ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-10-011110.3389/fonc.2021.731779731779A Scoring System for Assessing the Risk of Malignant Partially Cystic Thyroid Nodules Based on Ultrasound FeaturesYuwei Xin0Yuwei Xin1Feifei Liu2Yan Shi3Xiaohui Yan4Liping Liu5Jiaan Zhu6Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Ultrasound, Peking University People’s Hospital, Beijing, ChinaDepartment of Ultrasound, Peking University People’s Hospital, Beijing, ChinaDepartment of Ultrasound, Binzhou Medical University Hospital, Binzhou, ChinaDepartment of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan, ChinaDepartment of Ultrasound, Peking University People’s Hospital, Beijing, ChinaObjectiveTo assess the ultrasound (US) features of partially cystic thyroid nodules (PCTNs) and to establish a scoring system to further improve the diagnostic accuracy.MethodsA total of 262 consecutive nodules from September 2017 to March 2020 were included in a primary cohort to construct a scoring system. Moreover, 83 consecutive nodules were enrolled as an validation cohort from May 2018 to August 2020. All nodules were determined to be benign or malignant according to the pathological results after surgery or ultrasound-guided fine-needle aspiration (US-FNA). The US images and demographic characteristics of the patients were analyzed. The ultrasound features of PCTNs were extracted from primary cohort by two experienced radiologists. The features extracted were used to develop a scoring system using logistic regression analysis. Receiver operating characteristic (ROC) curves were applied to evaluate the diagnostic efficacy of the scoring system in both the primary cohort and validation cohort. In addition, the radiologists evaluated the benign and malignant PCTNs of the validation cohort according to the ACR TI-RADS guidelines and clinical experience, and the accuracy of their diagnosis were compared with that of the scoring system.ResultsBased on the eight features of PCTNs, the scoring system showed good differentiation and reproducibility in both cohorts. The scoring system was based on eight features of PCTNs and showed good performance. The area under the curve (AUC) was 0.876 (95% CI, 0.830 - 0.913) in the primary cohort and 0.829(95% CI, 0.730 - 0.903) in the validation cohort. The optimal cutoff value of the scoring system for the diagnosis of malignant PCTNs was 4 points, with a good sensitivity of 71.05% and specificity of 87.63%. The scoring system (AUC=0.829) was superior to radiologists (AUC= 0.736) in diagnosing PCTNs and is a promising method for clinical application.ConclusionsThe scoring system described herein is a convenient and clinically valuable method that can diagnose PCTNs with relatively high accuracy. The use of this method to diagnose PCTNs, which have been previously underestimated, will allow PCTNs to receive reasonable attention, and assist radiologist to confidently diagnose the benignity or malignancy.https://www.frontiersin.org/articles/10.3389/fonc.2021.731779/fullpartially cystic thyroid nodulesultrasound featuresscoring systemprediction modelmalignant risk |
| spellingShingle | Yuwei Xin Yuwei Xin Feifei Liu Yan Shi Xiaohui Yan Liping Liu Jiaan Zhu A Scoring System for Assessing the Risk of Malignant Partially Cystic Thyroid Nodules Based on Ultrasound Features Frontiers in Oncology partially cystic thyroid nodules ultrasound features scoring system prediction model malignant risk |
| title | A Scoring System for Assessing the Risk of Malignant Partially Cystic Thyroid Nodules Based on Ultrasound Features |
| title_full | A Scoring System for Assessing the Risk of Malignant Partially Cystic Thyroid Nodules Based on Ultrasound Features |
| title_fullStr | A Scoring System for Assessing the Risk of Malignant Partially Cystic Thyroid Nodules Based on Ultrasound Features |
| title_full_unstemmed | A Scoring System for Assessing the Risk of Malignant Partially Cystic Thyroid Nodules Based on Ultrasound Features |
| title_short | A Scoring System for Assessing the Risk of Malignant Partially Cystic Thyroid Nodules Based on Ultrasound Features |
| title_sort | scoring system for assessing the risk of malignant partially cystic thyroid nodules based on ultrasound features |
| topic | partially cystic thyroid nodules ultrasound features scoring system prediction model malignant risk |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.731779/full |
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