Thyroid nodules with isolated macrocalcification: malignancy risk and diagnostic efficacy of fine-needle aspiration and core needle biopsy

Ultrasonography. 2016;35(3):212-219 DOI 10.14366/usg.15074

 

Journal Homepage

Journal Title: Ultrasonography

ISSN: 2288-5919 (Print); 2288-5943 (Online)

Publisher: Korean Society of Ultrasound in Medicine

Society/Institution: Korean Society of Ultrasound in Medicine

LCC Subject Category: Medicine: Medicine (General): Medical technology

Country of publisher: Korea, Republic of

Language of fulltext: English

Full-text formats available: PDF, HTML, ePUB, XML

 

AUTHORS

Dong Gyu Na ( Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Korea)
Dae Sik Kim ( Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Korea)
Soo Jin Kim ( Department of Radiology, Human Medical Imaging and Intervention Center, Seoul, Korea)
Jae Wook Ryoo ( Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea)
So Lyung Jung ( Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea)

EDITORIAL INFORMATION

Double blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 15 weeks

 

Abstract | Full Text

Purpose: This study was performed to determine the malignancy risk of thyroid nodules with isolated macrocalcification and to evaluate the diagnostic efficacy of fine-needle aspiration (FNA) and core needle biopsy (CNB). Methods: From May 2008 to December 2014, a total of 44 patients with isolated macrocalcifications were enrolled from 4,081 consecutive patients who underwent FNA or CNB at a single institution. We assessed the malignancy risk of nodules with isolated macrocalcification. We compared the diagnostic results between FNA and CNB, and the diagnostic efficacy of each procedure was evaluated by the rate of inconclusive results. We compared the diagnostic performance for malignancy between FNA and CNB with a criterion of malignant or atypia/follicular lesion of undetermined significance (indeterminate) diagnostic results. We investigated whether the ultrasonographic feature of isolated macrocalcification was predictive of malignancy. Results: The malignancy risk of nodules with isolated macrocalcification was 16.1% in 31 nodules with final diagnoses and 11.4% in all nodules. CNB demonstrated a significantly lower rate of nondiagnostic and inconclusive results than FNA (7.7% vs. 53.8%, P=0.002 and 15.4% vs. 57.7%, P=0.003, respectively) in 26 nodules that underwent both FNA and CNB. CNB showed a marginally higher diagnostic performance for identifying malignancy than FNA (P=0.067). The ultrasonographic features of the anterior margin of isolated macrocalcification were not predictive of malignancy (P>0.999). Conclusion: Thyroid nodules with isolated macrocalcification had a low to intermediate malignancy risk and should not be considered benign nodules. CNB showed a higher diagnostic efficacy than FNA in these nodules.