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The Mcgill thyroid nodule score - does it help with indeterminate thyroid nodules?

Rickul Varshney1, Veronique-Isabelle Forest2, Marco A Mascarella3

  • 1McGill University, Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, 687 Pine Ave. West, E3-37, Montreal, QC, H3A 1A1, Canada. rickul.varshney@gmail.com.

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|February 4, 2015
PubMed
Summary

Ultrasound guided fine-needle aspiration (USFNA) biopsy for thyroid nodules frequently yields indeterminate results. The McGill Thyroid Nodule Score (MTNS) aids specialists in managing these cases, with higher scores indicating increased malignancy risk.

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Area of Science:

  • Endocrinology
  • Oncology
  • Radiology

Background:

  • Thyroid nodule biopsies via ultrasound-guided fine-needle aspiration (USFNA) often result in indeterminate pathology.
  • This diagnostic challenge complicates clinical management decisions for thyroid specialists.

Purpose of the Study:

  • To determine the incidence of malignancy in thyroid nodules with indeterminate USFNA results.
  • To assess the correlation between the McGill Thyroid Nodule Score (MTNS) and histopathological outcomes.

Main Methods:

  • A retrospective analysis of 437 patients who underwent thyroid surgery between 2010 and 2012.
  • Comparison of pre-operative USFNA results (benign, indeterminate, suspicious/malignant) with post-operative histopathology.
  • Categorization of indeterminate USFNA into Bethesda types III and IV, and correlation with MTNS and final pathology.

Main Results:

  • 57.0% of reviewed thyroid nodules had indeterminate USFNA results.
  • The malignancy rate within the indeterminate group was 39.8%.
  • Median MTNS was 7 for benign nodules and 9 for malignant nodules (p < 0.05), indicating a higher risk with elevated scores.

Conclusions:

  • A significant proportion (39.8%) of operated patients with indeterminate USFNA results were found to have malignant nodules.
  • The MTNS is a valuable tool for thyroid specialists in pre-operative decision-making for indeterminate thyroid nodules.