Peripheral Thyroid Nodule Calcifications on Sonography: Evaluation of Malignant Potential

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Peripheral calcifications are a recognized sonographic feature of thyroid nodules.
• Their association with malignancy requires further clarification regarding specific sonographic characteristics.

Purpose of the Study:

• To assess the association between sonographic features of peripheral calcifications and thyroid cancer.
• To evaluate if specific peripheral calcification characteristics can differentiate benign from malignant thyroid nodules.

Main Methods:

• Retrospective review of 97 thyroid nodules with peripheral calcifications undergoing ultrasound-guided fine-needle aspiration.
• Radiologists assessed nodule percentage, calcification continuity, internal component visibility, and soft tissue extrusion.
• Correlation analysis between calcification parameters and malignancy rates; interobserver agreement assessed using Cohen kappa coefficient.

Main Results:

• 27% of nodules with peripheral calcifications were malignant.
• No significant association found between calcification continuity, internal component visibility, or soft tissue extrusion and nodule malignancy.
• Good to fair interobserver agreement was observed for assessed peripheral calcification features.

Conclusions:

• Peripheral rim calcifications are strongly associated with thyroid malignancy.
• Specific sonographic features of these calcifications are not reliable for distinguishing benign from malignant nodules.
• High interobserver variability may contribute to the lack of diagnostic specificity.