THYROID NODULE GROWTH AS A PREDICTOR OF MALIGNANCY

Area of Science:

• Endocrinology
• Radiology
• Oncology

Background:

• Thyroid nodules are common, and distinguishing benign from malignant nodules is crucial.
• Ultrasound is a primary tool for thyroid nodule assessment.
• Standardized criteria for assessing nodule growth and malignancy risk are needed.

Purpose of the Study:

• To determine which measure of thyroid nodule growth on serial neck ultrasound is associated with malignancy.
• To evaluate the predictive value of different growth metrics for thyroid cancer detection.

Main Methods:

• Retrospective chart review of malignant and benign thyroid nodules with at least two ultrasounds.
• Nodule growth assessed by percentage increase in two dimensions, linear growth rate, and volume doubling time.
• Statistical analysis including logistic and linear regression to adjust for confounders.

Main Results:

• Growth defined as >20% increase in two dimensions (minimum 2 mm) was significantly associated with malignancy (OR 2.49, P=.026).
• No significant difference was found for growth defined as >2 mm/year or ≥50% volume growth.
• Median doubling time was significantly shorter for malignant nodules (244.2 days) compared to benign nodules (456.5 days).

Conclusions:

• Thyroid nodule growth, specifically a >20% increase in two dimensions, is a potential indicator of malignancy.
• Nodule shrinkage is not a reliable differentiator between benign and malignant thyroid nodules.
• Further research may refine ultrasound-based growth criteria for improved thyroid nodule risk stratification.