Surgeon-Performed Ultrasonographic Evaluation and Predication for Large Thyroid Nodules-A Case-Control Study.

Area of Science:

• Endocrinology
• Radiology
• Oncology

Background:

• Management strategies for large thyroid nodules (≥3.0 cm) lack clarity.
• Ultrasonography is crucial for thyroid nodule assessment but its role in risk-stratifying large nodules is understudied.

Purpose of the Study:

• To evaluate the effectiveness of ultrasonography in characterizing and risk-stratifying thyroid nodules measuring 3.0 cm or larger.

Main Methods:

• A retrospective case-control study compared sonographic features of 137 large thyroid nodules (≥3.0 cm) with 400 smaller nodules (<3.0 cm).
• Nodules were assessed for size, texture, echogenicity, shape, calcifications, border, spongiform appearance, and vascularity by a single thyroid surgeon.

Main Results:

• Large nodules (≥3.0 cm) showed an increased risk of malignancy (OR 2.41).
• Microcalcifications, hypoechogenicity, and irregular borders were more common in smaller nodules.
• Within large nodules, hypoechogenicity and irregular margins were linked to malignancy, with irregular borders showing higher specificity (100%) in this group.

Conclusions:

• Sonographic characteristics of large thyroid nodules differ significantly from smaller ones.
• Hypoechogenicity and irregular borders in large nodules are associated with malignancy.
• These findings support an aggressive approach, including fine needle aspiration and potential surgical resection, for large thyroid nodules exhibiting these features.