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Thyroid nodules: re-evaluation with ultrasound

S Takashima¹, H Fukuda, N Nomura

¹Department of Radiology, Osaka Teishin Hospital, Japan.

Journal of Clinical Ultrasound : JCU

|March 1, 1995

Summary

Ultrasound (US) microcalcifications in thyroid nodules show high specificity but poor sensitivity for detecting malignancy. While useful, US microcalcification findings alone are insufficient for definitively diagnosing malignant thyroid tumors.

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Area of Science:

Radiology
Oncology
Pathology

Background:

Thyroid nodules are common, and distinguishing benign from malignant types is crucial.
Ultrasound (US) is a primary imaging modality for evaluating thyroid nodules.
The sonographic appearance of microcalcifications requires clarification for diagnostic accuracy.

Purpose of the Study:

To clarify the ultrasound evaluation of microcalcifications in thyroid nodules.
To determine if US-detected calcifications can reliably predict malignant thyroid tumors.

Main Methods:

Prospective evaluation of diagnostic accuracy for malignancy in 259 pathologically verified thyroid nodules.
Sonographic and pathologic correlation of calcifications in 69 surgically removed nodules.

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Main Results:

Microcalcification on US showed high accuracy (76%), specificity (93%), and positive predictive value (70%) for malignancy as a single sign.
However, sensitivity for malignancy was poor (36%).
Pathologic correlation indicated that US microcalcifications without acoustic shadowing mainly represented true microcalcifications.

Conclusions:

Sonographic microcalcification has high specificity but insufficient accuracy for diagnosing malignant thyroid tumors alone.
Further evaluation alongside other sonographic signs is necessary for comprehensive diagnosis.