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Is sonographic intra-nodular vascularity a reliable predictor of thyroid malignancy? A UK tertiary centre study

Published online by Cambridge University Press:  21 May 2021

E Omakobia ,
S McClean ,
J England  and
A Walden
E Omakobia*
Affiliation:
Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
S McClean
Affiliation:
Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
J England
Affiliation:
Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
A Walden
Affiliation:
Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, UK
*
Author for correspondence: Mr Eugene Omakobia, Department of ENT and Head and Neck Surgery, Hull University Teaching Hospitals NHS Trust, HullHU16 5JQ, UK E-mail: eugeneomakobia@doctors.org.uk Fax: +44 (0)1274 366 549
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Abstract

Objective

British Thyroid Association 2014 guidelines emphasised ultrasound assessment of nodules. One ultrasonographic differentiator of debatable relevance is intra-nodular vascularity. This is the first UK study conducted to address this question.

Methods

Ultrasound reports for thyroid surgery patients over 10 years were retrospectively reviewed. Reports documenting ‘intra-nodular vascularity or flow’ were analysed. Reports identifying peripheral vascularity only or no intra-nodular flow formed the control group. Concordance with final histology was used to determine the odds ratio for malignancy.

Results

A total of 306 patients were included, and 119 (38.9 per cent) nodules demonstrated intra-nodular vascularity. Of these, 60 (50.4 per cent) were malignant compared with 42 per cent in the control group. Intra-nodular vascularity was not a statistically significant predictor of malignancy with an odds ratio of 1.39 (p = 0.18, 95 per cent confidence interval, 0.86–2.23).

Conclusion

Intra-nodular vascularity in isolation was not a reliable predictor of malignancy. This supports other world literature studies. Although intra-nodular flow should not be relied upon in isolation, interpretation in conjunction with other suspicious findings enhances the predictive value.

Keywords

UltrasoundThyroid GlandNeoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 7 , July 2021 , pp. 599 - 601
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press.

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Footnotes

Mr E Omakobia takes responsibility for the integrity of the content of the paper

Presented as a poster at the British Association of Endocrine and Thyroid Surgeons meeting, 3–4 October 2019, Barcelona, Spain, and at the North of England Otolaryngology Society, 23 October 2019, Wakefield, UK.

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