Ultrasound classification of thyroid nodules: does size matter?

Authors :: Sakajiri RK
Rahal Junior A
Francisco Neto MJ
Queiroz MRG
Garcia RG
Martins LAL
Malerbi DAC
Source :: Einstein (Sao Paulo, Brazil) [Einstein (Sao Paulo)] 2022 May 16; Vol. 20, pp. eAO6747. Date of Electronic Publication: 2022 May 16 (Print Publication: 2022).
Publication Year :: 2022
Abstract: Objective: To determine whether the size of thyroid nodules in ACR-TIRADS ultrasound categories 3 and 4 is correlated with the Bethesda cytopathology classification.<br />Methods: Thyroid nodules (566) subclassified as ACR-TIRADS 3 or 4 were divided into three size categories according to American Thyroid Association guidelines. The frequency of different Bethesda categories in each size range within ACR-TIRADS 3 and 4 classifications was analyzed.<br />Results: Most nodules in both ACR-TIRADS classifications fell in the Bethesda 2 category, regardless of size (90.8% and 68.6%, ACR-TIRADS 3 and 4 respectively). The prevalence of Bethesda 6 nodules in the ACR-TIRADS 4 group was 14 times higher than in the ACR-TIRADS 3 group. There were no significant differences between nodule size and fine needle aspiration biopsy classification in any of the ACR-TIRADS categories.<br />Conclusion: Size does not appear to be an important criterion for indication of fine needle aspiration biopsy in thyroid nodules with a high suspicion of malignancy on ultrasound examination.