Biopsy of Thyroid Nodules: Comparison of Three Sets of Guidelines

TLDR: The Kim and American Association of Clinical Endocrinologists criteria are more accurate than the Society of Radiologists in Ultrasound criteria and are recommended for achieving high specificity.

Abstract: OBJECTIVE. The purpose of this study was to compare the results with three sets of guidelines for fine-needle aspiration biopsy of thyroid nodules.MATERIALS AND METHODS. A total of 1,398 nodules confirmed with fine-needle aspiration biopsy or surgery were included in the study. We compared the diagnostic value of three sets of guidelines for ultrasound findings that should lead to fine-needle aspiration biopsy of a nodule. According to the Kim criteria, a nodule should have at least one of the following findings: marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, or length greater than width. According to the Society of Radiologists in Ultrasound, biopsy should be performed on a nodule 1 cm in diameter or larger with microcalcifications, 1.5 cm in diameter or larger that is solid or has coarse calcifications, and 2 cm in diameter or larger that has mixed solid and cystic components, and a nodule that has undergone substantial growth or is associated with abnormal cervical l...