Jin Young Kwak

Korea Institute of Radiological & Medical Sciences, Sŏul, Seoul, South Korea

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Publications (205)503.42 Total impact

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    ABSTRACT: We investigated the adjunctive role of preoperative serum thyroglobulin (Tg) in the diagnosis of thyroid nodules. A retrospective study was performed on 374 thyroid nodules (363 benign and 11 malignant) in 360 patients (296 women and 64 men; mean age, 50.1 years; range, 16-86 years) between December 2010 and July 2011. We evaluated clinicopathologic characteristics of patients and ultrasonographic (US) features of the lesions including presurgical Tg levels. Univariate and multivariate analysis were used to determine independent predictors of malignancy. Serum Tg was positively correlated with nodule size and thyroid volume (P < 0.001). There was no difference in serum Tg levels between malignant and benign nodules. Suspicious US features of thyroid nodules were the only independent predictors of malignancy (P< 0.001). Preoperative serum Tg was not useful in differentiating thyroid cancer from benign nodules. Suspicious US features were the only predicting factors for malignancy.
    Ultrasound quarterly. 12/2014; 30(4):287-90.
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    ABSTRACT: We investigated the additional diagnostic yield of the mutation test and evaluated the frequency of the BRAF mutation in conventional PTC (cPTC) according to ultrasound (US) features and the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) based on the BRAF(V600E) mutation status. During the study period, 279 patients who underwent FNA with an additional BRAF(V600E) mutation test were diagnosed as cPTC after surgery. We analyzed the association between the mutation and several clinical factors. Of the 279 cPTCs, 250 (89.6%) had the BRAF(V600E) mutation. The BRAF mutation test was helpful in diagnosing an additional 19% (53/279) of cPTCs. The frequency of the BRAF mutation in cPTCs with suspicious US features was higher than that of cPTCs with negative US features regardless of the BSRTC. Suspicious US features may be helpful in deciding whether an additional BRAF(V600E) mutation test should be done in thyroid nodules with indeterminate cytology. © The Author(s) 2014.
    The Annals of otology, rhinology, and laryngology. 11/2014;
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    ABSTRACT: Objective The aim of this study was to investigate the diagnostic performance of preoperative staging ultrasound (US) according to body mass index (BMI) in patients with papillary thyroid carcinoma (PTC)Patients and Methods This retrospective study included 625 PTC patients who underwent preoperative staging US and surgical excision at a referral center between December 2012 and April 2013. Four experienced radiologists prospectively evaluated the extent of primary tumors, multifocality, and the presence of lymph node metastasis. Patients were grouped according to BMI (normal < 25; overweight 25 ≤ and < 30; obese ≥ 30,/non-obese < 30; obese ≥ 30 kg/m2). Diagnostic performances of preoperative staging US (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy) were compared according to BMI based on pathologic findings of surgical specimens.ResultsPreoperative staging US in the obese group (BMI ≥ 30 kg/m2) showed a significantly lower negative predictive value and accuracy in the detection of central lymph node metastasis (P=0.010 and P=0.025, respectively) than in the non-obese (BMI < 30 kg/m2) group. However, there were no significant differences in the diagnostic performance of preoperative staging US for extrathyroidal extension, bilateral multifocality, and lateral lymph node metastasis in analyses using the two (non-obese vs. obese) and three BMI (normal vs. overweight vs. obese) groups, respectively.Conclusion Obesity (BMI ≥ 30 kg/m2) may affect the preoperative US staging of central lymph node metastasis in PTC patients.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 10/2014; · 3.40 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate the diagnostic performance of quantitative histogram parameters using real-time tissue elastography (RTE) in the diagnosis of patients with diffuse thyroid disease. One hundred and sixteen patients (mean age, 43.7 ± 10.97 y) who had undergone pre-operative staging ultrasonography and RTE were included. For each patient, 11 parameters were obtained from RTE images, from which the “elastic index” was calculated. Diagnostic performance of the elastic index and that of the 11 parameters on RTE were calculated and compared. Of the 116 patients, 31 had diffuse thyroid disease and 85 had normal thyroid parenchyma. Area under the receiver operating characteristic curve (Az) of MEAN (average relative value) elasticity was high (0.737), without significant differences from other elasticity values. Diagnostic performance of the elastic index was higher than the MEAN, Az = 0.753, without significance (p = 0.802). In conclusion, RTE using the elastic index was found to have good diagnostic performance and may be useful in the diagnosis and management of patients with diffuse thyroid disease.
    Ultrasound in Medicine & Biology. 09/2014; 40(9):2012–2019.
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    ABSTRACT: Purpose To evaluate the malignancy risks of thyroid nodules with nondiagnostic results at ultrasonography (US)-guided fine-needle aspiration biopsy (FNAB) and the criteria for selecting those for repeat US-guided FNAB according to the thyroid imaging reporting and data system (TIRADS). Materials and Methods This retrospective study was approved by the institutional review board, and the requirement to obtain informed consent was waived. Five hundred forty-eight nondiagnostic nodules were included. US features of internal composition, echogenicity, margin, calcifications, shape, and vascularity were evaluated, and thyroid nodules were classified according to TIRADS. TIRADS category 3 included nodules without any suspicious features of solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape. Categories 4a, 4b, 4c, and 5 included nodules with one, two, three or four, or five suspicious US features. The malignancy risk was calculated. Results Of the 548 nodules, 40 (7.3%) were malignant and 508 (92.7%) were benign. The malignancy risks of categories 3 and 4a nodules were 0.8% and 1.8%, respectively, whereas the malignancy risks of categories 4b, 4c, and 5 nodules were 6.1%, 14.4%, and 31%. In the 294 nodules larger than 10 mm, the malignancy risks of categories 3, 4a, 4b, 4c, and 5 nodules were 0.9%, 1.3%, 0%, 15%, and 33%, respectively. In the 254 nodules measuring 10 mm or smaller, the malignancy risks of categories 3, 4a 4b, 4c, and 5 nodules were 0%, 2.7%, 14%, 14.3%, and 31%. Conclusion Nondiagnostic thyroid nodules without suspicious US features and those with one suspicious feature can be followed up with US, but nondiagnostic nodules with two or more suspicious features should undergo repeat US-guided FNAB. © RSNA, 2014.
    Radiology 08/2014; · 6.34 Impact Factor
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    ABSTRACT: To investigate the characteristics of papillary thyroid carcinoma (PTC) with cystic changes visible on ultrasonography (US).
    Ultrasonography (Seoul, Korea). 08/2014;
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    ABSTRACT: The aim of this study was to investigate the prognosis of papillary thyroid carcinoma (PTC) patients according to different pathologic grades of lymphocytic thyroiditis (LT).
    Yonsei medical journal. 07/2014; 55(4):879-85.
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    ABSTRACT: We investigated the merit of ultrasound (US) features and BRAF(V600E) mutation as an additional study of cytology and compared the diagnostic performances of cytology alone, cytology with US correlation, cytology with BRAF(V600E) mutation, and a combination of cytology, US, and BRAF(V600E) mutation all together.
    Yonsei medical journal. 07/2014; 55(4):871-8.
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    ABSTRACT: The purpose of this study was to evaluate the diagnostic performance of quantitative histogram parameters using real-time tissue elastography (RTE) in the diagnosis of patients with diffuse thyroid disease. One hundred and sixteen patients (mean age, 43.7 ± 10.97 y) who had undergone pre-operative staging ultrasonography and RTE were included. For each patient, 11 parameters were obtained from RTE images, from which the "elastic index" was calculated. Diagnostic performance of the elastic index and that of the 11 parameters on RTE were calculated and compared. Of the 116 patients, 31 had diffuse thyroid disease and 85 had normal thyroid parenchyma. Area under the receiver operating characteristic curve (Az) of MEAN (average relative value) elasticity was high (0.737), without significant differences from other elasticity values. Diagnostic performance of the elastic index was higher than the MEAN, Az = 0.753, without significance (p = 0.802). In conclusion, RTE using the elastic index was found to have good diagnostic performance and may be useful in the diagnosis and management of patients with diffuse thyroid disease.
    Ultrasound in medicine & biology. 06/2014;
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    ABSTRACT: Background We hypothesized that a nomogram constructed of clinical and imaging variables could be applied to predicting the risk of malignancy in thyroid nodules diagnosed as AUS/FLUS. Methods This retrospectively designed study included 393 thyroid nodules in 392 patients (mean age: 49.06 ± 11.86 years) which were diagnosed as AUS/FLUS with US-FNA during the study period. Medical records, US images, and cytopathology results were reviewed and analyzed. The 393 thyroid nodules were divided into training and validation sets. Logistic regression analysis was performed to predict the probability of malignancy and nomograms were constructed using the training set and subsequently applied to the validation set. Results Three sets of nomograms were separately constructed using clinical factors and (a) individual US features, (b) final assessment of US, and (c) the number of suspicious US features. All three sets of nomograms built were proven accurate and discriminative, with an area under the receiver operating characteristic curve (AUC) of 0.817 (95% confidence interval (CI): 0.757-0.877) when using clinical factors and individual US features, of 0.769 (95% CI: 0.705-0.833) when using final assessment, and of 0.779 (95% CI: 0.718-0.840) when using the number of suspicious US features. The AUC of each validation set was 0.754 (95% CI: 0.659-0.850), 0.757 (95% CI: 0.661-0.853), and 0.721 (95% CI: 0.621-0.820), respectively. Conclusions Nomograms constructed in our study using US can be utilized in predicting the probability of malignancy in thyroid nodules diagnosed as AUS/FLUS on US-FNA, and may help in selecting patients who are at high risk for malignancy.
    Surgery 06/2014; · 3.37 Impact Factor
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    ABSTRACT: Recently, higher body mass index (BMI) has been associated with aggressive pathologic features of papillary thyroid carcinoma. The aim of this study was to clarify the relationship between BMI and aggressive pathologic features of papillary thyroid microcarcinoma (PTMC) and to evaluate whether the BMI can be a prognostic factor of PTMC. This retrospective study included 612 PTMC patients who underwent surgical excision at a referral center between April 2006 and December 2007. Patients were grouped according to BMI (<25 or ≥25 kg/m(2)). Multivariable logistic regression analysis was performed to determine independent predictors of aggressive pathologic features (advanced stage, extrathyroidal extension, and lymph node metastasis), with adjustment for age, gender, tumor size, multifocality, thyroid stimulating hormone (TSH) level, and BMI (value/group). PTMC patients with a BMI ≥ 25 kg/m(2) showed significantly higher prevalences of extrathyroidal extension, advanced pathologic TNM stage, and male gender, compared to those of patients with a BMI < 25 kg/m(2). Lymph node metastasis and mean TSH level were not significantly different between the two BMI subgroups. In multivariable analysis, the BMI ≥ 25 kg/m(2) group was positively associated with the presence of extrathyroidal extension (adjusted odds ratio 1.49, P = 0.05). Higher BMI was associated with extrathyroidal extension in PTMC patients. This study suggests that the BMI could be considered as a prognostic factor for predicting the presence of extrathyroidal extension and it may help decide the appropriate surgical extent for PTMC patients.
    Endocrine 05/2014; · 3.53 Impact Factor
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    ABSTRACT: Background. The association between the BRAF mutation and persistence/recurrence was investigated in patients with classical papillary thyroid carcinoma (PTC) at a BRAF mutation prevalent area.Methods. A total of 282 patients with total thyroidectomy and prophylactic central neck dissection were included. The BRAF mutation was evaluated with cytology specimen using dual priming oligonucleotide (DPO)-based multiplex PCR and direct sequencing preoperatively.Results. Thirty four patients (12%) had persistence/recurrence. In all PTC, the BRAF mutation on both methods was not associated with persistence/recurrence. In PTC > 10 mm, the BRAF mutation on DPO-based multiplex PCR was significantly associated with persistence/recurrence and a potential predictor for persistence/recurrence. In PTC ≤ 10 mm, none of the covariates were significantly different between patients with and without persistence/recurrence.Conclusions. The BRAF mutation was significantly associated with persistence/recurrence and a potential predictor in patients with classical PTC > 10 mm at a BRAF mutation prevalent area. Head Neck, 2014
    Head & Neck 05/2014; · 2.83 Impact Factor
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    Jin Young Kwak, Eun-Kyung Kim
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    ABSTRACT: Ultrasonography (US)-based elastography has been introduced as a noninvasive technique for evaluating thyroid nodules that encompasses a variety of approaches such as supersonic shear imaging and acoustic radiation force impulse imaging as well as real-time tissue elastography. However, the diagnostic performances for differentiating malignant thyroid nodules from benign ones with elastography as an adjunctive tool of gray-scale US is still under debate. In this review article, diagnostic performances of conventional US and a combination of conventional US and elastography are compared according to the type of elastography. Further, the interobserver variability of elastography is presented according to the type of elastography.
    Ultrasonography (Seoul, Korea). 04/2014; 33(2):75-82.
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    ABSTRACT: Purpose: To analyze which sonographic features of thyroid nodules with macrocalcifications were predictable of thyroid malignancy. Materials and Methods: We reviewed sonographic findings of 854 macrocalcified thyroid nodules in patients who underwent fine needle aspiration biopsy between December 2009 and January 2011. There were 171 non-diagnostic aspirations, 34 nodules with category 3, 4, 5 based on Bethesda system, which were not confirmed by surgery, and these nodules were excluded from the analysis. Sonographic characteristics of the macrocalcifications including its thickness, interruption, and existence of soft tissue rim outside the macrocalcification were analyzed. Other sonographic characteristics of nodules such as shape, margin, composition, echo pattern, vascularity, and underlying parenchymal echogenicity were also evaluated. The correlation of sonographic features with cytopathologic results and the diagnostic performance of sonographic features for the prediction of malignancy were analyzed. Results: Among 649 nodules, 179 (27.6%) nodules were malignant and 470 (72.4%) nodules were benign. Among the features of the macrocalcification, interruption, irregular thickness, or the presence of soft tissue outside calcification rim were associated with malignancy (p<0.001). A high sensitivity and negative predictive values for the prediction of malignancy was found in sonographic characteristics of irregular thickness (92.2% and 91.0%, respectively) and the presence of soft tissue (88.5% and 88.8%, respectively). Conclusion: Sonographic characteristics of macrocalcification such as interruption, irregular thickness and the presence of soft tissue rim were associated with malignancy in thyroid nodules with macrocalcifications.
    Yonsei medical journal 03/2014; 55(2):339-44. · 0.77 Impact Factor
  • Hee Jung Moon, Eun-Kyung Kim, Jin Young Kwak
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    ABSTRACT: The indications of repeat fine-needle aspiration (FNA) for thyroid nodules with benign results of the Bethesda system were investigated. A total of 1,398 nodules were classified according to the Thyroid Imaging Reporting and Data System (TIRADS). TIRADS category 3 included nodules without solidity, hypoechogenicity or marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, and taller-than-wide shape on ultrasonography (US). Categories 4a, 4b, 4c, and 5 included nodules with one, two, three or four, or five suspicious US features, respectively. The malignancy risks, and odds ratio (OR) with 95 % confidence interval (CI) were calculated. Analyses were performed for all nodules, nodules >10 mm, and nodules ≤10 mm. Of 1.398 nodules, 43 (3.1 %) were malignanct. The malignancy risks of benign nodules with categories 3, 4a, and 4b were 0.7, 1.2, and 0.7 %, respectively, whereas those for nodules with categories 4c and 5 were 9.8 and 22.2 %, respectively. The ORs of nodules with categories 4c and 5 were 19.4 (95 % CI 5.0-76.2) and 50.6 (95 % CI 10.4-245.0), respectively. In nodules >10 mm, the malignancy risks of categories 4c and 5 were 2.7 and 20 %, respectively, and the ORs were 10.7 (95 % CI 1.2-93.7) and 236.1 (95 % CI 12.6-4426.4), respectively. In nodules ≤ 10 mm, the malignancy risks of categories 4c and 5 were 12.6 and 22.6 %, respectively, and the ORs were 10.1 (95 % CI 1.3-78.0) and 18.9 (95 % CI 2.1-168.9), respectively. Repeat US-guided FNA should be considered in benign thyroid nodules with three or more suspicious US features regardless of size.
    Annals of Surgical Oncology 02/2014; · 4.12 Impact Factor
  • Jae Young Seo, Eun-Kyung Kim, Jin Young Kwak
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    ABSTRACT: The BRAF(V600E) mutation test has been more effective in thyroid nodules with suspicious US features than ones without suspicious features. Therefore, we investigated the role of the BRAF(V600E) mutation as an additional study to cytology in diagnosing a thyroid nodule without suspicious US features. This study was performed at Severance hospital from December 2010 through February 2012. During this period, 2,650 patients with 2,918 nodules underwent FNA with an additional BRAF(V600E) mutation test. Among them, we excluded thyroid nodules with suspicious US features. Finally, 485 thyroid nodules in 466 patients (mean age 50.3 years; range 9-80 years) were included in this study. We compared the differences between patients with malignant and benign thyroid nodules. We evaluated the detection rates of the BRAF(V600E) mutation according to the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). There were 60 (60/485, 12.4 %) malignant and 425 (425/485, 87.6 %) benign nodules. The detection rate of the BRAF(V600E) mutation in thyroid nodules without suspicious US features was only 6.6 % (32/485). Most had malignant cytology (62.5 %, 20/32). For nodules without malignant cytology, only 12 nodules (2.6 %, 12/462) had the BRAF mutation. Among the 12 nodules, nine nodules were suspicious for malignancy on cytology. Additional BRAF mutation analysis shows additional diagnostic value in thyroid nodules with "suspicious for malignant" cytology alone even when the nodules do not show suspicious US features. Therefore, the test should be selectively performed in thyroid nodules without suspicious US features, considering cost-effectiveness as well as diagnostic accuracy.
    Endocrine 01/2014; · 3.53 Impact Factor
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    ABSTRACT: Purpose: To assess the risk of malignancy of thyroid incidentalomas found on 18F-FDG PET/CT by US features and cytologic results, and to evaluate the clinical usage of a combination of US features and cytology for post-FNA management of thyroid incidentalomas on 18F-FDG PET/CT. Materials and Methods: From September 2006 to December 2008, 132 patients with 134 thyroid incidentalomas detected on 18F-FDG PET/CT who had undergone US and US-FNA were included in this study. We evaluated the malignancy rate of thyroid incidentalomas in different subgroups subdivided by US features and US-FNA cytology results. Several variables were compared between the benign and malignant group. Results: The risk of malignancy was 58.2 % (78/132) in thyroid incidentalomas on 18F-FDG PET/CT. Age, gender, and tumor size were not significantly different between the malignant and benign group. Malignancy rate of thyroid incidentalomas was significantly higher in the suspicious malignant (88.9 %) than in the probably benign group (11.3 %) on US (p < 0.001). Malignancy rates were high in thyroid nodules with "malignancy", "suspicious for malignancy", or "follicular neoplasm" on cytologic results, regardless of US features. However, malignancy rates of thyroid incidentalomas with "unsatisfactory" or "benign" results on cytology were higher in the suspicious malignant (75 %, 12.5 %, respectively) than in the probably benign (0 %) group on US. Conclusions: This study demonstrated that the risk of malignancy was high in thyroid incidentalomas on 18F-FDG PET/CT even without suspicious US features. However, there was no malignancy in nodules with no suspicious US features and benign cytology. Based on these results, we concluded that US may not replace FNA in the diagnosis of PET incidentalomas, and that a follow-up may be considered of thyroid incidentalomas with benign cytology and no suspicious US features.
    Ultraschall in der Medizin 01/2014; · 4.12 Impact Factor
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    ABSTRACT: Heterogeneous echogenicity and micro-nodulations of diffuse thyroid disease on ultrasonography (US) might influence the diagnostic performance of pre-operative US staging, especially the detection of multi-focality. This study was designed to determine whether heterogeneous echogenicity of the thyroid parenchyma influences the diagnostic performance of US in the detection of multi-focality in papillary thyroid carcinoma. Between December 2010 and April 2011, 811 patients underwent pre-operative staging US for papillary thyroid carcinoma and surgery. Twelve radiologists performed the pre-operative US for T and N staging. Underlying parenchymal echogenicity and unilateral and bilateral multi-focality of the thyroid nodules were also evaluated. Patients were divided into two groups on the basis of the underlying echogenicity of the thyroid gland. To evaluate the diagnostic accuracy of US with respect to underlying echogenicity, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated and compared between the two groups. Among the 811 patients included, US revealed underlying heterogeneous echogenicity of the thyroid parenchyma in 204 (25.2%) and underlying homogeneous echogenicity of the thyroid parenchyma in 607 (74.8%). There were no significant differences between the two groups in the diagnostic performance of pre-operative staging US in predicting unilateral multi-focality and bilaterality. Underlying heterogeneous echogenicity in a thyroid gland with Hashimoto's thyroiditis does not significantly influence the detection of multi-focality in papillary thyroid cancer on pre-operative US staging.
    Ultrasound in medicine & biology 01/2014; · 2.46 Impact Factor
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    ABSTRACT: Background: Recently, it has been reported that the risk of thyroid malignancy increases with increasing concentrations of serum TSH. The aim of study was to determine whether or not serum TSH can be a predictor for thyroid malignancy, when considering the relevant US features and clinical risk factors. Methods: This retrospective study included 1200 euthyroid patients with 1269 thyroid nodules who underwent ultrasound-guided fine-needle aspiration biopsy between January and June 2009. Serum TSH, US feature, and clinical parameters were compared according to final diagnosis. Subgroup analyses were performed according to nodule size. Results: Serum TSH did not show a positive association with malignancy for all nodules and micronodule subgroup in multivariate analysis, although they showed significant association with thyroid malignancy for macronodule subgroup. For all nodules and the two subgroups, suspicious US features and younger age were significantly associated with malignancy in univariate and multivariate analyses. Conclusions: Our study suggests that TSH alone is not as useful as US features in deciding whether or not to perform FNA in patients with micronodules. Head Neck, 2014.
    Head & Neck 01/2014; · 2.83 Impact Factor
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    ABSTRACT: Purpose To investigate the natural history of thyroid nodules found to be benign at initial fine-needle aspiration biopsy (FNAB) to determine the percentage of nodules that increased in volume by more than 50% as being an indicator of malignancy. Materials and Methods This retrospective observational cohort study was approved by the institutional review board, and the need to obtain informed consent was waived. The study included 854 FNAB-confirmed benign thyroid nodules. Suspicious ultrasonographic (US) features included marked hypoechogenicity, irregular or microlobulated margin, microcalcification, and taller-than-wide shape. Univariate and multivariate generalized linear mixed models were used to assess the association with nodule growth greater than 50% in volume. Results For the 854 nodules, the initial mean diameter was 19.92 mm (range, 3.10-60.00 mm), and the initial mean volume was 3.19 cm(3) (range, 0.01-4.64 cm(3)). The majority (682 [79.9%] of 854) of thyroid nodules with benign cytologic results at initial FNAB did not grow more than 50% in volume during 4 years of mean follow-up (range, 7-101 months). More than 4 years of follow-up time versus less than 2 years, younger age, a cystic component of less than 25%, and nodule size 1 cm or larger versus less than 1 cm were independently associated with growth. There was only one malignant nodule (0.6%) among 172 thyroid nodules with a volume increase of 50% or greater during the entire follow-up time. Ten malignant nodules (overall malignancy rate: 1.2%) were detected among the 854 total nodules, and eight of these 10 nodules showed suspicious features at US. Conclusion Repeat FNAB for nodules showing more than 50% growth in volume is unlikely to result in a diagnosis of malignancy. A positive FNAB result for malignancy is significantly more likely in the presence of suspicious US features. © RSNA, 2014.
    Radiology 01/2014; · 6.34 Impact Factor

Publication Stats

1k Citations
503.42 Total Impact Points

Institutions

  • 2008–2014
    • Korea Institute of Radiological & Medical Sciences
      Sŏul, Seoul, South Korea
  • 2006–2014
    • Yonsei University Hospital
      • Surgery
      Sŏul, Seoul, South Korea
  • 2013
    • Jeju National University
      Tse-tsiu, Jeju, South Korea
    • Kangbuk Samsung Hospital
      Sŏul, Seoul, South Korea
    • Ewha Womans University
      • Department of Radiology
      Sŏul, Seoul, South Korea
  • 2006–2013
    • Yonsei University
      • • Department of Radiology
      • • College of Medicine
      Seoul, Seoul, South Korea
  • 2003–2013
    • CHA University
      • College of Medicine
      Seoul, Seoul, South Korea
  • 2012
    • Kyung Hee University
      • College of Medicine
      Seoul, Seoul, South Korea