Nomogram for the diagnosis of suspected papillary thyroid carcinomas based on sonographic patterns: a retrospective study

Thyroid nodules are very common and can be diagnosed in up to 67% of people (1). Ultrasonography (US) has been shown to have high sensitivity, specificity, cost-effectiveness, high availability, limited discomfort to patients (2), and an anon-ionizing nature. Up to 10–15% of thyroid nodules are confirmed to be malignant (3). Malignant nodules require timely surgical treatment, whereas patients with benign nodules can be managed conservatively, so accurate diagnosis of thyroid nodules is vital for treatment (2). However, identification of benign and malignant thyroid nodules is difficult and a consensus identification method had not been reached until now (4). Papillary thyroid carcinoma (PTC) is the most common cell type of thyroid cancer, accounting for up to 85% of all cases (5). Although, previous study has proved the role of apparent diffusion coefficient value to diagnosis of thyroid cancer (6), high resolution US is still the first choice (7). The sonographic characteristics of thyroid nodules include composition, echogenicity, margins, calcifications, shape, and vascularity (2,7). The pattern of sonographic features associated with a nodule confers malignancy risk and guides fine needle aspiration (FNA) decision making (8)