Ultrasonography.  2016 Jul;35(3):220-225. 10.14366/usg.15077.

Discrepancies between the ultrasonographic and gross pathological size of papillary thyroid carcinomas

• Hahn SY
• Shin JH
• Oh YL
• Son YI

• KMID: 2327627
• DOI: http://doi.org/10.14366/usg.15077

Abstract

PURPOSE
The goal of this study was to investigate the level of agreement between tumor sizes measured on ultrasonography (US) and in pathological specimens of papillary thyroid carcinomas (PTCs) and to identify the US characteristics contributing to discrepancies in these measurements.
METHODS
We retrospectively reviewed the US findings and pathological reports of 490 tumors in 431 patients who underwent surgery for PTC. Agreement was defined as a difference of <20% between the US and pathological tumor size measurements. Tumors were divided by size into groups of 0.5-1 cm, 1-2 cm, 2-3 cm, and ≥3 cm. We compared tumors in which the US and pathological tumor size measurements agreed and those in which they disagreed with regard to the following parameters: taller-than-wide shape, infiltrative margin, echogenicity, microcalcifications, cystic changes in tumors, and the US diagnosis.
RESULTS
The rate of agreement between US and the pathological tumor size measurements was 64.1% (314/490). Statistical analysis indicated that the US and pathological measurements significantly differed in tumors <1.0 cm in size (P=0.033), with US significantly overestimating the tumor size by 0.2 cm in such tumors (P<0.001). Cystic changes were significantly more frequent in the tumors where US and pathological tumor size measurements disagreed (P<0.001).
CONCLUSION
Thyroid US may overestimate the size of PTCs, particularly for tumors <1.0 cm in size. This information may be helpful in guiding decision making regarding surgical extent.

Keyword

Thyroid cancer, papillary; Ultrasonography; Pathology, surgical; Dimensional measurement accuracy

MeSH Terms

Decision Making
Diagnosis
Dimensional Measurement Accuracy
Humans
Pathology, Surgical
Retrospective Studies
Thyroid Gland*
Thyroid Neoplasms*
Ultrasonography