摘要
<strong>Introduction:</strong> To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIRADS<sup><span style="white-space:nowrap;">®</span></sup> and Bethesda<sup><span style="white-space:nowrap;">®</span></sup>. <strong>Materials and Methods:</strong> A prospective multicentric study in 10 radiological hospitals and institutions of Latin America was performed and 818 thyroid nodules were analyzed by ultrasound and classified by using both ACR TIRADS<sup><span style="white-space:nowrap;">®</span></sup> and Alpha Score;fine-needle aspiration biopsy was performed when needed and classified with Bethesda. The relationships between predictors were analyzed by using binary logistic regression, statistical significance was defined by a p-value of 0.05, with an error margin of 4% and 95% confidence intervals. <strong>Results:</strong> Alpha Score 2.0 establishes five types of malignant predictors: microcalcifications, irregular borders, taller-than-wide shape, predominant solid texture and hypoechogenicity;a diameter equal to or greater than 1.5 cm adds an extra point to the final score. Resulting classification divides TNs into 4 categories: benign (1.9%), low suspicion (8.7%), mild suspicion (13.6%) and high suspicion (75.7%) of malignancy probability;sensitivity of 82%, specificity of 74%, the positive predictive value of 94%, the negative predictive value of 51%, the statistical accuracy of 81%, odds ratio of 108.89 and correlation with ACR TIRADS of 0.77 and Bethesda of 0.91.<strong> Conclusions: </strong>Alpha Score 2.0 has superior diagnostic accuracy and performance compared to the previously published Alpha Score and is able to classify a benign TN in a precise, safe and accurate way, avoiding unnecessary FNABs or determining the necessity of FNAB in cases of moderate to high suspicion of malignancy.
<strong>Introduction:</strong> To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIRADS<sup><span style="white-space:nowrap;">®</span></sup> and Bethesda<sup><span style="white-space:nowrap;">®</span></sup>. <strong>Materials and Methods:</strong> A prospective multicentric study in 10 radiological hospitals and institutions of Latin America was performed and 818 thyroid nodules were analyzed by ultrasound and classified by using both ACR TIRADS<sup><span style="white-space:nowrap;">®</span></sup> and Alpha Score;fine-needle aspiration biopsy was performed when needed and classified with Bethesda. The relationships between predictors were analyzed by using binary logistic regression, statistical significance was defined by a p-value of 0.05, with an error margin of 4% and 95% confidence intervals. <strong>Results:</strong> Alpha Score 2.0 establishes five types of malignant predictors: microcalcifications, irregular borders, taller-than-wide shape, predominant solid texture and hypoechogenicity;a diameter equal to or greater than 1.5 cm adds an extra point to the final score. Resulting classification divides TNs into 4 categories: benign (1.9%), low suspicion (8.7%), mild suspicion (13.6%) and high suspicion (75.7%) of malignancy probability;sensitivity of 82%, specificity of 74%, the positive predictive value of 94%, the negative predictive value of 51%, the statistical accuracy of 81%, odds ratio of 108.89 and correlation with ACR TIRADS of 0.77 and Bethesda of 0.91.<strong> Conclusions: </strong>Alpha Score 2.0 has superior diagnostic accuracy and performance compared to the previously published Alpha Score and is able to classify a benign TN in a precise, safe and accurate way, avoiding unnecessary FNABs or determining the necessity of FNAB in cases of moderate to high suspicion of malignancy.
作者
Glenn Mena
Maria Cristina Chammas
Carlos Mario Gonzalez Vasquez
Lylian Rocío Villagómez
Marco Alfredo Muñoz Pico
Patricio Alejandro Montalvo
Santiago Mena-Bucheli
Julio Olmedo
Elizabeth Quintero
Pedro Henrique de Marqui Moraes
Osmar Cassio Saito
Hubertino Diaz
Denise Romero
Gabriela Velalcazar
Angel Ramón Sosa Fleitas
Yamil Oliver Quevedo Ontaneda
Victor Ricardo Chara
Glenn Mena;Maria Cristina Chammas;Carlos Mario Gonzalez Vasquez;Lylian Rocío Villagómez;Marco Alfredo Muñoz Pico;Patricio Alejandro Montalvo;Santiago Mena-Bucheli;Julio Olmedo;Elizabeth Quintero;Pedro Henrique de Marqui Moraes;Osmar Cassio Saito;Hubertino Diaz;Denise Romero;Gabriela Velalcazar;Angel Ramón Sosa Fleitas;Yamil Oliver Quevedo Ontaneda;Victor Ricardo Chara(Alpha Imagen Radiología e Intervencionismo, Quito, Ecuador;Hospital das Clínicas Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil;Hospital Pablo Tobón Uribe, Medellin, Colombia;Hospital del Instituto Ecuatoriano de Seguridad Social Quito Sur, Quito, Ecuador;Hospital San Francisco de Quito, Quito, Ecuador;Hospital Edgardo Rebagliati Martins, Lima, Perú;Hospital Carlos Andrade Marín, Quito, Ecuador;Hospital de Clínicas San José de San Martín, Buenos Aires, Argentina;Hospital Universitario de Los Andes, Mérida, Venezuela;Hospital de la Policía, Quito, Ecuador;Hospital Sisol, Tacna, Perú)
