Demet Sengul, Ilker Sengul


Background:The goal is to evaluate the association between the topo-sonographic polarity of the thyroid nodules and the thyroid malignancy by analyzing its effect on The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), score of Strain Elastography (SE) for thyroid as Tsukuba Elasticity Score (TES), and histopathologic assessment.

Material and Methods: A preliminary single-center retrospective study was carried out by including the documents of 641 consecutive eligible patients, possessing 770 thyroid nodules which undergone neck ultrasonography (US), Doppler US, SE, and US-guided-fine needle aspiration (FNA) during April 2011 to April 2017. The stiffness had been measured by TES of SE. The ability of the prediction of the malignancy by the polarity of 770 thyroid nodules considering the association between; i) TBSRTC and histopathology and ii) TES and histopathology had been evaluated.

Results: Of the 770 thyroid nodules evaluated, 408 (53.0%) were located at the superior pole (Pol 1) while 362 (47.0%) were at the inferior pole (Pol 0) with 0.9046 AUC and 0.8171 AUC for the association between TBSRTC and histopathology and 0.9280 AUC and 0.7888 AUC for the association between TES and histopathology, respectively. However, those difference were not significant for Pol 1, topographically.

Conclusion: The topograghic and sonographic polarity of the thyroid nodules may not be useful for estimating the thyroid malignancy by using the association between TBSRTC and histopathology with TES and histopathology. However, the association with Pol 1, the superior thyroid pole, was stronger though the difference was not significant.


Polarity; Elastography; Fine-needle aspiration; Bethesda; TBSRTC; Thyroidectomy.

Full Text:



Gursoy A, Ertugrul DT, Sahin M, Tutuncu NB, Demirer AN, Demirag NG. Needle-free delivery of lidocaine for reducing the pain associated with the fine-needle aspiration biopsy of thyroid nodules: time-saving and efficacious procedure. Thyroid. 2007;17(4):317-21.

Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009;19(11):1159-65.

Ali SZ, Vielh P, Pusztaszeri M, Rossi D, Faquin WC, Bishop JA, et al. The Bethesda System for reporting thyroid cytopathology: past, present, future at The 19th International Congress of Cytology in Pacifico Yokohama, Japan, on 28 May–01 June, 2016, Symposiunm 12.

Ali SZ, Cibas ES. The Bethesda System for reporting thyroid cytopathology II. Acta Cytol. 2016;60(5):397-8.

Ali SZ, Cibas SE. The Bethesda System for Reporting Thyroid Cytopathology: Definitions, Criteria, and Explanatory Notes. 2nd ed. Cham: Springer Nature; 2018.

Zhang F, Oluwo O, Castillo F, Gangula P, Castillo M, Farag F, et al. Thyroid nodule location on ultrasonography as a predictor of malignancy. Late-breaking abstract #1204. AACE, American Association of Clinical Endocrinologists 2018, Boston, MA, USA

Zhang F, Oluwo O, Castillo FB, Gangula, Castillo M, Farag F, et al. Thyroid nodule location on ultrasonography as a predictor of malignancy. Endocr Pract. 2019;25(2):131-7. doi: 10.4158/EP-2018-0361. [Epub 2018, Nov 1].

Moss WJ, Finegersh A, Pang J, Califano JA, Coffey CS, Orosco RK, et al. Needle biopsy of routine thyroid nodules should be performed using a capillary action technique with 24- to 27-gauge needles: a systematic review and meta-analysis. Thyroid. 2018;28(7):857-63.

La Vecchia C, Malvezzi M, Bosetti C, Garavello W, Bertuccio P, Levi F, et al. Thyroid cancer mortality and incidence: a global overview. Int J Cancer. 2015; 136(9): 2187-95.

Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM,Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas Ccncers in the United States. Cancer Res. 2014:74(11):2913-21.

Welch HG, Black WC. Overdiagnosis in Cancer. J Nat Cancer Inst. 2010;102(9):605-13.

Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133.

Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008;22(6):901-11.

Machała E, Sopiński J, Iavorska I, Kołomecki K. Correlation of fine needle aspiration cytology of thyroid hland with Histopathological results. Pol Przegl Chir. 2018;21;90(6):1-5.

Zhao CK, Xu HX, Xu JM, Sun CY, Chen W, Liu BJ, et al. Risk stratification of thyroid nodules with Bethesda category III results on fine-needle aspiration cytology: The additional value of acoustic radiation force impulse elastography. Oncotarget. 2017;8(1):1580-92.

Cosgrove D, Piscaglia F, Bamber J, Bojunga J, Correas JM, Gilja OH, et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications. Ultraschall Med. 2013;34(3):238-53.

Bojunga J, Herrmann E, Meyer G, Weber S, Zeuzem S, Friedrich-Rust M. Real-time elastography for the differentiation of benign and malignant thyroid nodules: a meta-analysis.Thyroid. 2010;20(10):1145-50.

Ghajarzadeh M, Sodagari F, Shakiba M. Diagnostic accuracy of sonoelastography in detecting malignant thyroid nodules: a systematic review and meta-analysis. Am J Roentgenol. 2014;202(4):W379-89.

Razavi SA, Hadduck TA, Sadigh G, Dwamena BA. Comparative effectiveness of elastographic and B-mode ultrasound criteria for diagnostic discrimination of thyroid nodules: a meta-analysis. Am J Roentgenol. 2013;200(6):1317-26.

DOI: http://dx.doi.org/10.24125/sanamed.v14i1.325


  • There are currently no refbacks.

Copyright (c) 2019 Demet Sengul, Ilker Sengul

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.