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Distribution patterns of microcalcifications in suspected thyroid carcinoma: a classification method helpful for diagnosis

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Abstract

Purpose

The aim of this study was to compare the distribution patterns of microcalcifications in thyroid cancers with benign cases.

Methods

In total, 358 patients having microcalcifications on ultrasonography were analysed. Microcalcifications were categorised according to the distribution patterns: (I) microcalcifications inside one (a) or more (b) suspected nodules, (II) microcalcifications not only inside but also surrounding a suspected single (a) or multiple (b) nodules, and (III) focal (a) or diffuse (b) microcalcifications in the absence of any suspected nodule. Differences in distribution patterns of microcalcifications in benign and malignant thyroid lesions were compared.

Results

We found that the distribution patterns of microcalcifications differed between malignant (n = 325) and benign lesions (n = 117) (X2 = 9.926, p < 0.01). Benign lesions were classified as type Ia (66.7%), type Ib (29.1%) or type IIIa (4.3%). The specificity of type II and type IIIb in diagnosing malignant cases was 100%. Among malignant lesions, 172 locations were classified as type Ia, 106 as type Ib, 12 as type IIa, 7 as IIb, 7 as type IIIa and 19 as type IIIb. Accompanying Hashimoto thyroiditis was most frequent in type III (51.6%).

Conclusions

Types II and IIIb are highly specific for cancer detection. Microcalcifications outside a nodule and those detected in the absence of any nodule should therefore be reviewed carefully in clinical practice.

Key Points

• A method to classify distribution patterns of thyroid microcalcifications is presented.

• Distribution features of microcalcifications are useful for diagnosing thyroid cancers.

• Microcalcifications outside a suspicious nodule are highly specific for thyroid cancers.

• Microcalcifications without suspicious nodules should also alert the physician to thyroid cancers.

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Abbreviations

PTC:

Papillary thyroid cancer

FNA:

Fine-needle aspiration

FAC:

Follicular adenocarcinoma

MTC:

Medullary thyroid carcinoma

DSVPC:

Diffuse sclerosing variant of papillary carcinoma

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Acknowledgements

We want to express our gratitude to Medjaden Bioscience Limited Co. for the professional editing of the manuscript.

Funding

This study has received funding by the Natural Science Foundation of China (grant no. 81501477)

Author information

Authors and Affiliations

  1. Ultrasound Department, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Southern Distinct, Qingdao, Shandong, 266003, China

    Chun-ping Ning, Shi-bao Fang, Hong-qiao Wang & Yan-mi Zhong

  2. Radiology Department, The Affiliated Hospital of Qingdao University, Qingdao, China

    Qing-lian Ji

  3. Urology Department, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Southern Distinct, Qingdao, Shandong, 266003, China

    Hai-tao Niu

Authors
  1. Chun-ping Ning
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  2. Qing-lian Ji
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  3. Shi-bao Fang
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  4. Hong-qiao Wang
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  5. Yan-mi Zhong
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  6. Hai-tao Niu
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Corresponding authors

Correspondence to Shi-bao Fang or Hai-tao Niu.

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Guarantor

The scientific guarantor of this publication is Shibao Fang.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• case-control study/diagnostic study/observational

• performed at one institution

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Ning, Cp., Ji, Ql., Fang, Sb. et al. Distribution patterns of microcalcifications in suspected thyroid carcinoma: a classification method helpful for diagnosis. Eur Radiol 28, 2612–2619 (2018). https://doi.org/10.1007/s00330-017-5212-2

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  • DOI: https://doi.org/10.1007/s00330-017-5212-2

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