Sonographic predictors of aggressive behavior in medullary thyroid carcinomas

Chun ping Ning, Eun Kyung Kim

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Objective: To identify the clinical and sonographic risk factors for aggressive behavior of Medullary Thyroid Carcinomas (MTCs). Material and methods: This is a retrospective analysis. The informed consents were waived. Totally, 127 patients were selected from the database. Two radiologists were invited to review the clinical records and ultrasonic images and scored all the cases according to ACR TI-RADS, retrospectively. Kappa test was used to evaluate the consistency between the two reviewers. Logistic regression analysis was carried to identify the risk factors for aggressive behaviors of MTCs. Comparison of survival proportions between different groups were calculated by Kaplan–Meier method and log-rank test. Results: Female patients with MTCs were more commonly seen than male (1.7:1), male sex was a risk factor for both metastasis (OR: 4.471, P = 0.001) and perithyroidal invasion (OR = 4.674, P = 0.004). Consistency between the two reviewers were quite high (K value, 0.797–0.988). On sonograms, typical MTCs manifest as hypoechoic (96.9%) solid nodules (94.5%). Sex of patients (P = 0.001), margin (P = 0.003) and focality (P = 0.01) of the nodule were independent risk factors for metastasis, whereas sex of the patients (P = 0.004) and margin (P = 0.000) were independent risk factors for perithyroidal invasion. By Kaplan–Meier analysis, survival proportions different between groups with/without perithyroidal extension (P = 0.000) but not between groups with/without metastasis (P = 0.473). Conclusion: High frequency ultrasound and TI-RADS were effective methods for preoperative diagnosis of MTC. Sex of the patients and margin of the nodule are common risk factors for both metastasis and perithyroidal invasion. Focality of the tumor is another independent risk factor for metastasis.

Original languageEnglish
Pages (from-to)291-298
Number of pages8
JournalAsian Journal of Surgery
Issue number1
Publication statusPublished - 2022 Jan

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© 2021

All Science Journal Classification (ASJC) codes

  • Surgery


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