Medullary vs papillary: is there a sonographic difference between these two thyroid cancer types?

Abstract

Introduction Thyroid cancer has increased in incidence over the years, most likely due to improved imaging studies. In 2017 American College of Radiology proposed a scoring system – Thyroid Imaging, Reporting and Data System (TIRADS) for identifying clinically significant malignancies using thyroid ultrasound. However, this system was developed with papillary thyroid carcinoma (PTC) in mind because it is the most common. Medullary thyroid carcinoma (MTC) is much rarer but it is more aggresive. Therefore, we decided to determine the sonographic differences between papillary and medullary thyroid cancer types using TI-RADS Aims and Objectives Aim of the study is to determine the sonographic differences between papillary and medullary thyroid cancer types using TI-RADS. 1. To determine if distribution of sonographic features suggesting malignancy is different between PTC and MTC cases. 2. To evaluate differences of total TI-RADS scores awarded for sonographic features of thyroid nodules between PTC and MTC cases. 3. To evaluate the relation between thyroid nodule size and total TI-RADS score in PTC and MTC cases. Materials and methods A total of 76 MTC cases from 2004 to 2017 and 62 PTC cases from 2014 to 2017 were analyzed in Lithuanian University of Health Sciences Kaunas Clinics. Patients’ age, gender, sonographic features of thyroid nodules (echogenicity, shape, composition, margin, echogenic foci and nodule size) were assessed. The nodules were scored (0-3) as suggested by 2017 ACR TI-RADS. The results were compared between PTC and MTC. In all cases definite diagnosis was verified by histological evaluation of surgical specimen. Statistical analysis was performed with “IBM SPSS Statistics 17.0“. Student's t-test was used to compare the means of two variables and Spearman's rank correlation coefficient (rs) was used