Martina Martinelli's research while affiliated with Università degli Studi di Siena and other places

Background Recently, the American (ATA) and the European Thyroid Association (ETA), have proposed that thyroid ultrasound (US) should be used to stratify the risk of malignancy in thyroid nodules and to aid decision-making about whether FNAC is indicated. Objective To validate and to compare the ATA and ETA US risk stratification systems of thyroid nodules in a prospective series of thyroid nodules submitted to FNAC. Patients and methods We prospectively evaluated 432 thyroid nodules selected for FNAC from 340 patients. Cytology reports were based on the five categories according to the criteria of the British Thyroid Association Results The proportion of Thy2 nodules decreased significantly while the proportion of Thy4/Thy5 nodules significantly increased with increasing US risk class (p<0.0001). The ability to identify benign and malignant nodules was similar between ATA and ETA systems. According to ATA and ETA US risk stratification systems, 23.7 % and 56.0 % nodules did not meet the criteria for FNAC, respectively. Considering only categories at lower risk of malignancy cumulative malignancy rate in these nodules was 1.2% for ATA and 1.7% for ETA US risk stratification systems. Conclusions ETA and ATA US risk stratification systems provide effective malignancy risk stratification for thyroid nodules. In clinical practice, using this approach we should be able to reduce the number of unnecessary FNAC without losing clinically significant thyroid cancer.