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    Efficacy of multidisciplinary approach in thyroid nodules: analysis of factors used for predicting malignancy
    (TURKIYE KLINIKLERI, 2022) Kişio?lu, Savaş Volkan; Atacan, Hüseyin; Çakır, Emel; Oğuz, Şükrü; Karaküllükçü, Serdar; Ersöz, Halil Önder
    Objective: To date, numerous molecular tests have been developed for preoperative evaluation of thyroid nodules. Nevertheless, these tests cannot be administered in many centers due to their imprecise diagnoses and high costs. The present study aimed to investigate the effect of making surgical decisions in a panel through a multidisciplinary approach after clinical, ultrasonographic, and pathological evaluation of nodules on the accuracy of the decisions. Methods: The retrospective study included patients with thyroid nodules who underwent preoperative ultrasonography followed by fine-needle aspiration biopsy, which was confirmed by postoperative pathological examinations between January 2017 and January 2019. The relationship between ultrasonography features of nodules and malignancy was analyzed. A comparison was performed between patients who were referred for surgery through the multidisciplinary versus non-multidisciplinary approach. Results: A total of 255 nodules in 211 patients were evaluated in the study. The prevalence of malignancy was 100% in nodules with hypoechogenicity + microcalcification + margin irregularity (P <.001). The likelihood of malignancy was significantly higher in dual combinations of these 3 adverse conditions (P <.001 for all). Margin irregularity was found to be the most predictive model for malignancy (CI: 1.9-13.8, odds ratio: 5.249, P <.001). The multidisciplinary approach was superior to the non-multidisciplinary approach in the detection of malignancy (P =.008). Conclusion: Margin irregularity had the highest predictive value for the detection of malignancy. Employing the multidisciplinary approach in preoperative evaluation of thyroid nodules can be highly effective in detecting malignancy and preventing unnecessary surgery.