Assessment of risk factors and ultrasonographic characteristics for the differentiation between malignant and benign thyroid nodules in Beni-Suef governorate, Egypt.

Background: Thyroid nodules (TNs) are frequent and often benign. Accurately differentiating between benign and malignant nodules is crucial for proper management. This research aims to use ultrasonography to examine TNs and identify possible risk factors in order to improve patient outcomes and diagnostic accuracy.

Methods: The study included 128 euthyroid participants who underwent thyroidectomy, splitted into two groups (benign and malignant) regarding the histopathological outcomes. Data on age, sex, family history of thyroid cancer and radiation exposure were collected. Ultrasound (US) was used to assess nodule number, size, vascularity and TIRAD scores. US Lymph node status was also evaluated. Statistical analysis compared benign and malignant nodules.

Results: No significant differences were found between benign and malignant groups regarding age, sex, family history, and radiation exposure. Significant differences were observed in nodule size (p < 0.05), echogenicity (p < 0.001), and margins (p < 0.05), with larger, hyper/isoechoic, and smooth-margined nodules more common in the benign group. TIRAD scores (p < 0.001) and lymph node status (p < 0.001) also differed significantly, with benign cases showing TR3 scores and non-suspicious lymph nodes, while malignant cases had more TR4 scores and suspicious lymph nodes. Additionally, malignant nodules were significantly more hypoechoic (p < 0.001). Most benign cases were nodular colloid hyperplasia, followed by follicular adenoma and thyroiditis. Most malignant cases were Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). PTC was associated with younger age (p = 0.006), smaller nodule size (p = 0.04), and hypoechoic nodules (p = 0.04).

Conclusion: Sex, age, family history of thyroid cancer, and radiation exposure history did not significantly vary between groups with benign and malignant thyroid tumors, according to the research. Higher TIRAD scores and hypoechoic nodules were more common in malignant nodules. Benign nodules had smoother margins, were bigger, and were more likely to be hyper/isoechoic.