Abstract:
Background: The ultimate goal of diagnostic assessment of thyroid nodules is to accurately
identify malignancy. Ultrasound is widely used due to its accessibility. However, cytology
remains the gold standard and previous studies shown potential inconsistency between
ultrasound and cytology findings its lead to the patient for unnecessary FNA. Based on
researcher knowledge its first study conducted in Ethiopia.
Objective: The aim of this study was to assess malignant thyroid nodule detection using
ultrasound reporting systems and associated factors among thyroid nodule patients at selected
public hospitals in Addis Ababa, Ethiopia
Methods: Facility based cross-sectional study was conducted among three randomly selected
public hospitals in Addis Ababa Ethiopia, from October 15 to November 15, 2024. A simple
random sampling technique was used to select 294 study respondents. Data was extracted
from medical records using a structured checklist and analyzed using SPSS Version 25.
Descriptive statistics were initially computed. Diagnostic accuracy tests with their 95% CI
were conducted. Finally, multivariable logistic regression analysis was fitted to identify
factors associated with the malignant thyroid nodule detection. P-value <0.05 with 95% CI
was considered statistical significant association.
Result: The overall proportion of malignant thyroid nodule detection by ultrasound were
87% (95%CI 82-90%). Adjusted analysis showed that the odds of malignant thyroid nodule
detection were significantly associated with hypo echogenicity (AOR = 4.18, 95% CI = 1.40
12.50), taller than wider shape (AOR = 2.65, 95% CI = 1.16-6.08), size of the nodule (AOR
= 2.46, 95% CI = 1.14-5.28), central vascularity (AOR = 0.33, 95% CI = 0.45-0.76), and
isthmus location (AOR = 3.07, 95% CI = 1.11-8.49).
Conclusion and recommendations: Ultrasound feature such as hypo echogenicity, taller
than-wide shape, and size of nodule greater than 2cm, central vascularity and isthmus
location were significantly associated with malignant thyroid nodule detection. The thyroid
imaging reporting and data system is a reliable tool for predicts thyroid nodule malignancy so
those hospital in Addis Ababa use as a clinical guideline for evaluating thyroid nodules.
