Thyroid Nodule: Alpha Score 2.0 Classification for FNAB Selection, Multicentric Study in Latin America

Introduction: To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, to compare it with ACR TIRADS® Bethesda®. Materials Methods: A prospective in 10 radiological hospitals institutions Latin America was performed 818 were analyzed by ultrasound classified both Score; fine-needle aspiration biopsy when needed Bethesda. The relationships between predictors binary logistic regression, statistical significance defined p-value 0.05, an error margin 4% 95% confidence intervals. Results: Score 2.0 establishes five types predictors: microcalcifications, irregular borders, taller-than-wide shape, predominant solid texture hypoechogenicity; diameter equal or greater than 1.5 cm adds extra point final score. Resulting classification divides TNs into 4 categories: (1.9%), low suspicion (8.7%), mild (13.6%) high (75.7%) malignancy probability; sensitivity 82%, specificity 74%, positive predictive value 94%, negative 51%, accuracy 81%, odds ratio 108.89 correlation TIRADS 0.77 Bethesda 0.91. Conclusions: has superior diagnostic performance compared previously published is able classify TN precise, safe accurate way, avoiding unnecessary FNABs determining necessity FNAB cases moderate malignancy.