McGill Thyroid Nodule Score (MTNS): "rating the risk," a novel predictive scheme for cancer risk determination

• Published in: Journal of otolaryngology-head and neck surgery Vol. 40 Suppl 1; p. S1
• Main Authors: Sands, Noah B, Karls, Shawn, Amir, Alexander, Tamilia, Michael, Gologan, Olga, Rochon, Louise, Black, Martin J, Hier, Michael P, Payne, Richard J
• Format: Journal Article
• Language: English
• Published: England 01.02.2011
• Subjects: Biopsy, Fine-Needle; Disease Progression; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Positron-Emission Tomography; Quebec - epidemiology; Retrospective Studies; Risk Assessment - methods; Risk Factors; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - epidemiology; Thyroid Nodule - diagnosis; Thyroid Nodule - epidemiology; Thyroid Nodule - surgery; Quebec
• ISSN: 1916-0216
• DOI: 10.2310/7070.2011.100098

There are presently a great number of publications pertaining to the clinical risk factors associated with thyroid cancer. These studies deal mostly with a single feature from either patient demographics, physical examination, laboratory values, imaging, or cytology. We sought to create a novel scoring system that integrates the diagnostic indices of each of these clinical features for carcinoma. A retrospective analysis of 1047 consecutive thyroidectomy patients was performed. Each patient was assigned a cancer risk score according to a newly devised 22-variable scoring scheme termed the McGill Thyroid Nodule Score (MTNS). The MTNS was developed by a multidisciplinary team of endocrinologists, thyroid surgeons, and pathologists using already established evidence-based risk factors for thyroid cancer. The exact incidence of malignancy was calculated for each MTNS score based on final pathology. The incidence for scores of 1 to 3 was 27%, of 4 to 7 was 32%, of 8 was 39%, of 9 to 11 was 63%, of 12 to 13 was 88%, and of 14 to 18 was 93%. All (130 of 130) patients with a score ≥ 19 had carcinoma. A score ≤ 8 correlated with a 32% (115 of 357) risk of thyroid cancer, whereas a score > 8 implied an 86% (417 of 487) risk. Our data suggest that a combined scoring system, the MTNS, can serve as an accurate predictor of the risk for thyroid cancer in a specific thyroid nodule. This will help physicians better formulate management decisions accordingly.