McGill thyroid nodule score
Updates to Article Attributes
The McGill Thyroid Nodule Score (MTNS) is a scoring system developed to estimate the risk of malignancy of thyroidthyroid nodules.1
Scoring system
ItThe MTNS is based on 22 parametres, each one has a specific score parameters:
- 8 clinical or laboratory
parametresparameters:_gender-
gender (male)
.: 1 point_Age -
age (>45 years old)
.: 1 point_Palpabilities -
palpabilities of nodule(present)
.: 1 point_TSH levels -
TSH level (>1,4 mIU/L)
.: 1 point_Ionizing -
ionizing radiation exposure
. 3: 3 points_Family -
family history of thyroid cancer
. 3: 3 points_Ethnicity -
ethnicity (Hawaii,
PilipinoFilipino, Iceland).: 3 points
-
gender (male)
- 8 imaging findings:
_hypoechioc-
hypoechoic nodule
. 1: 1 point_Increased -
increased vascularity at
Eco-color-doppler. 1pointcolor Doppler: 1 point_Shape -
shape (taller than wide)
.: 1 point -
calcifications:
1point_Calcifications-
coarse calcifications:
coarse calcifications. 11 pointMicrocalcifications. -
microcalcifications: 2 points
_Enalarging
-
coarse calcifications:
-
enlarging:
more than 10%. 1-
>10%: 1 point
More than 30%. 2 -
>30%: 2 points
_Lynphadenopathy
-
>10%: 1 point
-
lymphadenopathy (present)
. 2: 2 points_Size -
size:
2-
2.0 - 2
,9.9 cm2: 2 points - 3.0 - 3
,9.9 cm3: 3 points - 4 cm
oor greater. 4: 4 points_PET
-
2.0 - 2
-
PET scan focally positive
.: 4 points
-
hypoechoic nodule
- 6 cytological or molecular results:
_H-
Hürthle cell lesion(present)
. 2: 2 points_Favour -
favour neoplasm(present)
.: 3 points_Atypia -
atypia (non reactive):
mild.-
mild: 3 points
Moderate. 4 -
moderate: 4 points
Severe. 5 -
severe: 5 points
_Sospicious
-
mild: 3 points
-
suspicious for malignancy(present)
.: 7 points -
HBME-1 (positive): 7 points
_HBME-1(positive -
BRAF mutation (present)
.: 7 points_ BRAF mutation(present). 7 points
-
Hürthle cell lesion(present)
Score Interpretation and percentage of risk of malignancy:
- 0 point = 0%
- 1-3 points = 27%
- 4-7 points = 32%
- 8 points = 39%
- 9-11 points = 63%
- 12-13 points = 88%
- 14-18 points = 93%
- >18 points = 100%.
Notes
Some think the MTNS is particurarly useful when the result of FNA is indeterminate.
The "mild", "moderate", and "severe" classification refers to subclassifications within the Bethesda 3 category. This is not always available on pathology reports.
-<p><strong>McGill Thyroid Nodule Score </strong>is a scoring system developed to estimate the risk of malignancy of t<a href="/articles/assessment-of-thyroid-lesions-ultrasound">hyroid nodules</a>.<sup>1</sup></p><p> </p><p>It is based on 22 parametres, each one has a specific score :</p><p>8 clinical or laboratory parametres:</p><p>_gender(male). 1 point</p><p>_Age( >45 years old). 1 point</p><p>_Palpabilities of nodule(present). 1 point</p><p>_TSH levels(>1,4 mIU/L). 1 point</p><p>_Ionizing radiation exposure. 3 points</p><p>_Family history of thyroid cancer. 3 points </p><p>_Ethnicity(Hawaii, Pilipino , Iceland). 3 points</p><p>8 imaging findings:</p><p>_hypoechioc nodule. 1 point</p><p>_Increased vascularity at Eco-color-doppler. 1point</p><p>_Shape(taller than wide). 1point</p><p>_Calcifications: coarse calcifications. 1 point</p><p> Microcalcifications. 2 points</p><p>_Enalarging: more than 10%. 1 point</p><p> More than 30%. 2 points</p><p>_Lynphadenopathy(present). 2 points</p><p>_Size: 2 - 2,9 cm 2 points </p><p> 3 - 3,9 cm 3 points</p><p> 4 cm o greater. 4 points</p><p>_PET scan focally positive. 4 points</p><p>6 cytological or molecular results:</p><p>_Hürthle cell lesion(present). 2 points</p><p>_Favour neoplasm(present). 3 points</p><p>_Atypia(non reactive) : mild. 3 points </p><p> Moderate. 4 points</p><p> Severe. 5 points </p><p>_Sospicious for malignancy(present). 7 points</p><p>_HBME-1(positive). 7 points</p><p>_ BRAF mutation(present). 7 points</p><p> </p><p><strong>Score Interpretation and percentage of risk of malignancy</strong>: </p><p>0 point = 0% </p><p>1-3 points = 27%</p><p>4-7 points = 32%</p><p>8 points = 39%</p><p>9-11 points = 63%</p><p>12-13 points = 88%</p><p>14-18 points = 93%</p><p>>18 points = 100%.</p><p> </p><p>MTNS is particurarly useful when the result of <a href="/articles/ultrasound-guided-fna-of-the-thyroid">FNA</a> is indeterminate.</p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p>- +<p>The <strong>McGill Thyroid Nodule Score (MTNS) </strong>is a scoring system developed to estimate the risk of malignancy of <a href="/articles/assessment-of-thyroid-lesions-ultrasound">thyroid nodules</a>.<sup>1</sup></p><h4>Scoring system</h4><p>The MTNS is based on 22 parameters:</p><ul><li>8 clinical or laboratory parameters:<ul>
- +<li>gender (male): 1 point</li>
- +<li>age (>45 years old): 1 point</li>
- +<li>palpabilities of nodule (present): 1 point</li>
- +<li>TSH level (>1,4 mIU/L): 1 point</li>
- +<li>ionizing radiation exposure: 3 points</li>
- +<li>family history of thyroid cancer: 3 points</li>
- +<li>ethnicity (Hawaii, Filipino, Iceland): 3 points</li>
- +</ul>
- +</li></ul><p> </p><ul><li>8 imaging findings:<ul>
- +<li>hypoechoic nodule: 1 point</li>
- +<li>increased vascularity at color Doppler: 1 point</li>
- +<li>shape (taller than wide): 1 point</li>
- +<li>calcifications: <ul>
- +<li>coarse calcifications: 1 point</li>
- +<li>microcalcifications: 2 points</li>
- +</ul>
- +</li>
- +<li>enlarging: <ul>
- +<li>>10%: 1 point</li>
- +<li>>30%: 2 points</li>
- +</ul>
- +</li>
- +<li>lymphadenopathy (present): 2 points</li>
- +<li>size:<ul>
- +<li>2.0 - 2.9 cm: 2 points</li>
- +<li>3.0 - 3.9 cm: 3 points</li>
- +<li>4 cm or greater: 4 points</li>
- +</ul>
- +</li>
- +<li>PET scan focally positive: 4 points</li>
- +</ul>
- +</li></ul><p> </p><ul><li>6 cytological or molecular results:<ul>
- +<li>Hürthle cell lesion (present): 2 points</li>
- +<li>favour neoplasm (present): 3 points</li>
- +<li>atypia (non reactive): <ul>
- +<li>mild: 3 points</li>
- +<li>moderate: 4 points</li>
- +<li>severe: 5 points</li>
- +</ul>
- +</li>
- +<li>suspicious for malignancy (present): 7 points</li>
- +<li>HBME-1 (positive): 7 points</li>
- +<li>BRAF mutation (present): 7 points</li>
- +</ul>
- +</li></ul><p><strong>Score Interpretation and percentage of risk of malignancy</strong>: </p><ul>
- +<li>0 point = 0% </li>
- +<li>1-3 points = 27%</li>
- +<li>4-7 points = 32%</li>
- +<li>8 points = 39%</li>
- +<li>9-11 points = 63%</li>
- +<li>12-13 points = 88%</li>
- +<li>14-18 points = 93%</li>
- +<li>>18 points = 100%.</li>
- +</ul><h4>Notes</h4><p>Some think the MTNS is useful when the result of <a href="/articles/ultrasound-guided-fna-of-the-thyroid">FNA</a> is indeterminate.</p><p>The "mild", "moderate", and "severe" classification refers to subclassifications within the Bethesda 3 category. This is not always available on pathology reports.</p>