McGill thyroid nodule score
Updates to Article Attributes
Body
was changed:
The McGill Thyroid Nodule Score (MTNS) is a scoring system developed to estimate the risk of malignancy of thyroid nodules.1
Scoring system
The MTNS is based on 22 parameters:
-
eight clinical or laboratory parameters
:- gender (male): 1 point
- age (>45 years old): 1 point
- palpable nodule (present): 1 point
- TSH level (>1,4 mIU/L): 1 point
- consistency (stone/bone hard): 2 points
- ionizing radiation exposure: 3 points
- family history of thyroid cancer: 3 points
- ethnicity (Hawaiian, Filipino, Icelandic): 3 points
-
eight imaging findings
:- hypoechoic nodule: 1 point
- increased vascularity at color Doppler: 1 point
- shape (taller than wide): 1 point
- calcifications
:- coarse calcifications: 1 point
- microcalcifications: 2 points
- enlarging
:- >10%: 1 point
- >30%: 2 points
- lymphadenopathy (present): 2 points
- size
:- 2.0
- 2-2.9 cm: 2 points - 3.0
- 3-3.9 cm: 3 points - 4 cm or greater: 4 points
- 2.0
- PET scan focally positive: 4 points
-
six cytological or molecular results
:- Hürthle cell lesion (present): 2 points
- favour neoplasm (present): 3 points
- atypia (non reactive)
:- mild: 3 points
- moderate: 4 points
- severe: 5 points
- suspicious for malignancy (present): 7 points
- HBME-1 (positive): 7 points
- BRAF mutation (present): 7 points
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%
Practical points
Some think the MTNS is 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.
-<strong>eight clinical or laboratory parameters:</strong><ul>- +<strong>eight clinical or laboratory parameters</strong><ul>
-<strong>eight imaging findings:</strong><ul>- +<strong>eight imaging findings</strong><ul>
-<li>calcifications: <ul>- +<li>calcifications<ul>
-<li>enlarging: <ul>- +<li>enlarging<ul>
-<li>size:<ul>-<li>2.0 - 2.9 cm: 2 points</li>-<li>3.0 - 3.9 cm: 3 points</li>- +<li>size<ul>
- +<li>2.0-2.9 cm: 2 points</li>
- +<li>3.0-3.9 cm: 3 points</li>
-<strong>six cytological or molecular results:</strong><ul>- +<strong>six cytological or molecular results</strong><ul>
-<li>atypia (non reactive): <ul>- +<li>atypia (non reactive) <ul>