McGill thyroid nodule score

Last revised by Bálint Botz on 12 Dec 2021

Citation, DOI, disclosures and article data

Citation:

Nicolini G, Botz B, Knipe H, et al. McGill thyroid nodule score. Reference article, Radiopaedia.org (Accessed on 18 Apr 2024) https://doi.org/10.53347/rID-44393

DOI:

https://doi.org/10.53347/rID-44393

Permalink:

https://radiopaedia.org/articles/44393

rID:

44393

Article created:

19 Apr 2016, Giacomo Nicolini

Disclosures:

At the time the article was created Giacomo Nicolini had no recorded disclosures.

View Giacomo Nicolini's current disclosures

Last revised:

12 Dec 2021, Bálint Botz ◉

Disclosures:

At the time the article was last revised Bálint Botz had no recorded disclosures.

View Bálint Botz's current disclosures

Revisions:

8 times, by 6 contributors - see full revision history and disclosures

Systems:

Head & Neck

Sections:

Classifications

Tags:

thyroid nodule, fna, thyroid malignancy, thyroid, endocrine, refs, cases

Synonyms:

McGill thyroid nodule score (MTNS)

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
  - 2.0-2.9 cm: 2 points
  - 3.0-3.9 cm: 3 points
  - 4 cm or greater: 4 points
- PET scan focally positive: 4 points
six cytological or molecular results
- Hürthle cell lesion (present): 2 points
- favor 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%
>19 points = 100%

Practical points

Some think the McGill Thyroid Nodule Score is useful when the result of FNA is indeterminate.

The "mild", "moderate", and "severe" classification refer to subclassifications within the Bethesda 3 category. This is not always available on pathology reports.