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Original research article


Avoiding unnecessary fine-needle aspiration cytology by accuractely predicting the benign nature of thyroid nodules using ultrasound

Sudhir VinayakJoyce A Sande
Department of Radiology, Aga Khan University Hospital, Nairobi, Kenya
Date of Submission: 22-Dec-2011, Date of Acceptance: 03-Apr-2012, Date of Web Publication: 28-Apr-2012.
Corresponding Author:
Corresponding Author

Joyce A. Sande

P.O. Box 63928-00619 Nairobi, Kenya.
E-mail: sande.joyce2@gmail.com

Corresponding Author:
Corresponding Author

Joyce A. Sande

P.O. Box 63928-00619 Nairobi, Kenya.
E-mail: sande.joyce2@gmail.com

DOI: 10.4103/2156-7514.95446 Facebook Twitter Google Linkedin

ABSTRACT



Objective: The objective of this study was to describe a reliable ultrasound based index scoring system based on ultraound characteristics to identify benign thyroid nodules and avoid unnecessary fine needle aspiration cytology.
Materials and Methods: Patients undergoing ultrasound-guided fine-needle aspiration cytology (FNAC) for thyroid nodules were evaluated prospectively. A total of 284 patients were evaluated from November 2005 to November 2011. There were 284 nodules. Any solid or partly solid focal nodule in the thyroid gland was included in the study. Cysts with no solid component were excluded. We used LOGIQ 9 (GE Healthcare) scanner equipped with a 10--14 MHz linear matrix transducer with color and power Doppler capability. Four US characteristics were evaluated, i.e., nodule margins, echo texture, vascularity, and calcification. Fine needle aspiration (FNA) was performed on all nodules. The nodules were labeled benign or suspicious using an ultrasound index score and the results compared with FNAC. Follicular neoplasms on fine-needle aspiration cytology were further assessed by excision biopsy and histology. Cytology/histology was used as the final diagnosis.
Results: In total 284 nodules were analyzed. All the 234 nodules in US labeled benign category were proven to be benign on cytology/histology. Therefore the specificity of ultrasound in labeling a nodule benign was 100%. Twenty of the 50 nodules that were suspicious on US were malignant. The most significant US differentiating characteristics were nodule margins, vascularity, and microcalcification.
Conclusion: Our results show that US can accurately characterize benign thyroid nodules using an index scoring system and therefore preclude FNAC in these patients.
Keywords: Fine Needle Aspiration Cytology, Benign Thyroid Nodule, Thyroid, Ultrasound

Cited in 7 Documents

  1. Po-Wen Cheng, Hsu-Wen Chou, Chi-Te Wang, Wu-Chia Lo and Li-Jen Liao Evaluation and development of a real-time predictive model for ultrasound investigation of malignant thyroid nodules Eur Arch Otorhinolaryngol 271(5) 2014 1199. Doi: 10.1007/s00405-013-2629-3
  2. Yu-Chun Chang, Wu-Chia Lo and Li-Jen Liao Surgeon-performed Ultrasound Elastography in the Evaluation of Thyroid Nodules Journal of Medical Ultrasound 22(3) 2014 145. Doi: 10.1016/j.jmu.2014.06.004
  3. Takanori Nishiyama, Koji Sakamoto, Fumihiro Ito, Seiichi Shinden and Kaoru Ogawa A Study on Thyroid Nodules without Preoperative Malignant Features Jibi inkoka rinsho 107(9) 2014 729. Doi: 10.5631/jibirin.107.729
  4. Takanori Nishiyama, Koji Sakamoto, Fumihiro Ito, Seiichi Shinden and Kaoru Ogawa A Study on Thyroid Nodules without Preoperative Malignant Features Pract.Otol.(Kyoto) 141(0) 2015 102. Doi: 10.5631/jibirinsuppl.141.102
  5. Risto Kojcev, Ashkan Khakzar, Bernhard Fuerst, Oliver Zettinig, Carole Fahkry, Robert DeJong, Jeremy Richmon, Russell Taylor, Edoardo Sinibaldi and Nassir Navab On the reproducibility of expert-operated and robotic ultrasound acquisitions Int J CARS 12(6) 2017 1003. Doi: 10.1007/s11548-017-1561-1
  6. Samer Narouze and Dmitri Souzdalnitski Management of Thyroid Incidentalomas Encountered by Anesthesiologists and Pain Physicians Regional Anesthesia and Pain Medicine 38(5) 2013 431. Doi: 10.1097/AAP.0b013e31829f890a
  7. Pu Cheng, En-Dong Chen, Hua-Min Zheng, Qiu-Xiang He and Quan Li Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China Asian Pacific Journal of Cancer Prevention 14(8) 2013 4689. Doi: 10.7314/APJCP.2013.14.8.4689

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