Abstract
Objective
The objective was to correlate the number, size and extent of the nodules as determined during the preoperative clinical examination of the thyroid gland, USG, intra-operative examination and histopathology. Also, FNAC (with or without USG guidance) and USG findings suggestive of malignancy were correlated with the final histopathology.
Setting
Tertiary referral centre
Patients
A retrospective chart review was done for 106 patients who underwent surgery for benign or malignant nodular thyroid disease in our center, between Jan 2004–Dec 2006.
Results
USG has 7 times higher predictive value than clinical examination in detecting number of nodules and determining size of nodules. USG guided FNAC has a sensitivity of 85.71% and specificity of 90.0% in detecting malignancy in nodular thyroid disease. However for predicting malignancy in thryoid nodules, this study shows that USG has a sensitivity of 20.0% and specificity of 97.67%.
Conclusion
In patients with nodular thyroid disease, USG can accurately determine the number and the size of the nodules. It is extremely useful in guiding FNAC; However its role in predicting malignancy is doubtful. We therefore recommend that USG guided FNAC be carried out as a routine in the evaluation of thyroid nodules.
Keywords: Nodular thyroid disease, Ultrasonography, Guided FNAC
Full Text
The Full Text of this article is available as a PDF (90.5 KB).
References
- 1.Castro M.R., Gharib H. Thyroid nodules and cancer: when to wait and watch when to refer. Postgrad Med. 2000;107(1):113–124. doi: 10.3810/pgm.2000.01.808. [DOI] [PubMed] [Google Scholar]
- 2.Burguera B., Gharib H. thyroid incidentalomas: prevalence, diagnosis, significance, and management. Endocrinol Metab Clin North Am. 2000;29(1):187–203. doi: 10.1016/S0889-8529(05)70123-7. [DOI] [PubMed] [Google Scholar]
- 3.Brander A., Viikinkoski P., Nickels J., et al. Thyroid gland: U/S screening in a random adult population. Radiology. 1991;181:683–687. doi: 10.1148/radiology.181.3.1947082. [DOI] [PubMed] [Google Scholar]
- 4.Mortensen J.D., Woolner L.B., Bennett W.A. Gross and microscopic findings in clinically normal thyroid gland. J Clin Endocrinol Metab. 1955;15:1270–1280. doi: 10.1210/jcem-15-10-1270. [DOI] [PubMed] [Google Scholar]
- 5.Danese D., Sciacchitano S., Farsetti A., Andreoli M., Pontecorvi A. Diagnostic accuracy of conventional versus sonography-guided fine needle aspiration biopsy of thyroid nodules. Thyroid. 1998;8:15–21. doi: 10.1089/thy.1998.8.15. [DOI] [PubMed] [Google Scholar]
- 6.Braga M, Teresa C et al. (2001) Efficacy of ultrasoundguided FNAB in the diagnosis of complex thyroid nodules. J Clin Endocrinol Metab 4089–4091 [DOI] [PubMed]
- 7.Giuffrida D., Gharib H. Controversies in the management of cold, hot, and occult thyroid nodules. Am J Med. 1995;99:642–650. doi: 10.1016/S0002-9343(99)80252-6. [DOI] [PubMed] [Google Scholar]
- 8.Koike E., Noguchi S., Yamashita H., et al. Ultrasonographic characteristics of thyroid nodules. Arch Surg. 2001;136:334–337. doi: 10.1001/archsurg.136.3.334. [DOI] [PubMed] [Google Scholar]
- 9.Marqusee E., Bensen C.B., Frates M.C., et al. Usefulness of ultrasonography in the management of nodular thyroid disease. Ann Intern Med. 2000;133:696–700. doi: 10.7326/0003-4819-133-9-200011070-00011. [DOI] [PubMed] [Google Scholar]
- 10.Court Payen M., Holm H.H., et al. US-guided fineneedle aspiration biopsy of thyroid nodules. Acta Radiol. 2002;43(2):131–140. doi: 10.1080/028418502127347880. [DOI] [PubMed] [Google Scholar]
- 11.Baskin H.J., et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules and multinodular goiters. Endocr Pract. 2004;10(3):242–245. doi: 10.4158/EP.10.3.242. [DOI] [PubMed] [Google Scholar]
- 12.Casella C., Talarico C., Pinta M., Nascimbeni R., et al. The role of color flow doppler ultrasonography in the diagnosis of nodular goitre. Ann Ital Chir. 2003;74(5):495–499. [PubMed] [Google Scholar]