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Related Experiment Videos

Frozen section in thyroid surgery: is it a necessity?

Bahadir Cetin1, Sabahattin Aslan, Celal Hatiboglu

  • 1First Department of Surgery, Ankara Oncology Hospital, Ankara, Turkey. bahadircetin1@yahoo.com

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|March 5, 2004
PubMed
Summary

Intraoperative frozen-section (FS) biopsy aids thyroid nodule diagnosis, especially when fine-needle aspiration (FNA) is suspicious. FS is less crucial for definitive FNA results, and neither method detects all occult thyroid cancers.

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Area of Science:

  • Endocrinology
  • Surgical Pathology
  • Oncology

Background:

  • Intraoperative frozen-section (FS) biopsy is used for thyroid nodule malignancy assessment.
  • FS findings often conflict with preoperative fine-needle aspiration (FNA) biopsy results.
  • The study evaluates the utility of intraoperative FS biopsy for thyroid nodular disease.

Purpose of the Study:

  • To assess the diagnostic value of intraoperative FS biopsy in patients with thyroid nodules.
  • To compare the accuracy of FS and FNA biopsies against final histologic examination.
  • To determine the impact of FS on surgical decisions.

Main Methods:

  • 203 patients with thyroid nodules underwent surgery.
  • Nodules were evaluated by FNA preoperatively and FS intraoperatively.

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  • Sensitivity, specificity, and accuracy of both methods were calculated versus histologic findings.

    • Main Results:

    • FS showed higher sensitivity (87.1%) and accuracy (97.8%) than FNA (74.1%, 95.2%) for malignancy detection.
    • FS altered surgical decisions in 20% of cases with suspicious FNA results.
    • FS provided no additional benefit for nodules with definitively benign or malignant FNA results.

    Conclusions:

    • Intraoperative FS is most valuable for thyroid nodules with suspicious FNA findings.
    • FS is generally unnecessary when FNA results are clearly benign or malignant.
    • Both FNA and FS have limitations in detecting occult thyroid carcinomas.