Ultrasound-guided fine-needle aspiration biopsy in unselected consecutive patients with thyroid nodules

The objective was to analyze the results of UG-FNAB, performed in unselected consecutive patients with thyroid nodules. Methods. The UG-FNAB records were analyzed in this retrospective study. Indication for biopsy was the presence of at least one nodule detected by ultrasound. Results. 330 patients at mean age ± SD 48.4 ± 11.2 years; women/men = 12.8/1 were analyzed. From the total 596 nodules found 546 (91.6%) were investigated with 1231 punctures (2.3 per nodule and 3.7 per patient). Benign solitary nodules had 42.7%, multinodular goiter (MNG) 44.8%, inconclusive 4.8%, and others 2.1% and malignant nodules 5.5% of the patients (6.6% of solitary and 5.1% of MNG patients). The risk for a separate nodule in MNG to be malignant was 2.7%. Conclusions. UG-FNAB is a safe and reliable diagnostic approach for thyroid nodules. It is the method of choice for hypo- and isoechoic not purely cystic solitary nodules, regardless of the nodule size. In MNG, its positive predictive value and diagnostic accuracy are lower. The final decision for regular US monitoring, UG-FNAB of the dominant nodule, multipuncture UG-FNAB or surgical exploration is one of complex appraisal. We consider UG-FNAB appropriate for most nodules in MNG, according to the above mentioned criteria.