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Ultrasonography: Its role in nodular thyroid disease
Ajith Nilakantan1, M D Venkatesh, Dilip Raghavan
1Dept of ORL-HNS, Armed Forces Medical College, Pune, 411 040 India ; Dept of ENT-HNS, Armed Forces Medical College, Pune, 411 040 India.
Summary
Ultrasound (USG) accurately assesses thyroid nodule size and number, and USG-guided Fine Needle Aspiration Cytology (FNAC) is effective for malignancy diagnosis. However, USG alone has limited predictive value for malignancy in thyroid nodules.
Area of Science:
- Endocrinology
- Diagnostic Imaging
- Surgical Pathology
Background:
- Nodular thyroid disease is common.
- Accurate preoperative assessment of thyroid nodules is crucial for appropriate management.
- Correlation between imaging, cytology, and histopathology is essential.
Purpose of the Study:
- To correlate preoperative clinical, ultrasound (USG), intra-operative, and histopathological findings for thyroid nodules.
- To evaluate the diagnostic accuracy of Fine Needle Aspiration Cytology (FNAC) with and without USG guidance.
- To assess the utility of USG in predicting malignancy in thyroid nodules.
Main Methods:
- Retrospective chart review of 106 patients with nodular thyroid disease.
- Comparison of clinical examination, USG, intra-operative findings, and histopathology.
- Analysis of FNAC (with or without USG guidance) accuracy for malignancy detection.
Main Results:
- USG demonstrated a 7-fold higher predictive value than clinical examination for nodule number and size.
- USG-guided FNAC showed 85.71% sensitivity and 90.0% specificity for malignancy.
- USG alone had 20.0% sensitivity and 97.67% specificity in predicting malignancy.
Conclusions:
- USG accurately determines thyroid nodule number and size.
- USG is valuable for guiding FNAC in nodular thyroid disease.
- The role of USG alone in predicting malignancy is questionable; USG-guided FNAC is recommended for routine evaluation.
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