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Published on: November 10, 2014
Ultrasonography-guided fine-needle aspiration cytology for thyroid nodules: an emphasis on one-sampling and biopsy
Dong Wook Kim1, Hye Jung Choo, Ji Sung Park
1Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea. dwultra@lycos.co.kr
Insights
Ultrasonography (US)-guided fine-needle aspiration cytology (US-FNAC) with a single needle pass is adequate and effective for diagnosing thyroid nodules. This method demonstrated high accuracy and minimal complications, making it a reliable diagnostic tool.
Area of Science:
- Endocrinology
- Oncology
- Radiology
Background:
- Thyroid nodules are common, requiring accurate diagnostic methods.
- Fine-needle aspiration cytology (FNAC) is a primary diagnostic tool.
- Optimizing US-FNAC techniques is crucial for diagnostic yield.
Purpose of the Study:
- To evaluate the adequacy and efficacy of ultrasonography (US)-guided fine-needle aspiration cytology (US-FNAC) using a single-sampling technique for thyroid nodule diagnosis.
- To assess the diagnostic accuracy and complication rates associated with this US-FNAC approach.
Main Methods:
- Retrospective review of 1456 US-FNAC procedures on 977 patients from July 2007 to June 2009.
- Utilized various US-FNAC techniques, including "single-needle-pass" with one specimen per nodule.
- Correlated cytopathology results with surgical pathology for 396 patients.
Main Results:
- Adequate sampling was achieved in 88.5% of cases.
- High diagnostic performance metrics were observed: sensitivity 94.3%, specificity 91.9%, accuracy 93.6%.
- No significant complications were reported, with only mild pain in 8.9% of patients.
Conclusions:
- US-guided fine-needle aspiration cytology (US-FNAC) with a single-sampling technique is adequate and effective for the cytological diagnosis of thyroid nodules.
- The method demonstrates high diagnostic accuracy and a favorable safety profile.
- This approach offers a reliable and efficient option for thyroid nodule evaluation.
Abstract:
The aim of this study was to assess the adequacy and efficacy of ultrasonography (US)-guided fine-needle aspiration cytology (US-FNAC) with one-sampling technique (only one specimen through a single needle pass was obtained during the procedure on each thyroid nodule in each study patient) for the cytological diagnosis of thyroid nodules. In this study, US-FNAC techniques, including "free two-hand," "mixed sampling," "flipping-extraction," and "single-needle-pass" procedures were used to collect thyroid cells from July 2007 to June 2009. The cytopathology results and patients' complications were reviewed retrospectively. Of the 1456 thyroid-nodule samples obtained from 977 patients (1.49 per patient), the incidence of adequate and inadequate samplings was 88.5% (1289/1456) and 11.5% (167/1456), respectively. After thyroid surgery in 396 patients, 568 nodules were confirmed as 353 papillary thyroid carcinomas including one diffuse sclerosing variant, five follicular thyroid carcinomas, three medullary thyroid carcinomas, one anaplastic thyroid carcinoma, one metastatic renal cell carcinoma, two poorly differentiated carcinomas, 17 follicular adenomas, two nodular thyroiditis, two pseudonodules related to thyroiditis, and 182 cases of nodular hyperplasia. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, false-negative rate, and false-positive rate for the US-FNAC were 94.3%, 91.9%, 96.2%, 88.3%, 93.6%, 3.9%, and 2.6%, respectively. There were no significant patients' complications, but 87 patients (8.9%) reported mild pain during or after the procedure. This study showed a good adequacy and efficacy of US-FNAC for thyroid nodules despite one-sampling.
