Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules Smaller Than 5 mm in the Maximum Diameter: Assessment of Efficacy and Pathological Findings.
10.3348/kjr.2009.10.5.435
- Author:
Dong Wook KIM
1
;
Auh Whan PARK
;
Eun Joo LEE
;
Hye Jung CHOO
;
Sang Hyo KIM
;
Sang Hyub LEE
;
Jae Wook EOM
Author Information
1. Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 614-735, Korea. dwultra@lycos.co.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Thyroid, nodule;
Fine-needle biopsies;
Ultrasound (US);
Microcarcinoma
- MeSH:
Adolescent;
Adult;
Aged;
*Biopsy, Fine-Needle;
Diagnosis, Differential;
Female;
Humans;
Male;
Middle Aged;
Retrospective Studies;
Sensitivity and Specificity;
Thyroid Neoplasms/*pathology/ultrasonography;
Thyroid Nodule/*pathology/ultrasonography;
*Ultrasonography, Interventional
- From:Korean Journal of Radiology
2009;10(5):435-440
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The aim of this study was to determine the efficacy of the use of an ultrasound-guided fine-needle aspiration biopsy (US-FNAB) to diagnose thyroid nodules smaller than 5 mm in the maximum diameter and to evaluate pathological findings of small thyroid malignancies. MATERIALS AND METHODS: From May 2007 to April 2008, we evaluated the findings of US-FNABs of small thyroid nodules less than 5 mm in the maximum diameter. The cytopathological findings were retrospectively reviewed and the diagnostic performance of the use of an US-FNAB was examined in all patients. RESULTS: Of 201 small thyroid nodules in 180 patients, there were 162 adequate specimens (81%). Among 180 patients, 75 patients underwent thyroid surgery and 50 malignant and 33 benign nodules were identified based on a pathological examination. All small malignant thyroid nodules were identified as papillary thyroid microcarcinomas (PTMCs). There were 34 (55%) true positive, 0 (0%) false positive, 23 (37%) true negative and five (8%) false negative results for malignancy after performing a first US-FNAB in 62 surgically confirmed nodules. The sensitivity (87%), specificity (100%), positive predictive value (100%), negative predictive value (82%), accuracy (92%), false positive rate (0%) and false negative rate (8%) for an US-FNAB were determined. In 23 patients with a primary PTMC, capsular invasion (9%, 2 of 23), a perithyroidal lymph node metastasis (30%, 7 of 23), the rate of multifocality (9%, 2 of 23) and bilaterality (4%, 1 of 23) were also determined. CONCLUSION: An US-FNAB of thyroid nodules smaller than 5 mm in the maximum diameter is an effective diagnostic procedure.
