Diagnostic adequacy of surgeon-performed ultrasound-guided fine needle aspiration biopsy of thyroid nodules

J Surg Oncol. 2013 Feb;107(2):206-10. doi: 10.1002/jso.23212. Epub 2012 Jul 5.

Abstract

Background: Surgeon-performed ultrasonography (US) of thyroid nodules might serve as a potential therapeutic guide to designate accurate surgical or clinical intervention.

Objective: To evaluate the diagnostic adequacy of surgeon-performed ultrasonography guided fine needle aspiration biopsy (FNAB) of thyroid nodules, the factors responsible for diagnostic adequacy and the impact of surgeon-performed US on treatment approach.

Methods: Retrospective review of a single surgeon performed 621 US-guided FNABs without on-site cytological specimen assessment. Outside US findings were compared to the surgeon-performed US. Measured variables and outcomes for the study included diagnostic adequacy rates and the effects of detected differences between US reports on treatment variability.

Results: Diagnostic adequacy rate of surgeon-performed US-guided FNAB was determined to be 94.52% without on-site specimen evaluation by cytologist. Non-diagnostic specimens occurred in 34 of 621 (5.48%) nodules. The differences detected between the outside US and surgeon-performed US altered invasive treatment algorithm in 30 (5.47%) patients. FNAB was avoided for 15 (2.7%) patients. Total thyroidectomy became the preferred surgical option in 15 (2.7%) patients after the discovery of additional nodules in the contralateral lobe.

Conclusion: Surgeon-performed US offers clear clinical benefits in terms of diagnostic yield of FNAB with providing valuable additional data that might alter surgical treatment approach.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Algorithms
  • Biopsy, Fine-Needle
  • Decision Support Techniques
  • Female
  • Follow-Up Studies
  • Humans
  • Image-Guided Biopsy
  • Male
  • Middle Aged
  • Preoperative Care / methods*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Thyroid Gland / diagnostic imaging
  • Thyroid Gland / pathology*
  • Thyroid Gland / surgery
  • Thyroid Nodule / diagnostic imaging
  • Thyroid Nodule / pathology*
  • Thyroid Nodule / surgery
  • Thyroidectomy*
  • Ultrasonography, Doppler, Color
  • Ultrasonography, Interventional