False negative rate of fine-needle aspiration in thyroid nodules: impact of nodule size and ultrasound pattern

Head Neck. 2019 Apr;41(4):967-973. doi: 10.1002/hed.25530. Epub 2019 Feb 10.

Abstract

Background: To retrospectively evaluate the false negative rate of ultrasound-guided fine needle aspiration (FNA) according to the nodule size and ultrasound pattern.

Methods: We included 432 consecutive thyroid nodules from 384 patients who underwent ultrasound-guided FNA with benign results (≥1 cm). The false negative rate in the nodules was assessed according to the nodule size and ultrasound pattern based on the Korean-Thyroid Imaging Reporting and Data System (K-TIRADS).

Results: The overall false negative rate was 3.2%. There was a trend toward an increasing false negative rate as the K-TIRADS score increased (P < .001). In low or high suspicion nodules (K-TIRADS 3 and 5), there was no significant difference in false negative rate according to the nodule size; however, among the intermediate suspicion nodules (K-TIRADS 4), the false negative rate was higher in large nodules (≥3 cm, P = .039).

Conclusion: The impact of nodule size on the false negative rate differed according to the ultrasound pattern.

Keywords: false negative rate; fine needle aspiration; thyroid cancer; thyroid nodule; ultrasound.

MeSH terms

  • Adult
  • Biopsy, Fine-Needle
  • Cohort Studies
  • Databases, Factual
  • False Negative Reactions
  • Female
  • Humans
  • Image-Guided Biopsy / methods*
  • Male
  • Middle Aged
  • Republic of Korea
  • Retrospective Studies
  • Thyroid Neoplasms / diagnostic imaging*
  • Thyroid Neoplasms / pathology*
  • Thyroid Nodule / diagnostic imaging*
  • Thyroid Nodule / pathology*
  • Ultrasonography / methods