Ultrasonography: Its role in nodular thyroid disease

Indian J Otolaryngol Head Neck Surg. 2007 Dec;59(4):332-5. doi: 10.1007/s12070-007-0095-1. Epub 2007 Dec 11.

Abstract

Objective: The objective was to correlate the number, size and extent of the nodules as determined during the preoperative clinical examination of the thyroid gland, USG, intra-operative examination and histopathology. Also, FNAC (with or without USG guidance) and USG findings suggestive of malignancy were correlated with the final histopathology.

Setting: Tertiary referral centre

Patients: A retrospective chart review was done for 106 patients who underwent surgery for benign or malignant nodular thyroid disease in our center, between Jan 2004-Dec 2006.

Results: USG has 7 times higher predictive value than clinical examination in detecting number of nodules and determining size of nodules. USG guided FNAC has a sensitivity of 85.71% and specificity of 90.0% in detecting malignancy in nodular thyroid disease. However for predicting malignancy in thryoid nodules, this study shows that USG has a sensitivity of 20.0% and specificity of 97.67%.

Conclusion: In patients with nodular thyroid disease, USG can accurately determine the number and the size of the nodules. It is extremely useful in guiding FNAC; However its role in predicting malignancy is doubtful. We therefore recommend that USG guided FNAC be carried out as a routine in the evaluation of thyroid nodules.

Keywords: Guided FNAC; Nodular thyroid disease; Ultrasonography.