Aspiration Biopsy Of Thyroid Nodules Research Articles

Evaluation of ultrasound-guided fine-needle aspiration biopsy for thyroid nodules

background We retrospectively studied whether ultrasound-guided fine-needle aspiration biopsy (US-FNAB) showed improved sensitivity in patients with palpable thyroid nodules. methods: A total of 70 patients (72 lesions) with thyroid nodules underwent US-FNAB and 94 patients (94 lesions) underwent FNAB guided by manual palpation (standard FNAB). The diagnoses obtained by US-FNAB were compared with the surgical findings. results The sensitivity of US-FNAB for palpable thyroid nodules was 62% the specificity was 74% the accuracy was 68% the positive predictive value was 100%, the negative predictive value was 70% and the inadequate biopsy rate was 17%. In contrast, the sensitivity of standard FNAB was 45%, the specificity was 51%, the accuracy was 48% the positive predictive value was 96, the negative predictive value was 55, and the inadequate biopsy rate was 30%. The accuracy of US-FNAB was significantly higher than that of standard FNAB. For tumors ≤2 cm in diameter, the sensitivity and accuracy of USFNAB were both significantly higher than those of standard FNAB. conclusion These findings suggest that USFNAB can improve the preoperative diagnosis of thyroid cancer, especially in patients with tumors ≤2 cm in diameter.

Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules.

Fine-needle aspiration biopsy (FNAB) is an accurate, slightly invasive, and safe method for the preoperative diagnosis of thyroid nodules. Recently, ultrasound guidance has been suggested as a valuable aid to enhance FNAB diagnostic performance. In this study, we have compared diagnostic accuracy of conventional FNAB (C-FNAB) versus sonography-guided FNAB (SG-FNAB) on a large sample population of 9683 patients with thyroid nodules. Over a 15-year period, 4986 patients were investigated by C-FNAB and 4697 underwent SG-FNAB. A valid cytological diagnosis was obtained in 85.9% of C-FNAB and in 91.5% of SG-FNAB cases, allowing detection of thyroid cancer in 1.6% and 2.1% of patients, respectively. The indeterminate pattern of follicular neoplasia was observed in 238 C-FNAB (5%) and in 272 (5.4%) SG-FNAB nodules. Specimens were cytologically inadequate in 433 C-FNAB (8.7%), but only in 167 SG-FNAB cases (3.5%). A total of 535 C-FNAB and 540 SG-FNAB nodules underwent surgery. False-negative results occurred in 7 C-FNAB nodules (2.3%), but only in 3 SG-FNAB cases (1%). Sensitivity, specificity, and global diagnostic accuracy of C-FNAB compared with SG-FNAB were 91.8% versus 97.1%, 68.8% versus 70.9%, and 72.6% versus 75.9%, respectively. Our results, based on a large population of thyroid nodules, demonstrate that SG-FNAB allows a more precise and adequate sampling of thyroid nodular lesions and is associated with a lower rate of false-negatives, thus improving global diagnostic accuracy in the preoperative selection of thyroid cancer.

Fine-needle aspiration biopsy of thyroid nodules: impact on clinical practice.

The aim of the present study was to analyze the changes in our clinical practice due to the use of FNAB in the management of nodular thyroid disease. Patients attended the thyroid unit for thyroid nodules. The study comprises three periods: First, from January 1980 to May 1984, 226 patient. Second, from June 1985 to December 1990, 166 patients. Third, from January 1991 to December 1993, 403 patients. retrospective the 1st period and prospective the 2nd and 3rd periods. During the 1st and 2nd periods, decision for surgery was based on clinical parameters together with results of 99Tc radionucleotide scan and B mode ultrasound studies. In the 3rd period surgical decision was based principally on cytologic results. We comparatively studied the frequency of surgical operation and frequency of malignancy in surgical thyroid specimens between the study periods. Determination of sensitivity, specificity and accuracy of the diagnostic methods was done. We observed a decrease in the frequency of patients requiring surgery, 89.9%, 67.8% and 46.6% for the 1st, 2nd and 3rd study periods, X2 = 114.7, p < 0.0001; and an increase in the frequency of malignancy in the surgical specimens, 14.7%, 24.4% and 32.9% for 1st, 2nd and 3rd periods respectively, X2 = 4.5, p < 0.05. The sensitivity 92.5% and 93.5%, the specificity 50.6% and 61.1%, and the accuracy 60.9% and 71.8% of the FNAB for the second and third periods respectively. The rates of false negative cytological specimens were 1.8% and 2.1% for 2nd and 3rd respectively, p > 0.05. Since the introduction of FNAB in the evaluation of our patients around 70% of these had a definitive preoperative diagnosis of either benign or malignant disease. Simplification in management of patients with nodular thyroid disease is the most important impact for the use of FNAB. Furthermore, a decrease in the number of patients requiring surgical treatment and an increase of malignant nodules in the specimens obtained by surgery were also observed. We think that FNAB is the most direct and accurate method in the management of patients with thyroid nodules.

Efficacy of fine-needle aspiration biopsy of thyroid nodules: experience of a Mexican institution.

In most centers only selected patients with high risk thyroid nodules undergo thyroid surgery, and fine needle aspiration biopsy (FNA) is used to select patients for surgical treatment. The aim of the present study was to evaluate the impact of FNA on the management of thyroid nodules at our institution. A total of 872 patients who underwent FNA over a period of 7 years were retrospectively analyzed. There were 66 men and 806 women with a mean age of 40 +/- 15 years. Altogether 549 patients presented with a thyroid nodule and 323 with multinodular disease. The sensitivity and specificity of FNA were 90.0% and 99.8%, respectively. The positive and negative predictive values were 98% and 99%, respectively, and the accuracy was 99%. Our results are in agreement with those of other reports establishing that FNA of the thyroid is safe, reliable, and effective for differentiating benign from malignant nodules.

Fine Needle Aspiration and Frozen Section Diagnosis in the Management of Thyroid Nodules

Fine needle aspiration (FNA) is a valuable technique in the evaluation of thyroid nodules. A total of 182 FNAs of the thyroid performed at the Sultan Qaboos University Hospital were reevaluated and 153 were found to be adequate (84%). The cytological results of FNA were divided into neoplastic and non-neoplastic groups. Subsequent histology was obtained in 53 patients with an intraoperative frozen actions (FS) in 27 patients. Papillary carcinoma was found to be the most common, accounting for 70% of these cases with histological follow-up in the neoplastic group. The utility of performing FNA in all thyroid nodules and an intraoperative frozen section only in selected cases is discussed.

Fine-Needle Aspiration Biopsy of Thyroid Nodules: Advantages, Limitations, and Effect

The efficacy of fine-needle aspiration (FNA) biopsy and its role in the management of a nodular goiter are clearly established. The accuracy of cytologic diagnosis approaches 95%. FNA biopsy is a reasonable approach to thyroid nodules; it has decreased costs substantially because it facilitates selection of patients who need to undergo surgical excision. Selecting patients for operation on the basis of results of FNA biopsy has more than doubled the yield of carcinoma. The limitations of cytologic examination, nondiagnostic results, and cellular follicular neoplasms should be remembered but need not negate continued use of FNA biopsy. Negative (benign) and positive (malignant) cytologic results are conclusive; careful clinical follow-up of benign nodules and surgical excision of malignant nodules are recommended. Nondiagnostic results are inconclusive; further evaluation by repeated FNA biopsy, ultrasound-guided biopsy, or radionuclide scanning is necessary. Suspicious cytologic results are also inconclusive and are associated with a 20% chance of malignant involvement; surgical treatment is necessary for clarification. The role of levothyroxine therapy remains uncertain and is not recommended until compelling data are available. FNA biopsy is a safe, simple, reliable, and cost-effective means of detecting benign nodules. FNA biopsy, not thyroid scanning or ultrasonography, is the preferred initial diagnostic test in all patients with thyroid nodules.

Fine Needle Aspiration Biopsies (FNAB) in the Preoperative Diagnosis of Thyroid Nodules

Fine Needle Aspiration Biopsies (FNAB) in the Preoperative Diagnosis of Thyroid Nodules

A Preliminary Report of Thyroglobulin Release after Fine Needle Aspiration Biopsy of Thyroid Nodules

To demonstrate whether or not fine needle aspiration biopsy caused release of thyroglobulin into the circulation and if there was a correlation between histological diagnosis and thyroglobulin release from thyroid during aspiration, serum thyroglobulin concentrations were determined in 12 patients with solitary cold nodule or multinodular goitre. Of the 12 patients studied, seven had significant (P less than 0.05) elevations of serum thyroglobulin after aspiration. It is suggested that circulating thyroglobulin may increase after minor trauma to thyroid tissue such as following fine needle aspiration.

Aspiration Biopsy of Thyroid Nodules: A Review of Experience at King Faisal Specialist Hospital

ABSTRACT A series of 137 aspiration biopsies of thyroid nodules were reviewed. In 110 biopsies adequate material was obtained and the diagnosis rendered included papillary carcinoma 31; follicular ...

Fine-needle aspiration biopsy of the thyroid. Superior diagnostic tool.

Fine-needle aspiration biopsy of thyroid nodules is an easily performed office procedure that has the highest sensitivity and specificity and the lowest cost of all evaluation methods. Interpretation requires an experienced cytologist or endocrinologist, or both. Patient acceptance has been high. With use of fine-needle aspiration biopsy, many unnecessary operations have been avoided.

Diagnostic Accuracy and Use of Aspiration Biopsy in the Management of Thyroid Nodules

The diagnostic accuracy of fine-needle aspiration biopsy of thyroid nodules was assessed in 111 patients who underwent thyroidectomy and in three persons whose thyroid glands were examined at autopsy. The basis for not performing surgery in 107 patients studied during the same period is also discussed. Carcinoma (excluding incidental occult carcinoma) was found in 76% of the nodules with malignant cytologic findings (class 5, 10/10; and class 4, 3/7), 20% (3/15) of the nodules with suspicious cytologic findings (class 3), and 9% (8/87) of the nodules with benign cytologic findings (classes 1 and 2). The major reasons for avoiding surgery included resolution of the nodule after aspirating a cyst (eight cases) or after hemorrhage (two cases), multinodular goiter (13 cases), functioning nodule (ten cases), lymphocytic thyroiditis (nine cases), high operative risk without suspicious cytologic findings (15 cases), and response to suppression therapy (27 cases). Among 186 patients given thyroxine suppression therapy, 10% of the nodules disappeared and 12% decreased to less than 1 cm in diameter or more than 50% in volume. Aspiration biopsy is useful to select patients for early surgery or for long-term medical management. Its lack of precision, however, requires that it be employed as an adjunct to other clinical considerations.

Fine-needle aspiration biopsy of thyroid nodules: impact on thyroid practice and cost of care: Hamberger B, Gharib H, Melton LJ III, Goellner JR, Zinsmeister AR: Am J Med 1982; 73: 381–384

Fine-needle aspiration biopsy of thyroid nodules: impact on thyroid practice and cost of care: Hamberger B, Gharib H, Melton LJ III, Goellner JR, Zinsmeister AR: Am J Med 1982; 73: 381–384

Fine-needle aspiration biopsy of thyroid nodules: Impact on thyroid practice and cost of care

We studied the impact of fine-needle aspiration biopsy on the management of patients with solitary thyroid nodules. Sixty-four patients were examined before the introduction of fine-needle aspiration biopsy, and 147 patients were examined after its introduction. The percentage of patients who underwent thyroid operation decreased from 67 percent to 43 percent, while the yield of carcinoma increased from 14 percent to 29 percent. Cost of medical care per patient declined by 25 percent. The results suggest that fineneedle aspiration biopsy provides valuable information to assist in the selection for surgery of patients with solitary nodules. Fineneedle aspiration appears to be safe, reliable, and cost-effective. The merits of the technique commend it for routine use in the evaluation of thyroid nodules.

Management of thyroid disease with particular reference to thyroid nodules

A host of expensive thyroid tests and operations could be avoided if aspiration biopsy of thyroid nodules were more widely accepted by American physicians. The procedure is both an accurate diagnostic tool and an effective treatment of many thyroid nodules.