BackgroundThe widespread use of high-resolution ultrasonography (US) imaging has led to an increased detection of thyroid nodules, which are common in the general population.PurposeTo evaluate the correlation between ultrasonographic and pathological findings of thyroid nodules undergoing US-guided fine-needle aspiration (FNA) and assess the contribution of US features to malignancy prediction.Material and MethodsA total of 573 patients (137 men, 436 women; age range = 20-88 years) who underwent US-guided FNA were included. Nodule characteristics were recorded using the British Thyroid Association (BTA) U classification, and cytological results were assessed according to the Bethesda system. Logistic regression analysis (LRA) was performed to determine the relationship between US features and malignancy.ResultsThe distribution of nodules in U2, U3, U4, and U5 categories was 212, 171, 84, and 36, respectively, with corresponding Bethesda (2-6) classifications of 287, 159, 18, 27, and 12. Malignancy rates (Bethesda 4-6) were 0%, 10%, 28.6%, and 44.5%, respectively. Hypoechogenicity (relative to muscle), internal vascularization, and microcalcifications were significantly associated with malignancy (P <0.05). LRA achieved an 85.5% accuracy in malignancy prediction.ConclusionUS features in the BTA U classification align with pathological findings. Hypoechoic solid nodules, central vascularization, and microcalcifications should raise suspicion for malignancy in the differential diagnosis of thyroid nodules. These study findings highlight the strong association between vascularity in the BTA classification and malignancy, suggesting its potential role in risk stratification.

It has been demonstrated that needle guidance systems can enhance the precision and safety of ultrasound-guided punctures in human medicine. Systems that permit the utilization of commercially available standard needles, instead of those that necessitate the acquisition of costly, proprietary needles, are of particular interest. The objective of this phantom study is to evaluate the reliability and accuracy of magnet-based ultrasound needle guidance systems, which superimpose the position of the needle tip and a predictive trajectory line on the live ultrasound image. We conducted fine-needle aspiration cytology of thyroid nodules. The needles utilized in these procedures are of a slender gauge (21-27G), with lengths ranging from 40 to 80 mm. A dedicated training workstation with integrated software-based analyses of the movement of the needle tip was utilized in 240 standardized phantom punctures (angle: 45°; target depth: 20 mm). No system failures occurred, and the target achieved its aim in all cases. The analysis of the software revealed stable procedural parameters with minor relative deviations from the predefined reference values regarding the distance of needle tip movement (-4.2% to +6.7%), needle tilt (-6.4% to +9.6%), and penetration depth (-7.5% to +4.5%). These deviations appeared to increase with the use of thin needles and, to a lesser extent, long needles. They are attributed to the slight bending of the needle inside the (phantom) tissue. The training workstation we employed is thus suitable for use in educational settings. Nevertheless, in intricate clinical puncture scenarios-for instance, in the case of unfavorable localized small lesions near critical anatomical structures, particularly those involving thin needles-caution is advised, and the system should not be relied upon exclusively.

Abstract Background Diagnosis of thyroid cancer is based on fine needle aspiration cytology of thyroid nodules, based on nodules’ sonographic appearance and size. The American Thyroid Association published new guidelines for management of thyroid nodules in 2009 and 2015, where in some cases, only follow-up of thyroid nodules without any other procedure is recommended. This may lead to a decrease in diagnosed thyroid cancer cases. We studied thyroid cancer trends in Israel between the Arab population who are more likely to be living in rural areas, and the Jewish population who predominantly living in urban areas, and assesses whether these guidelines were reflected in the trends. Methods Data on new thyroid cancer cases were retrieved for Jews and Arabs separately from the Israel National Cancer Registry. Trends in age standardized incidence rates between 1996-2019 were evaluated for the two population groups using joinpoint regression model. Population group was included in the regression models to compare the trends between the two groups. We also studied trends in treatment of thyroid cancer at Rambam Health Care Campus. Results In both populations, age standardized thyroid cancer incidence rate increased between 1996 and 2013. However, between 2013-2019, Annual Percentage Change continuously increased in Arabs, but decreased in Jews. In the hospital study, we found that the Arab patients were 30% more likely to have surgery for small tumors. Conclusions The decrease in thyroid cancer incidence in the Jewish population compared with the Arab population may be related to differences in implementing the 2009 guidelines, which do not recommend fine needle aspiration cytology for very small tumors. We have found evidence that these guidelines were not followed to the same extent among Arab community clinics. This may explain the persisting increasing trend among Arabs, and could be one of the possible explanations for the differences in trends between the two groups. Key messages • Updated Guidelines regarding thyroid cancer diagnosis may be differently implemented by rural and urban populations. • Trends assessment may be biased due to differences in guidelines implementation.

Abstract Background Thyroid nodules are frequent among the general population. Ultrasound is the most commonly used imaging technique in the evaluation of thyroid nodules, Fine needle cytology (FNC) has been routinely used as the baseline investigation for diagnosis of nodular thyroid disease. Its advantages include minimal invasion and high sensitivity, specificity, and accuracy. Objective Our aim is to compare the sample adequacy of FNA sample obtained by 21 gauge needle versus 25 gauge needle, aiming to improve the overall quality of FNC and hence better evaluation of thyroid nodules avoiding repeating FNC and unnecessary thyroidectomies. Patients and Methods Our study was conducted on 22 adult patients with thyroid nodules, whose ages range between 17 and 68 years old and were referred to undergo FNA procedures. Results 22 patients with thyroid nodules were included in this study, the mean of Mayers score was 4.23 ± 2.18 and ranged from 1 to 8, while most of patients were adequate by (72.73%). Regarding the difference between two groups in Mayers score &amp; adequacy, there was no statistically significant difference between the two groups in Mayers score nor adequacy (as P-value &amp;gt;0.05). Conclusion In conclusion concerning the diagnostic accuracy either 21- or 25-gauge needles can be used. We recommend using 21 gauge needles for markedly calcified nodules, because 25-gauge needles bend more easily in such cases.

Introduction: Medullary thyroid carcinoma (MTC) is a rare type of thyroid cancer and the main treatment is surgery. The extent of surgery depends on the spread of tumour and often involves thyroidectomy and neck dissection. Recurrent or metastasis tumour can be detected with raising calcitoninand there are various options of treatment. Methods: This was a retrospective study of MTC over seven years in a tertiary cancer centre which evaluated the treatment outcome and the non-surgical options available in recurrent and metastatic tumours. Results: Among the 601 thyroid cancers, 34 patients (5.3%) were MTC, of which 29 were studied. Majority were women, below 60 years, were diagnosed with fine needle aspiration cytology of thyroid nodule or nodes and had raised calcitonin value (Ctn). The value of Ctn was correlated with tumour burden rather than extent (p=0.7). Recurrence was seen in 35% and all patients with locoregional recurrence had curative surgery whereas metastatic patients were offered palliative treatment. Acceptance of palliative treatment was less due to financial burden. The five year overall survival for nonmetastatic disease was 89.4 % and for patients with metastatic disease at presentation was 54.7 %. Conclusion: The incidence of medullary thyroid carcinoma is low compared to the differentiated thyroid carcinoma. The main treatment is surgery and other treatment options are limited.

Factors for second non-diagnostic ultrasound-guided fine-needle aspiration cytology in thyroid nodules

Objectives: To assess the diagnostic effi cacy of fi ne needle aspiration cytology (FNAC) in identifying cancer in isolated thyroid nodules using nodule histology as the gold standard. Materials and Methods: Between January 2021 and September 2022, 145 individuals who were hospitalized to ENT department, Khyber Teaching Hospital in Peshawar, Pakistan, with a single thyroid nodule and underwent surgery for histopathology and whose needle aspiration cytology of thyroid nodules was done were included in the research. We looked at the FNAC reports as well as the histopathology results.Results: For diagnosing cancer in a single thyroid nodule FNAC had sensitivity of 81%, specifi city of 73.56%, PPV of 67.14% and NPV of 85.33%.Conclusion: The FNAC test is a good test to screen for cancer in solitary thyroid nodules.

BackgroundTo investigate the relationship between cyclin D2 (CCND2) and miR-206 expression in fine-needle aspiration cytology of thyroid carcinoma.MethodsA total of 65 patients with thyroid carcinoma were selected as the subjects and 65 patients with benign thyroid nodules were in control group. The fine-needle aspiration cytology of thyroid nodules was performed. CCND2 and miR-206 levels were detected by PCR.ResultsCompared with the patients with benign thyroid nodules, the expression level of miR-206 in fine-needle aspiration cytology of thyroid cancer patients decreased significantly and the expression level of CCND2 increased significantly. CCND2 and miR-206 expression was negatively correlated in thyroid cancer tissues. Area under curve (AUC) of miR-206 level in the diagnosis of thyroid cancer was 0.889, and the sensitivity and specificity were 92.3% and 81.5%, respectively. AUC of CCND2 level in the diagnosis of thyroid cancer was 0.837, and the sensitivity and specificity were 67.7% and 89.2%, respectively. The AUC of combined detection of CCND2 and miR-206 in the diagnosis of thyroid cancer was 0.959, and the sensitivity and specificity were 93.8% and 87.7%, respectively. The levels of miR-206 and CCND2 were significantly correlated with TNM staging and lymph node metastasis.ConclusionsmiR-206 and CCND2 may become new biomarkers for clinical diagnosis of thyroid cancer based on the fine-needle aspiration cytology of thyroid nodules.

Diagnostic Accuracy of Fine-Needle Aspiration Cytology of Thyroid Nodules and Seven Years of Experience

IntroductionPatients presenting with a thyroid nodule, if malignant, may call for removal. A good screening tool with high diagnostic value for preoperative evaluation is preferred. Through real-time visualization of the needle to aspirate from the suspicious site, ultrasonography-guided fine-needle aspiration cytology could be an excellent screening tool.Materials and methodA cross-sectional descriptive study was conducted at Ganesh Man Singh Memorial Academy of Ear Nose Throat–Head and Neck Studies, Kathmandu, Nepal, from September 2018 to November 2019. We included 59 subjects of 15–72 years meeting the inclusion criteria. All study participants underwent preoperative ultrasonography-guided fine-needle aspiration cytological evaluation of thyroid nodule, which was correlated with their histopathological findings to determine diagnostic values.ResultThe sensitivity, specificity, and accuracy of ultrasonography-guided fine-needle aspiration cytology of thyroid nodule was 96.96%, 61.53%, and 81.35%, respectively. On stratification according to size, high sensitivity of 100% was observed in evaluating lesions of size < 2 cm and > 4 cm. There was a good inter-rater agreement between findings of ultrasonography-guided fine-needle aspiration cytology and histopathology with a kappa coefficient of 0.607.ConclusionUltrasonography-guided fine needle aspiration cytology is a reliable procedure to evaluate thyroid lesions with high diagnostic value. It is an excellent tool for evaluating small, non-palpable nodules.

BACKGROUND: Fine needle aspiration cytology (FNAC) of the thyroid has been a reliable and cost-effective method for diagnosing thyroid disorders. Since FNAC results are usually operator dependent, there is a compelling need to explore FNAC accuracy among Omanis.OBJECTIVE: Describe cytological features of FNAC and assess FNAC accuracy compared to the postsurgical histopathology report.DESIGN: Retrospective diagnostic accuracy studySETTING: Tertiary care center.PATIENTS AND METHODS: Our study included adult Omani adult patients with thyroid nodules who underwent FNAC from 2014 to 2017 and had final pathology results for patients who underwent thyroid surgery. The results were classified according to the UK Royal college of Pathologists ‘Thy’ categories. Accuracy of FNAC was calculated by determining false and true positive and negative results based on histopathology findings.MAIN OUTCOME MEASURES: FNAC accuracy (sensitivity and specificity) compared to the postsurgical histopathology.SAMPLE SIZE: 867 patients with 1359 ultrasound guided FNACs of thyroid nodule; 137 underwent surgery.RESULTS: The mean age of the 867 patients was 43.7 (13.3) years, with a median of 42 years, and 87.8% were females. Out of 1359 FNACs, 1001 (73.7%) were benign (Thy2), 119 (8.8%) were atypia of undetermined significance or follicular lesion of undetermined significance (Thy3a), 31 (2.3%) were follicular neoplasm or suspicious for a follicular neoplasm (Thy3f), 52 (3.8%) were suspicious for malignancy (Thy4), 55 (4%) were malignant (Thy5), 101 (7.4%) as Unsatisfactory (Thy1). Only 137 patients underwent thyroid surgery, and the FNAC reports were compared with their final histopathology reports. The sensitivity, specificity and total accuracy of FNAC were 80.2%, 98.9% and 89.9%, respectively. The positive and negative predictive values of FNAC were 98.6% and 84.3%, respectively.CONCLUSION: Our study findings confirmed that FNAC of the thyroid is a sensitive, specific, and accurate initial tool for the diagnosis of thyroid lesions. Most of the FNACs were benign with a very low malignancy rate. Due to the minimal chance of false negative results and the slow-growing nature of thyroid malignancy, it is important that patients with benign FNAC should have periodic clinical and radiological follow-up.LIMITATIONS: Retrospective design and single-center study, and thyroid nodule size unavailable.CONFLICT OF INTEREST: None.

Background: Fine needle aspiration (FNA) cytology is a key investigation of thyroid nodules. There are several reports of FNA accuracy, which ranges from 75.0% to 94.8%, while false negative rates are 5.8% to 21.5%. In Thailand, there is no available data of FNA accuracy according to the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The present study reported single-institute data of FNA accuracy, that could be used in thyroid nodule management. Objective: To determine the diagnostic accuracy of FNA cytology results of thyroid nodules collected in Thammasat University (TU) Hospital. Materials and Methods: The present study was a retrospective study collected cytologic results of all thyroid nodules that subsequently had definitive histopathologic diagnoses. The data were gathered from clinics at TU Hospital that performed thyroid nodule FNA between May 2011 and November 2014. The FNA cytology results were classified according to TBSRTC. Each cytopathologic result was compared with its postoperative tissue histopathology. The malignancy rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Results: The present study included 197 thyroid nodule FNA cytology results. The sensitivity and specificity were 77.8% and 65.4%, respectively. The calculated PPV was found to be 47.7%, and the NPV was 87.9%. The accuracy of these results was 69.0%. The malignancy rate of the unsatisfactory group was 6.25%, benign group 8.05%, atypia of undetermined significance or follicular lesion of unknown significance 22.22%, follicular neoplasm/suspicious for follicular neoplasm 14.20%, suspicious for malignancy 73.68%, and malignant 100%. Conclusion: The FNA cytology in TU Hospital has comparable sensitivity to the other studies. Interestingly, the malignancy rate in the follicular neoplasm category is lower than that of the other institutes because of a high false positive rate in this category. This causes lower specificity and accuracy, which may cause a higher rate of unnecessary operations. Keywords: FNA; Thyroid nodule; Diagnostic accuracy

Objective:To explore the diagnostic efficacy of ultrasound-guided fine needle aspiration cytology（US-FNAC） for thyroid nodules ≥1 cm, and the effect of Hashimoto's thyroiditis（HT） on it. Methods:The clinical data of 1027 cases of thyroid nodules ≥ 1 cm were retrospectively analyzed. Two-dimensional ultrasound, US-FNAC and BRAFV600E gene testing were performed. The postoperative pathological results were used as the criterion. The two dimensional ultrasound examination, clinical characteristics, follow-up results, and BRAFV600E were used to diagnosis for unoperated patients. The diagnostic efficiency of US-FNAC in HT（+） group and HT（-） group was compared, and the factors affecting the diagnostic efficiency were analyzed. Results:Of the 1027 nodules, the cytological results were nondiagnostic/unsatisfactory in 73 nodules（7.1%）, benign in 282（27.5%）, atypia of undetermined significance/follicular lesion of undetermined significance in 230（22.4%）, follicular neoplasm/suspicious for a follicular neoplasm in 20（1.9%）, suspicious for malignancy in 120（11.7%）, and malignant in 302（29.4%）. 515 cases underwent surgery. Among them, 495 were malignant and 20 were benign. 512 cases continued to be followed up without surgery, and the BRAFV600E of them were wild type. Combined with the two dimensional ultrasound examination, clinical features, and follow-up results, they were judged to be benign. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false positive rate and the false negative rate the of US-FNAC were 98.7%, 98.4%, 99.3%, 99.5%, 97.5%, 0.7% and 1.6%, respectively. The accuracy, sensitivity and negative predictive value of the HT（+） group were 95.5%, 95.4% and 82.8%, respectively, which were lower than that of HT（-） group （99.5%, 99.4%, 99.2% ）（P=0.001, 0.018, P<0.001）. The false negative rate of the HT（+） group was 4.6%, higher than 0.6% of the HT（-） group（P=0.018）, and HT was an risk factor for increased FNR（OR=7.596, 95%CI: 1.452-39.740）. Conclusion:US-FNAC is an effective method for the diagnosis of thyroid nodules and it has high sensitivity and specificity in ≥ 1 cm nodules. However, the combination of HT reduces the diagnostic accuracy and HT is a risk factor for increased false negative rate.

Indeterminate cytological result at fine-needle aspiration cytology (FNAC) remains a clinical challenge for endocrinologists. Aim of the present study was to evaluate whether a coexistent chronic autoimmune thyroiditis (CAT) might affect the diagnostic accuracy of fine-needle aspiration cytology for thyroid nodules. A retrospective cohort study was designed including all nodules receiving an indeterminate cytology result (TIR3A or TIR3B) undergoing thyroid surgery and subsequent histological confirmation. Patients were stratified into two groups according to the presence or absence of CAT. The hypothesis to be tested was whether follicular cell alterations induced by CAT might increase the rate of indeterminate cytological results in histologically benign thyroid nodules. Additional control groups were represented by nodules with determinate cytology, either benign (TIR 2) or malignant (TIR5). One hundred and eighty-nine indeterminate thyroid nodules were included (67 TIR3A and 122 TIR3B). At post-surgical histology, 46 nodules (24.3%) were malignant. No significant differences were observed in the rate of histologically proven malignancy between patients without CAT and patients with CAT in the TIR3B (29.4% vs 32.4%; P = 0.843) nor TIR3A (13.0% vs 11.4%; P = 1.000) nodules. The rate of coexistent CAT was similar between TIR3B and TIR5 nodules harboring PTC at histology (30.4% vs 39.4%, P = 0.491) and between indeterminate nodules and a control group of TIR2 nodules (39.2% vs 37.0%; P = 0.720). The similar rates of histologically proven malignancy found in cytologically indeterminate nodules in the presence or absence of concomitant CAT would not support that CAT itself affects the diagnostic accuracy of fine-needle aspiration cytology.

Introduction: Thyroid nodules are one of the common surgical presentations in Africa and are of great concern because of their potential to be malignant. Zambia is not excluded from these common surgical conditions. However, there are no preoperative cellular or intra-operative tissue diagnoses of the thyroid nodules done before thyroidectomy making it challenging to plan optimal and definitive management. Fine needle aspiration cytology (FNAC) is known to play a pivotal role in the screening and managing thyroid swellings. This study assesses the diagnostic accuracy of FNAC on thyroid nodules in patients at two tertiary hospitals in Zambia to establish a basis of introducing its use in the management of thyroid nodules at the institutions. Objectives: To evaluate the accuracy of FNAC, as compared to histopathology, in the diagnosis of thyroid nodules at University Teaching Hospital (UTH) and Ndola Central Hospital (NCH) in Zambia. Methods: This was a prospective cross-sectional study conducted in UTH and NCH surgery department from June 2014 to March 2015. Seventy-three patients, who presented with palpable thyroid nodules and underwent thyroidectomy, were enrolled in the study. The FNAC diagnosis of the patients was compared to the histopathology finding following thyroidectomy. Results: Females made up the majority of the patients (n=67, 91.8%). The ages of the patients ranged from 18 to 78 years. The mean age was 44.3 years, and the peak age of incidence was in the fourth decade. All patients were clinically euthyroid at the time of enrolment. The FNAC findings included 23 cases reported as unsatisfactory (31.5%); 29 cases benign (39.7%); 2 cases atypical (2.7%); 6 cases suspicious (8.2%); and 13 cases malignant (17.8%).Histopathology findings were available from all 73 tissue samples of participants, of which 55 (75.3%) and 18 (24.7%) were reported as benign and malignant respectively. Of the 18 malignant cases identified by histology, the most common cancer was follicular carcinoma (n=9, 50%), followed by papillary carcinoma (n=6, 33.3%) and undifferentiated carcinoma (n=3, 16.7%). In this study, FNAC had sensitivity, specificity, negative and positive predictive values, and accuracy of 83.33%, 89.09%, 94.23 and 71.42%, and 87.67% respectively. Conclusion: In this study, FNAC of thyroid nodules had a high sensitivity, specificity, predictive values and accuracy, and can therefore be recommended to be adopted as a preoperative tool for screening of thyroid nodules.

Introduction: Fine-needle aspiration (FNA) cytology biopsy of the thyroid gland is an accurate and useful diagnostic tool in the initial evaluation of nodular thyroid lesions. We aimed in this study to determine the cytomorphological patterns of thyroid lesions diagnosed by FNA among Sudanese patients. Methods: A descriptive retrospective, clinic-based study was performed. Cytopathological records of patients that attended the Total Lab Care Clinic in Khartoum-Sudan between January 2016 and December 2017 were reviewed. Results: A total of 1646 patients records were reviewed; 1385 (84.1%) were females and 261 (15.9%) males. A total of 1563 (94.9%) were negative for malignancy, 39 (2.4%) were positive for malignancy, 42 (2.6%) were indeterminate for malignancy and 2 (0.1%) were non-diagnostic. Colloid goiter was seen in 1147 patients (73.4%), benign hemorrhagic cysts were seen in 257, Hashimoto thyroiditis was seen in 77, benign thyroid nodules were seen in 76, keratocysts were seen in 2, thyroglossal duct cysts were seen in 2, thyroid follicular adenoma was seen in 1 and myxedema was seen in 1. For malignant patients; 11 had anaplastic thyroid cancer, 8 had papillary thyroid cancer, 7 had follicular thyroid cancer, 5 had metastatic thyroid cancer, 4 had medullary thyroid cancer, 3 had non-Hodgkin lymphoma and 1 had thyroid follicular adenoma. For those indeterminate for malignancy, 24 had follicular neoplasm and 18 had Hurthle cell neoplasm. Conclusions: Fine needle aspiration cytology for thyroid nodules provides a rapid and non-invasive technique for the evaluation and differentiation between benign and malignant lesions. This study also addresses the increased predominance of benign thyroid lesions among young patients and thyroid malignancy among the 4th decade of life.

Introduction: Thyroid nodules are a common clinical finding which is important due to their malignant potential. Fine-needle aspiration cytology (FNAC) is routinely used for first-line diagnosis of thyroid lesions and to differentiate benign from malignant nodules. Objective: The objective was to evaluate the advantage of FNAC as a simple procedure for the diagnosis of thyroid swelling. Materials and Methods: This is a retrospective study conducted at the department of pathology of a tertiary care hospital among 681 diagnosed patients of thyroid swelling who underwent FNAC. The results were interpreted according to the Bethesda nomenclature. Results: The most common age group affected was 20–29 years (29.22%), female patients were 90.46% and that of males were 09.54%, benign cases constituted 91.63%, follicular lesion of undetermined significance were 00.33%, follicular neoplasm were 02.93%, suspicious cases were 00.44%, malignant cases were 4.40%, and unsatisfactory were 00.33%). Among benign group, 45.03% of cases were of colloid goiter and 23.72% were of Hashimoto's thyroiditis. The malignant diagnoses yielded 83.33% of papillary carcinoma, 10% of medullary carcinoma, and 3.33% of anaplastic carcinoma. Conclusion: FNAC is a rapid and cost-effective screening test for accurate diagnosis of thyroid swellings.

BackgroundThis study aimed to assess the utility and characteristics of preoperative ultrasonography (US) in patients transferred to referral hospitals from local clinics with a diagnosis of malignancy on US-guided fine-needle aspiration cytology of thyroid nodules.Material/MethodsFrom January 2018 to June 2018, 109 transferred patients underwent preoperative US in our hospital for suspected thyroid malignancy on cytological analysis after US-guided fine-needle aspiration of thyroid nodules in local clinics. Preoperative US was performed by a single radiologist in all patients. Among them, 6 were excluded from the study because of refusal of thyroid surgery. Preoperative US and histopathological results were compared in all patients.ResultsAfter thyroid surgery, pathological examination revealed papillary thyroid carcinoma (PTC) (n=98), follicular adenoma (n=1), and nodular hyperplasia (n=4). Of the 103 patients, 91 exhibited suspicious US findings on the preoperative US, whereas 12 did not. In the 91 patients with suspicious US findings, PTC (n=90) and follicular adenoma (n=1) were confirmed after thyroid surgery. In the 12 patients with no suspicious US findings, PTC (n=8) and nodular hyperplasia (n=4) were confirmed after thyroid surgery. On repeat analysis of the cytological slides of the 4 nodular hyperplasia cases from the local clinics, Bethesda category II (n=1) and III (n=3) were determined.ConclusionsIn the transferred patients with a malignant cytology, preoperative US might be helpful to detect false-positive cytology cases.

Background Routine application of fine needle aspiration cytology (FNAC) has decreased unnecessary referral of thyroid nodules for surgical treatment and has also increased the cancer rates found in surgery materials. Success of thyroid FNAC depends on skilled aspiration, skilled cytological interpretation and rational analysis of cytological and clinical data. The aim of this study was to determine the diagnostic accuracy rates of thyroid FNAC results obtained in our institution. Methods The data from FNAC and thyroidectomy reports of patients presenting with goiter and who had been evaluated from 1st January 2014 to 1st March 2018 were used. There were 149 patients in total who had undergone thyroidectomy following FNAC. The Bethesda System for Reporting Thyroid Cytology was used in all cytological diagnoses. Results The sensitivity of thyroid FNAC for malignant cases was 57.89%, specificity was 88.10%, false-positive rate was 11.90%, false-negative rate was 42.11%, positive predictive value was 52.38%, negative predictive value was 90.24% and accuracy rate was 82.52%. "Focus number" variable was detected as the factor that affected the accurate prediction of FNAC and thyroidectomy results by the pathologist. Conclusions This study showed that there was a moderate conformity between thyroid FNAC and thyroidectomy cyto-histopathological diagnosis in malignant cases. As two or more nodules have a negative effect on the physician's diagnosis of malignant nodules, we think that a more sensitive approach is needed in the determination of these cases. Sampling defects may affect this non-matching.

Fine-needle aspiration cytology using a novel ultrasound needle guidance system on the basis of standard needle magnetization was consecutively performed in 30 (15 in-plane and 15 out-of-plane) suspicious thyroid nodules. Nondedicated, commercially available needles were used. The technical effectiveness and safety of the system were satisfying; system failures were observed in 2 cases. The needle tip could be (at least occasionally) visualized inside the thyroid nodule in 96%, and the subjective procedure ratings were excellent in 57%. The out-of-plane technique was significantly superior in both respects (P = .021 and .027, respectively). Standard needle magnetization ultrasound needle guidance was easy to apply and cost-effective and has the potential to improve fine-needle aspiration cytology performance.