Younghen Lee MD, Presenter: Nothing to Disclose

Namjoon Lee MD, Abstract Co-Author: Nothing to Disclose

Junghyuk Kim MD, Abstract Co-Author: Nothing to Disclose

The goal of this study was to assess the accuracy and limitation of preoperative US-guided fine needle aspiration(USGFNA) of thyroid nodule

The USGFNA results of 138 patients(113 women,25 men with a mean age of 48 years (12-76 years)) with 155 thyroid nodules, who afterwards underwent thyroid surgery, from February 2002 to March 2004, were retrospectively compared with pathologic findings. Their mean size was 2.1cm, a range of 0.4 to 5.5cm. USGFNA was performed by a skillful radiologist.

Thyroid malignancy was confirmed histopathlogically in 65 cases including 63 papillary carcinoma, 1 hurthle cell carcinoma and 1 anaplastic carcinoma. Of 46 nodules classified as positive in USGFNA, 36 were malignant. Of 109 nodules classified as negative, 80 were benign. Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of USGFNA detecting thyroid malignancy were 55.4%, 88.9%, 78.3%, 73.4% and 74.8%. 39 of 155 USGFNA results (25.2%) were discrepant correlated with pathologic results. There were 10 false positive and 29 false negative results. The discrepancies contributed to cytodiagnostic misinterpretation, smear of suboptimal quality, too small size under US resolution, overlapping cytologic feature and sampling error due to nodular inhomogenity. The latter cases were malignancy coexisted in the midst of nodular hyperplasia and chronic lymphocytic thyroiditis.

Although USGFNA is widely considered as a safe and effective diagnostic modality in management of thyroid nodule, it has several unavoidable limitations. So, particular attention should be given to minimize the false-negative diagnosis by close clinicopathologic cooperation.

Lee, Y, Lee, N, Kim, J, US-guided Fine Needle Aspiration of Thyroid Nodules: Correlation between Cytology and Histology and Evaluation of Discrepant Cases.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4405881.html