Pablo Daniel Domínguez MD, Presenter: Nothing to Disclose

Alberto Alonso MD, Abstract Co-Author: Nothing to Disclose

Alberto Villanueva, Abstract Co-Author: Nothing to Disclose

Alberto Benito MD, PhD, Abstract Co-Author: Nothing to Disclose

Javier Larrache MD, Abstract Co-Author: Nothing to Disclose

Maria Dolores Lozano MD, Abstract Co-Author: Nothing to Disclose

To review our experience with US-guided fine-needle aspiration biopsies (FNAB) of the thyroid gland to determine the frequency of complications and unsatisfactory smears and the correlation with surgical excision results.

Thyroid US-guided FNAB from 2000 and 2001 were reviewed, all performed by a radiologist or a radiology resident. Three radiologists and two cytologists were responsible of 95% of studied cases. Radiological and pathological reports were analyzed for nodule size and appearance, number of punctures, performer, complications and cytology and histology results. In benign lesions new FNAB in 1 year was recommended if asymptomatic and surgery if symptomatic. When results were indeterminate (follicular proliferation) or malignant surgery was indicated in all cases.

650 lesions in 624 patients (102 men and 522 women, mean age 51y, range 12 to 84) were punctured. 87.2% were focal lesions and 12.8% diffuse disease. Average nodule size was 20.0 mm (SD 10.9, range 2 to 72 mm). Cytological diagnosis results included 129 inadequate specimens (20.7%), 455 benign (72.9%), 20 indeterminate (3.2%), and 20 malignant (3.2%). There was a statistically significant yet clinically irrelevant difference in mean nodule size of adequate and inadequate specimens (20.5vs18.1 mm respectively, p .041). There were statistically significant differences in the proportion of inadequate smears between performers (range 12% to 29%) yet not related to experience (residents’ inadequate ratio of 14%), suggesting importance of puncture technique or other factors. In 156 (25%) patients who underwent surgery, pathology demonstrated benign lesions in 118 (18.9%) and malignant lesions in 38 (6.1%). For the diagnosis of malignancy sensitivity was 45%, specificity 99%, PPV value 93% and NPV value 84%. Malignancy was found at surgery in 8 patients with repeated benign cytology. No severe complications and only 2 mild complications occurred.

FNAB of thyroid gland is a safe procedure in our institution, with 20.7% of inadequate cytological specimens. For the diagnosis of malignancy sensitivity is intermediate and specificity is high. Repeated FNAB controls do not exclude malignancy.

To review our experience with US-guided fine-needle aspiration biopsies (FNAB) of the thyroid gland to determine the frequency of complications and unsatisfactory smears and the correlation with surgical excision results.

Thyroid US-guided FNAB from 2000 and 2001 were reviewed, all performed by a radiologist or a radiology resident. Three radiologists and two cytologists were responsible of 95% of studied cases. Radiological and pathological reports were analyzed for nodule size and appearance, number of punctures, performer, complications and cytology and histology results. In benign lesions new FNAB in 1 year was recommended if asymptomatic and surgery if symptomatic. When results were indeterminate (follicular proliferation) or malignant surgery was indicated in all cases.

650 lesions in 624 patients (102 men and 522 women, mean age 51y, range 12 to 84) were punctured. 87.2% were focal lesions and 12.8% diffuse disease. Average nodule size was 20.0 mm (SD 10.9, range 2 to 72 mm). Cytological diagnosis results included 129 inadequate specimens (20.7%), 455 benign (72.9%), 20 indeterminate (3.2%), and 20 malignant (3.2%). There was a statistically significant yet clinically irrelevant difference in mean nodule size of adequate and inadequate specimens (20.5vs18.1 mm respectively, p .041). There were statistically significant differences in the proportion of inadequate smears between performers (range 12% to 29%) yet not related to experience (residents’ inadequate ratio of 14%), suggesting importance of puncture technique or other factors. In 156 (25%) patients who underwent surgery, pathology demonstrated benign lesions in 118 (18.9%) and malignant lesions in 38 (6.1%). For the diagnosis of malignancy sensitivity was 45%, specificity 99%, PPV value 93% and NPV value 84%. Malignancy was found at surgery in 8 patients with repeated benign cytology. No severe complications and only 2 mild complications occurred.

FNAB of thyroid gland is a safe procedure in our institution, with 20.7% of inadequate cytological specimens. For the diagnosis of malignancy sensitivity is intermediate and specificity is high. Repeated FNAB controls do not exclude malignancy.

Domínguez, P, Alonso, A, Villanueva, A, Benito, A, Larrache, J, Lozano, , Fine Needle Aspiration of Thyroid Gland: A Retrospective Analysis of the Safety and Efficacy of 650 Consecutive Ultrasonography-guided Procedures.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4416682.html