Myrsini Gkeli, Presenter: Nothing to Disclose

Victoria Kartsouni, Abstract Co-Author: Nothing to Disclose

Eleni Dokoz, Abstract Co-Author: Nothing to Disclose

Sofia Sfika, Abstract Co-Author: Nothing to Disclose

Smaragda Angeli, Abstract Co-Author: Nothing to Disclose

Dimitra Daskalopoulou, Abstract Co-Author: Nothing to Disclose

To determine whether ultrasound guided fine needle biopsy (Ug-FNB) is an effective procedure for diagnosing non palpable cervical lymphadenopathy in patients with known well differentiated thyroid cancer (DTC).  

This is a retrospective study that concerns 1654 non-palpable cervical lymph nodes in 1285 patients with known DTC who were examined by ultrasonography (U/S) and Ug-FNB for possible metastases before surgery and during the postoperative follow-up, in the period from 2006 and up to 2012. Final diagnosis was determined by histopathological exam of excision biopsy or by clinical and U/S follow-up for more than 12 months. Diagnostic yield, sensitivity, specificity, accuracy and complications of Ug-FNB were evaluated.  

From 1285 patients with known DTC, 65% were in primary staging and treatment and 35% had total thyroidectomy (TT) with or without central neck dissection. Cytological diagnosis was made in 1646 of 1654 nodes yielding a diagnostic rate of 99,5%. From 1646 cervical lymph nodes (CLN) that had an adequate Ug-FNB, cytology showed metastases in 794 and benign findings in 852 nodes. All malignant nodes underwent surgery. No false positive results were mentioned. From the 852 benign nodes, 189 underwent initial TT and local cervical lymph nodes dissection and 27 nodes underwent an excisional biopsy. The remaining 636 nodes were unchanged or had regressed spontaneously on clinical and U/S follow-up, for more than 12-month monitoring period. Five false negative cytological results were referred. In the differentiation of benign from metastatic non palpable CLNs, Ug-FNB had a sensitivity and specificity of 99,4% and 100%. The positive predictive value, negative predictive value and accuracy in diagnosis of malignancy were respectively 100%, 99,4% and 99,7%. There were no procedure related complications.  

Ug-FNB is a safe and efficient procedure for early detection of metastatic CLNs in patients with DTC. This is of great clinical importance because it optimizes surgical and radiation therapy treatments based on a balanced decision between the need of local radical excision, correct disease staging, and limiting the risk of complications.

Ug-FNB is a safe and efficient procedure in diagnosis of occult metastatic CLNs in patients with DTC, obviating unnecessary local radical excision or an excisional biopsy

Gkeli, M, Kartsouni, V, Dokoz, E, Sfika, S, Angeli, S, Daskalopoulou, D, Ultrasound-guided Fine Needle Biopsy of Occult Cervical Lymphadenopathy in Patients with Well Differentiated Thyroid Cancer: Accuracy and Impact on Clinical Decision Making; Seven Year Experience of an Anticancer Oncological Hospital.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017583.html