Journal of Korean Society of Ultrasound in Medicine 2012;31(1): 17-21.
Ultrasonography-guided Fine-needle Aspiration for Solid Thyroid Nodules Less than 5 mm in the Largest Diameter: Comparison in Diagnostic Adequacy and Accuracy According to Nodule Size.
Jang Hee Lee, Dong Wook Kim, Seung Hun Baek
1Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Korea.
2Clinical Research Center, Busan Paik Hospital, Inje University College of Medicine, Korea.
  Published online: March 26, 2012.
PURPOSE: This study assessed the adequacy and accuracy of ultrasonography (US)-guided fine-needle aspiration (US-FNA) of solid thyroid nodules, less than 5 mm in maximum diameter. MATERIALS AND METHODS: From January to December 2009, US-FNA was performed for small solid thyroid nodules in 201 patients. Each thyroid nodule was classified into group A and B according to the largest diameter (1 mm < or = group A < 3 mm and 3 mm < or = group B < 5 mm). The adequacy and accuracy of US-FNA in two groups were compared using the histopathological results as a reference standard. RESULTS: Of the 227 thyroid nodules in 201 patients, the inadequacy of US-FNA in group A and B was 24.3% (18/74) and 13.1% (20/153), respectively, showing a statistically significant difference between the two groups (p = 0.0333, chi-square test). Eighty nodules were removed surgically in 72 patients, from which papillary thyroid carcinoma (n = 52), follicular thyroid carcinoma (n = 1), nodular hyperplasia (n = 26), and pseudonodule related to thyroiditis (n = 1) were confirmed. Based on the histopathological results of the 80 surgical nodules, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US-FNA in group A and B were 55.0% and 79.4%, 81.8% and 100%, 84.6% and 100%, 50% and 68.2%, and 64.5% and 85.7%, respectively. CONCLUSION: The adequacy and accuracy of US-FNA for solid thyroid nodules, > or = 3 mm in the largest diameter, were higher than those of US-FNA for very small nodules, < 3 mm in the largest diameter.
Keywords: Thyroid; Thyroid nodule; Biopsy, Fine-needle; Ultrasonography; Malignancy
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