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Abstract
Background and Objectives
Ultrasonography is a safe and noninvasive imaging modality with high sensitivity that can be used to identify the presence, location, and size of thyroid nodules. Fine-needle aspiration (FNA) biopsy of thyroid nodules is a minimally invasive and safe procedure that is usually performed on an outpatient basis. The purpose of this study was to investigate the diagnostic efficacy of ultrasonography performed by an otolaryngologist (OUS) and OUS-guided FNA for the thyroid and determine the clinical value of OUS in predicting the presence of malignancy in thyroid nodules.
Materials and Methods
A single otolaryngologist examined 151 consecutive patients referred to our institution and performed OUS or OUS-guided FNA biopsies on all of them in an office setting. Final diagnosis was based on the FNA biopsy or pathological result of operation. We used the following parameters to assess the relevance of the sonographic findings in the prediction of thyroid malignancy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and relative risk (RR).
Results
In total, 12.9% of all the patients showed malignancy. The PPVs for the sonographic features were as follows: a taller-than-wide shape, 63.6%; marked hypoechogenicity, 61.5%; microcalcification, 46.7%; microcalcification or macrocalcification, 44.0%; and spiculated margin, 38.2%. The RR values showed that microcalcification or macrocalcification (p<0.05, RR=7.2) and marked hypoechogenicity (p<0.05, RR=6.7) are significant findings that indicate thyroid malignancy.
References
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Table 1.
Cytologic results of OUS-guided FNA
| Cytologic results | Number of patients (%) |
|---|---|
| Unsatisfactory | 13 (12.9) |
| Benign | 67 (66.3) |
| Atypia | 5 (5) |
| Follicular neoplasm | 0 |
| Suspicious for malignancy | 3 (3) |
| Malignancy | 13 (12.9) |
Table 2.
Diagnostic index for individual sonographic criteria of malignant thyroid nodule
Table 3.
Results of univariate analysis for individual sonographic criteria of malignant thyroid nodules
Table 4.
Risk for individual sonographic criteria of malignant thyroid nodules (multivariate logistic regression analysis)
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