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KMID : 0361820080270040213
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Journal of the Korean Society of Medical Ultrasound
2008 Volume.27 No. 4 p.213 ~ p.219
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Analysis of the Malignancy Rate for Thyroid Nodules based on the Use of a Fine Needle Aspiration Biopsy and Ultrasonography
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Choi Ju-Wan
Park Ji-Won
Jung Han-Young
Kim Hye-Jung
Kim Gab-Chul
Kim Yong-Sun
Park Ji-Young
Lee Hui-Joong
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Abstract
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Purpose: This study was designed to analyze the malignancy rate for thyroid nodules determined after a fine needle aspiration biopsy (FNAB) and ultrasonography (US) and to propose follow-up FNAB indications.
Materials and Method : A total of 287 patients (265 female, 22 male) who underwent repeated US-guided FNABs were included in the cohort study. The results of the FNABs were classified as inadequate, benign, indeterminate,suspicious for a malignancy and a malignancy. The US findings were assigned five grades according to the possibility of a malignancy present. The frequency of a malignant nodule was evaluated by the use of the Kaplan-Meier method and Cox proportional risk model.
Results: The malignancy rates of inadequate, benign, and indeterminate nodules were 12.8%, 8.2% and 37.5%, respectively, for the FNAB findings. The rates of grades 3, 4 and 5 were 38.6%, 50.0% and 53.8%, respectively,for the US findings. Inadequate and indeterminate nodules as determined by an FNAB and grades 3, 4 and 5 assigned after US showed a higher malignancy rate than other nodules and would be regarded as high risk lesions.The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 93.3%,38.4%, 22.0%, 96.9% and 47.0%, respectively, if the nodule was considered a high-risk lesion, based on the FNAB or US findings.
Conclusion: Thyroid nodules should be evaluated based on an FNAB and US findings. If a thyroid nodule is classified as a high-risk lesion, a follow-up study is needed due to the high malignancy rate.
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KEYWORD
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Thyroid nodule, Fine needle aspiration biopsy, Thyroid US
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