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KMID : 0361820120310010017
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Journal of the Korean Society of Medical Ultrasound
2012 Volume.31 No. 1 p.17 ~ p.21
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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
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Lee Jang-Hee
Kim Dong-Wook
Baek Seung-Hun
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Abstract
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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 & Methods: From January to December 2009, US-FNA was per- formed for small solid thyroid nodules in 201 patients. Each thyroid nodule was classi- fied into group A and B according to the largest diameter (1 mm ≤ group A < 3 mm and 3 mm ≤ 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 statis- tically 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, ≥ 3 mm in the largest diameter, were higher than those of US-FNA for very small nodules, < 3 mm in the largest diameter.
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KEYWORD
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Thyroid, Thyroid nodule, Biopsy, Fine-needle, Ultrasonography, Malignancy
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