Thyroid nodules’ evaluation by ultrasound and fine-needle aspiration cytology

Abstract

The clinical significance of knowing the status of thyroid nodules is the need to exclude thyroid cancer. The purpose of this study is to evaluate ultrasound (U/S) features of thyroid nodules and correlate them with fine-needle aspiration cytology (FNAC). A descriptive prospective study was conducted at the Radiology Department, King Khalid University Hospital, King Saud University (KSU), Riyadh, KSA. The inclusion criteria were adult patients with neck swelling, palpable neck lesion, and/or abnormal thyroid-stimulating hormone (TSH) laboratory test result. Philips IU22, epic, sonosite, and Toshiba-Xerio ultrasound (U/S) systems with 7-MHz transducers were used in this study. All participants underwent a thyroid U/S scan according to standard protocol. FNAC-U/S was conducted for 159 nodules (according to suspicious U/S features) using a 10-ml plastic syringe with conventional (23 to 25) gauge needle. There were 246 participants included in this study (165 females [67%] and 61 males [33%], age range 13 to 88 years). There were 303 types of thyroid nodules noted, as follows: 47.8% were solid nodules, 42.5% were complex, and 9.6% were cystic nodules. Among 159 FNAC samples, 8.2% (n = 13) were positive results for malignancy. Females predominantly had malignant results (P = 0.001). U/S showed a sensitivity of 89.1 and 78.0% and a specificity of 43.0 and 57% for the right and left lobes, respectively. FNAC showed a sensitivity of 10.0% and 21% and a specificity of 56.9 and 42% for the right and left lobes, respectively. In conclusion, nodule malignancy and gender were significantly associated. Mixed and hypoechoic nodules were common features of malignancy. Both U/S and FNAC confirmation were important in thyroid nodule evaluation.

Keywords: Ultrasound, thyroid, nodules, fine needle, aspiration, cytology, Saudi Arabia.

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