Cervical ultrasound assessment of thyroid nodules at risk of malignancy: Single-center experience

Abstract

Aim. The increasing diagnosis of thyroid nodules makes proper assessment of their nature and course of treatment essential, considering that thyroidectomy may be unnecessary and only contribute to higher healthcare system costs. Although criteria have been proposed for the stratification of these patients according to risk by use of cervical ultrasound and fine needle aspiration biopsy (FNAB), not all medical units may be equipped or have access to trained medical professionals to perform FNAB. The aim of this study was to show that cervical ultrasound may be sufficient for the evaluation of thyroid nodules in the treatment decision-making process. Patients and methods. 206 patients with single thyroid nodules and nodular goiter were assessed through cervical ultrasound and FNAB for the correlation between pretreatment classification and final diagnosis on histological examination. Results. 26.5% of single nodes proved malignant on paraffin studies, as compared to only 14% of nodular goiters. FNAB recorded a sensibility of 33.3%, specificity of 93.3%, false-negative rate of 50% and false-positive rate of 12.5%, whereas cervical ultrasound recorded a sensibility of 92.3%, specificity of 75.3%, false-negative rate of 2.8% and false-positive rate of 48.9%. Conclusion. Cervical ultrasound evaluation is a reliable method in the preoperative diagnosis of thyroid cancer patients.