Repeated fine-needle aspiration cytology for the diagnosis and follow-up of thyroid nodules

Graciano, Agnaldo José; Chone, Carlos Takahiro; Fischer, Carlos Augusto; Bublitz, Giuliano Stefanello; Peixoto, Ana Jacinta de Aquino

doi:10.1016/j.bjorl.2014.07.002

Cited by 8 publications

(4 citation statements)

References 37 publications

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“…In this group of patients, the clinical management would have changed to a more conservative one not warranting surgery, had they not had a high MTNS score. The proportion of cases in our study that downgraded to a benign score of B2 after r-USFNA are not consistent with those reported in the literature however, ranging from 42.3 to 78.4 % of cases (average 60.3 %) [ 6 , 16 – 18 , 20 , 21 ]. The reason for this discrepancy could be attributed to the very small number of samples in our study that had a repeat USFNA score of B2.…”

Section: Discussioncontrasting

confidence: 89%

The role of repeat fine needle aspiration in the management of indeterminate thyroid nodules

Jooya

Saliba

Blackburn

et al. 2016

J of Otolaryngol - Head & Neck Surg

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BackgroundManagement decisions are not straightforward when the Ultrasound Guided Fine Needle Aspiration (USFNA) demonstrates a Bethesda score of either category III or IV, and a diagnostic hemi-thyroidectomy or a repeat USFNA (r-USFNA) could be performed. The aim of this study is to assess the effectiveness of r-USFNA in the management of indeterminate thyroid nodules by evaluating the likelihood of obtaining a definite diagnosis.MethodsWe reviewed the medical records of all patients with thyroid nodules between 2011 and 2015 at the Jewish General Hospital (Montreal, Canada). Three hundred fifty-one patients who had undergone a surgical procedure (hemi or total thyroidectomy) and a diagnosis of B3 or B4 on the primary USFNA (p-USFNA) were included in the study. Ninety-six of the included patients also had a repeat USFNA prior to the surgery. Demographic data, type of procedure, and McGill Thyroid Nodule Score (MTNS) were obtained from the medical records. Malignancy rates were calculated based on the final surgical histopathology report.ResultsUpon r-USFNA, an average 76 % of patients did not change Bethesda categories, 7.4 % downgraded to a benign category. The results showed that, on an average 17.3 % of patients with p-USFNA of B3 and 20 % of patients with p-USFNA of B4, upgraded to a malignant or suspicious for malignancy category, thus changing the clinical management to total thyroidectomy. Our data demonstrates that r-USFNA facilitates choosing the correct surgery of total thyroidectomy in about 20 % of nodules that have upgraded from B3/B4 to a more definite malignant category.Conclusionsr-USFNA in patients with indeterminate diagnoses (B3 or B4) increases categorization into more definite categories. Approximately 20 % of patients are found to have malignant thyroid nodules and suspicious for malignancy thyroid nodules upon repeating the biopsy, hence a diagnostic hemi-thyroidectomy was avoided and a more definitive surgery could be performed. Furthermore, repeat USFNA results in a fewer number of hemi-thyroidectomy and completion thyroidectomy procedures.

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Section: Discussioncontrasting

confidence: 89%

The role of repeat fine needle aspiration in the management of indeterminate thyroid nodules

Jooya

Saliba

Blackburn

et al. 2016

J of Otolaryngol - Head & Neck Surg

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“…This is in accordance with the study by Afroze et al, 17 wherein papillary carcinoma was the most common thyroid tumor reported on final histopathology. 21,22 A study by Roy et al 23 showed that the sensitivity of FNAC was 81.5% and specificity of FNAC was 95.3% in their evaluation of thyroid nodules. 23 Sengupta et al, 24 had a sensitivity of 90% and specificity of 100%.…”

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confidence: 99%

Role of fine-needle aspiration cytology in evaluating thyroid nodules

Bahaj

Alkaff

Melebari

et al. 2020

SMJ

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To evaluate the accuracy and efficacy of fine-needle aspiration cytology (FNAC) in diagnosing thyroid nodules, correlating it with the histopathological findings. Methods: A retrospective evaluation of 314 patients was undertaken at a tertiary referral center of King Abdullah Medical City (KAMC), Makkah, Kingdom of Saudi Arabia, between 2010-2019. Patients who presented with thyroid swellings underwent ultrasonography and FNAC. If indicated, surgery was performed. The FNAC findings were compared to the final histopathological reports. Results: The findings for FNAC from our data set of 314 patients showed a sensitivity value of 79.8%, Original Article specificity of 82.1%, accuracy of 74.8%, positive predictive value of 74.8%, and negative predictive value of 85.9%. Conclusion: Our study showed that FNAC has high sensitivity and specificity in the initial evaluation of patients with thyroid nodules. When guided by ultrasonography, the accuracy can be markedly improved. Molecular markers once widely available can improve the diagnostic power of FNAC to be no less than the histopathologic evaluation of thyroid tissue.

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“…Repeat FNAC is the usual method of management after indeterminate diagnosis because the expected risk of malignancy is far more than 5% according to Koh J et al .’s study 39 . Repeat FNAC appears to not increase the expected likelihood of a malignant finding for patients who have an initial benign reading according to Graciano AJ et al .’s research 40 .…”

Section: Discussionmentioning

confidence: 99%

Risk of malignancy in thyroid nodules: predictive value of puncture feeling of grittiness in the process of fine-needle aspiration

Luo

Zhang

Huang

et al. 2017

Sci Rep

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Fine-needle aspiration cytology (FNAC) is widely used for diagnosing thyroid nodules. However, there has been no specific investigation about the puncture feeling of grittiness. The aim of the present study was to see if the puncture feeling of grittiness during fine-needle aspiration procedure, combined with standard FNAC, could improve the accuracy in diagnosing thyroid cancer. A total of one thousand five hundred and thirty-one thyroid FNAC specimens acquired between January 2013 and January 2017 were retrospectively retrieved. All cases underwent surgical intervention. The FNAC diagnoses and puncture feeling of grittiness were evaluated and compared with the results of final histopathological diagnoses. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of diagnosis for thyroid nodules by FNAC alone, puncture feeling of grittiness alone, and the combination of FNAC plus grittiness were calculated respectively. The findings of our study suggest that puncture feeling of grittiness is a useful adjunct. Adding puncture feeling of grittiness to FNAC can significantly enhance the ability to differentiate malignant thyroid nodules from benign thyroid nodules. More importantly, we found that puncture feeling of grittiness is surprising trust-worthy in being near perfectly reproducible per individual radiologist, and among different operators.

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Repeated fine-needle aspiration cytology for the diagnosis and follow-up of thyroid nodules

Abstract: Repeat FNA is a valuable procedure in cases with initial non-diagnostic or A/FLUS cytology, but its routine use for patients with an initial benign examination appears to not increase the expected likelihood of a malignant finding.

Cited by 8 publications

References 37 publications

The role of repeat fine needle aspiration in the management of indeterminate thyroid nodules

The role of repeat fine needle aspiration in the management of indeterminate thyroid nodules

Role of fine-needle aspiration cytology in evaluating thyroid nodules

Risk of malignancy in thyroid nodules: predictive value of puncture feeling of grittiness in the process of fine-needle aspiration

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