DIAGNOSTIC ACCURACY OF ULTRASONOGRAPHY IN DIFFERENTIATING BENIGN AND MALIGNANT THYROID NODULES, TAKING FNAC AS GOLD STANDARD

Dr Ayesha Tareen, Dr Muhammad Omer Aamir, Dr Syed Naseer Ahmed, Dr Javed Anwar, Dr Sami Ullah Khan, Dr sadia Dilsahad, Dr Palwasha Gul, Dr Khalid shakeel Baber, Dr Baber Khan

Abstract


BACKGROUND: Ultrasound is the most broadly performed procedure in the thyroid gland screening. It has easy performance and cost effectiveness in determining the size and number of nodules. The aim of this study was to determine the diagnostic accuracy of ultrasonography in differentiating benign and malignant thyroid nodules, taking histopathological findings of FNAC as gold standard. MATERIAL AND METHODS: This Descriptive, cross-sectional was conducted from 25th July 2018 to 24th January 2019 in the Department of Radiology, Combined Military Hospital, Quetta. A total of 142 patients with thyroid nodule of any size and duration >3 months, age >15 years & either gender were included. All the patients underwent grey scale ultrasonography. Findings were correlated with FNAC report. RESULTS: The data were analyzed and quantitative metric like sensitivity (Sn= 93.15%), specificity (Sp = 89.86%), positive predictive value (PPV = 90.67%), negative predictive value (NPV = 92.54%) and diagnostic accuracy (Acc = 91.55%) of ultrasonography in differentiating benign and malignant thyroid nodules were calculated taking FNAC as gold standard. CONCLUSIONS: This study concluded that ultrasound is the non-invasive modality of choice with high diagnostic accuracy in diagnosing malignant thyroid nodules.

 

Keywords: Thyroid cancer, ultrasound, sensitivity.


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Tahmasebi M, Dezfouli MRB, Gharibvand MM, Jahanshahi A, Nikpour N, Rahim F. Diagnostic accuracy of sonography in assessment of thyroid masses in comparison with pathology. Russian Open Med J. 2016;5:103.

Avinash B, Ahmed N, Sreedevi T, Swapna Ch, Latha RM, et al. Role of ultrasonography to differentiate benign and malignant thyroid nodules in correlation with fine-needle aspiration cytology. Int J Sci Stud. 2016;4(5):81-7.

Andrioli M, Carzaniga C, Persani L. Standardized ultrasound report for thyroid nodules: the endocrinologist's viewpoint. Eur Thyroid J. 2013;2(1):37-48.

Ma JJ, Ding H, Xu BH, Xu C, Song LJ, Huang BJ, et al. Diagnostic performances of various gray-scale, color Doppler, and contrast-enhanced ultrasonography findings in predicting malignant thyroid nodules. Thyroid. 2014;24(2):355-63.

Kim SY, Han KH, Moon HJ, Kwak JY, Chung WY, Kim EK. Thyroid nodules with benign findings at cytologic examination: results of long-term follow-up with US. Radiol. 2014;271(1):272-81.

Kwak JY, Kim EK. Ultrasound elastography for thyroid nodules: recent advances. Ultrasonography. 2014;33(2):75-82.

Remonti LR, Kramer CK, Leitão CB, Pinto LC, Gross JL. Thyroid ultrasound features and risk of carcinoma: a systematic review and meta-analysis of observational studies. Thyroid. 2015;25:538-50.

Kim JY, Jung SL, Kim MK, Kim TJ, Byun JY. Differentiation of benign and malignant thyroid nodules based on the proportion of sponge-like areas on ultrasonography: imaging-pathologic correlation. Ultrasonography. 2015;34(4):304-11.

Maimaiti Y, Sun S, Liu Z, Zeng W, Liu C, Wang S, et al. Diagnostic accuracy of ultrasonographic features for benign and malignant thyroid nodules smaller than 10 mm. Int J Clin Exp Med. 2016;9(3):6476-82.

Popli MB, Rastogi A, Bhalla PJS, Solanki Y. Utility of gray-scale ultrasound to differentiate benign from malignant thyroid nodules. Indian J Radiol Imaging. 2012;22(1):63–8.

Afifi AH, Alwafa WAHA, Aly WM, Alhammadi HAB. Diagnostic accuracy of the combined use of conventional sonography and sonoelastography in differentiating benign and malignant solitary thyroid nodules. Alexandria J Med. 2017;53:21–30.

Zahir ST, Vakili M, Ghaneei A, Sharahjin NS, Heidari F. Ultrasound assistance in differentiating malignant thyroid nodules from benign ones. J Ayub Med Coll Abbottabad. 2016;28(4):644-9.

Solbiati L, Charboneau JW, Osti V, James EM, Hay ID. The Thyroid Gland. In: Wilson SR, Charboneau JW, Rumack CM, editors. Diagnostic Ultrasound. 3 rd ed. Missouri: Mosby, Elsevier Inc.; 2005. p. 735-70.

Yeung MJ, Serpell JW. Management of the solitary thyroid nodule. Oncologist 2008;13:105-12.

Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ. Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2009;19:1167-214.

Mortenson J, Woolner L, Benneu W. Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab 1955;15:1270-80.

Alam T, Khattak YJ, Beg M, Raouf A, Azeemuddin M, Khan AA. Diagnostic accuracy of ultrasonography in differentiating benign and malignant thyroid nodules using fine needle aspiration cytology as the reference standard. Asian Pac J Cancer Prev. 2014;15(22):10039-43.

Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, et al. Benign and malignant thyroid nodules: US differentiation – A multicenter retrospective study. Radiology 247: 762-770, 2008.

Avinash B, Ahmed N, Sreedevi T, Swapna Ch, Latha RM, Babu J. Role of Ultrasonography to Differentiate Benign and Malignant Thyroid Nodules in Correlation with Fine-needle Aspiration Cytology. Int J Sci Stud 2016;4(5):81-87.

Nawaz S, Khan MB, Parveen B, Asif M, Rashid M, Azeem M, et al. Diagnostic accuracy of thyroid ultrasound in detection of malignancy in thyroid nodules. Pak J Physiol. 2018;14(3):11–3.

Ghajarzadeh M, Sodagari F, Shakiba M. Diagnostic accuracy of sonoelastography in detecting malignant thyroid nodules: a systematic review and meta-analysis. Am J Roentgenol 2014; 202(4): W379-W389.

Zhuo J, Ma Z, Fu WJ, Liu SP. Differentiation of benign from malignant thyroid nodules with acoustic radiation force impulse technique. Br J Radiol 2014; 87(1035): 20130263.

Campanella P, Ianni F, Rota CA, Corsello SM, Pontecorvi A. Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis. Eur J Endocrinol 2014; 170(5): R203-R211.

Kim SY, Han KH, Moon HJ, Kwak JY, Chung WY, Kim EK. Thyroid nodules with benign findings at cytologic examination: results of long-term follow-up with US. Radiology 2014; 271(1): 272-281.

Yang C, Han C, Wang LP, Feng N, Wang YF, You XD. Exploration on an ultrasonographic imaging reporting and data system in malignancy grading of thyroid nodules. Zhonghua Zhong Liu Za Zhi 2013; 35(10): 758-763.

Wu HX, Zhang BJ, Wang J, Zhu BL, Zang YP, Cao YL. Conventional ultrasonography and real time ultrasound elastography in the differential diagnosis of degenerating cystic thyroid nodules mimicking malignancy and papillary thyroid carcinomas. Asian Pac J Cancer Prev 2013; 14(2): 935-940.


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