Correlative evaluation of findings between ultrasonography, fine needle aspiration cytology and histopathology in cases of goitre
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20242981Keywords:
High resolution USG, TIRADS, Bethesda classification, FNAC, HPEAbstract
Background: Thyroid imaging reporting and data system (TIRADS) criteria is followed in ultrasonography (USG), based on the risk of malignancy depending on the presence of suspicious ultrasound features. Patients in the high-risk category of TIRADS undergo fine needle aspiration cytology (FNAC), with the Bethesda classification used to determine the risk of malignancy. There is dearth of data comparing sonographic classification of thyroid nodule and its cytological association with respect to final histopathological diagnosis in India.
Methods: Prospective observational study on correlation of USG, FNAC and HPE of thyroid swellings conducted in department of otolaryngology at Jaipur national university institute for medical science and research centre, Jaipur, Rajasthan from June 2022 to April 2024 on 50 patients with palpable thyroid lump.
Results: In the present study, USG has a sensitivity of 63.63%, specificity of 97.44%, a positive predictive value (PPV) of 87.5%, a negative predictive value (NPV) of 90.4% and an overall accuracy of 84.00%. FNAC shows a sensitivity of 72.7%, specificity of 89.7%, PPV of 66.7%, NPV of 92%, and an overall accuracy of 86%.
Conclusions: Benign lesions on both FNAC and USG were almost in concurrence with HPE in our study. The results of FNAC for diagnosing malignancy in our study were almost at par with the results of HPE and outweighed the results of USG. Surgical management should be based on FNAC finding even if USG shows benign features. It should be essential part of armamentarium of evaluation of thyroid swelling. This combined approach provides a robust framework and enhances the accuracy for distinguishing between benign and malignant thyroid lesions, ultimately contributing to improved patient care and outcomes. However, the histopathological examination will remain the gold standard.
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References
Gupta KP, Gupta A, Gupta A. Radiopathological Correlation of Thyroid Masses: a Prospective Study. Int J Sci Stud. 2019;7(3):89-93.
Horvath E, Majlis S, Rossi R, Franco C, Niedmann JP, Castro A, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab. 2009;94:1748-51.
Al-Ghanimi IA, Al-Sharydah AM, Al-Mulhim S, Faisal S, Al-Abdulwahab A, Al-Aftan M, et al. Diagnostic Accuracy of Ultrasonography in Classifying Thyroid Nodules Compared with Fine-Needle Aspiration. Saudi J Med Med Sci. 2020;8(1):25-31.
Kim EK, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol. 2002;178:687-91.
Ilahi A, Muco E, Ilahi TB. StatPearls. StatPearls Publishing; Treasure Island (FL): Anatomy, Head and Neck, Parathyroid. 2023.
Horvath E, Majlis S, Rossi R, Franco C, Niedmann JP, Castro A, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab. 2009;94:1748-51.
Smithson M, Asban A, Miller J, Chen H. Considerations for Thyroidectomy as Treatment for Graves Disease. Clin Med Insights Endocrinol Diabetes. 2019;12:1179551419844523.
Schäffler A. Hormone replacement after thyroid and parathyroid surgery. Dtsch Arztebl Int. 2010;107(47):827-34.
Zakaria HM, Al Awad NA, Al Kreedes AS, Al-Mulhim AM, Al-Sharway MA, Hadi MA, Al Sayyah AA. Recurrent laryngeal nerve injury in thyroid surgery. Oman Med J. 2011;26(1):34-8.
Goellner JR, Gharib H, Grant CS, Johnson DA. Fine needle aspiration cytology of the thyroid. Acta Cytol. 1987;31:587-90.
Melo-Uribe MA, Sanabria Á, Romero-Rojas A, Pérez G, Vargas EJ, Abaúnza MC, et al. The Bethesda system for reporting thyroid cytopathology in Colombia: Correlation with histopathological diagnoses in oncology and non-oncology institutions. J Cytol. 2015;32:12–6.
Kim EK, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol. 2002;178:687-91.
Horvath E, Majlis S, Rossi R, Franco C, Niedmann JP, Castro A, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab. 2009;94:1748-51.
Bhise SV, Shaikh A, Hippargekar PM, Kothule S. A Prospective Study of Ultrasonographic and FNAC Correlation of Thyroid Swellings with Histopathology. Indian J Otolaryngol Head Neck Surg. 2022;74(2):1942-8.
Shukla S, Patel BP, Shukla S, Patel VK, Vaidya K, Rathore D, et al. Clinicopathological study of thyroid swellings and it’s correlation with ultrasonography. Int Surg J. 2021;8(4):1218-25.
Kumar EP, Namratha S, Pakanati SSR, Pokala U. Int J Otorhinolaryngol Head Neck Surg. 2021;7(8):1227-30.
Yang Q, Kennicott K, Zhu R, Kim J, Wakefield H, Studener K, et al. Sex hormone influence on female-biased autoimmune diseases hints at puberty as an important factor in pathogenesis. Front Pediatr. 2023;11:1051624.
Akhtar MK, Sah D, Acharya R, Jha AK, Mahato RK, Rimal BM, Hussain A. Correlation between Ultrasonography and Fine Needle Aspiration Cytology (FNAC) Findings in Patients with Thyroid Lesions. Int J Med Sci Diagnosis Res. 2021;5(8):10.