Volume 37, Issue 6 pp. 1367-1377

Original Research

Size and Ultrasound Features Affecting Results of Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules

YiJie Dong MD,

YiJie Dong MD

orcid.org/0000-0001-8989-3893

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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MinJing Mao MD,

MinJing Mao MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

Departments of Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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WeiWei Zhan MD,

Corresponding Author

WeiWei Zhan MD

[email protected]

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

Address correspondence to WeiWei Zhan, MD, Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, 197 Ruijin Er Rd, 200025 Shanghai, China. E-mail: [email protected]Search for more papers by this author

JianQiao Zhou MD,

JianQiao Zhou MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Wei Zhou MD,

Wei Zhou MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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JieJie Yao MD,

JieJie Yao MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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YunYun Hu MD,

YunYun Hu MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Yan Wang MD,

Yan Wang MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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TingJun Ye MD,

TingJun Ye MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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YiJie Dong MD,

YiJie Dong MD

orcid.org/0000-0001-8989-3893

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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MinJing Mao MD,

MinJing Mao MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

Departments of Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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WeiWei Zhan MD,

Corresponding Author

WeiWei Zhan MD

[email protected]

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

JianQiao Zhou MD,

JianQiao Zhou MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Wei Zhou MD,

Wei Zhou MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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JieJie Yao MD,

JieJie Yao MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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YunYun Hu MD,

YunYun Hu MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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Yan Wang MD,

Yan Wang MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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TingJun Ye MD,

TingJun Ye MD

Departments of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China

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First published: 09 November 2017

https://doi.org/10.1002/jum.14472

Citations: 22

Drs Dong and Mao contributed equally to this work.

We thank all the nurses and staff working in the Department of Ultrasound of Ruijin Hospital. This study was supported by the National Clinical Key Specialty Construction Projects of China and the National Natural Science Fund (grant 81471668).

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Abstract

Objectives

Our goal was to assess the diagnostic efficacy of ultrasound (US)-guided fine-needle aspiration (FNA) of thyroid nodules according to size and US features.

Methods

A retrospective correlation was made with 1745 whole thyroidectomy and hemithyroidectomy specimens with preoperative US-guided FNA results. All cases were divided into 5 groups according to nodule size (≤5, 5.1–10, 10.1–15, 15.1–20, and >20 mm). For target nodules, static images and cine clips of conventional US and color Doppler were obtained. Ultrasound images were reviewed and evaluated by two radiologists with at least 5 years US working experience without knowing the results of pathology, and then agreement was achieved.

Results

The Bethesda category I rate was higher in nodules larger than 15 mm (P < .05). The diagnostic accuracy was best in nodules of 5 to 10 mm in diameter. The sensitivity, accuracy, PPV, and LR for negative US-guided FNA results were better in nodules with a size range of 5 to 15 mm. The specificity, negative predictive value (NPV), and LR for positive results and the Youden index rose with increasing nodule size. Seventeen false-positive and 60 false-negative results were found in this study. The false-negative rate rose with increasing nodule size. However, the false-positive rate was highest in the group containing the smallest nodules. Nodules with circumscribed margins and those that were nonsolid and nonhypoechoic and had no microcalcifications correlated with Bethesda I FNA results. Nodules with circumscribed margins and those that were nonsolid, heterogeneous, and nonhypoechoic and had increased vascularity correlated with false-negative FNA results. Borders correlated with Bethesda I false-negative and false-positive FNA results.

Conclusions

Tiny nodules (≤5 mm) with obscure borders tended to yield false-positive FNA results. Large nodules (>20 mm) with several US features tended to yield false-negative FNA results.

References

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Volume37, Issue6

June 2018

Pages 1367-1377

Size and Ultrasound Features Affecting Results of Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules

Abstract

Objectives

Methods

Results

Conclusions

References

Citing Literature

References

Information

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Size and Ultrasound Features Affecting Results of Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules

Abstract

Objectives

Methods

Results

Conclusions

References

Citing Literature

References

Related

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