HIGH-RESOLUTION ULTRASOUND ASSOCIATED WITH ASPIRATION BIOPSY IN THE FOLLOW-UP OF PATIENTS WITH DIFFERENTIATED THYROID-CANCER

OBJECTIVE: To assess the value of ultrasound in the follow-up of patie nts undergoing surgery for differentiated thyroid carcinoma. SUBJECTS: The study included 89 patients (70 women and 19 men) with differentia ted thyroid carcinoma (76 papillary and 13 follicular cancer). METHODS : High-frequency ultrasound (US) was used in the evaluation of 89 subj ects who underwent surgery for thyroid carcinoma. Fine-needle aspirati on was performed in cases with positive US. in addition, determination s of thyroglobulin (Tgb) in serum, scintigraphy with I-131, and cervic al palpation were evaluated. We determined sensitivity, specificity, a nd overall accuracy for each of these diagnostic methods. RESULTS: Ult rasonography was positive in 22 subjects, 16 in the nodal area and 6 i n the thyroid bed. Twenty-two subjects received fine-needle aspiration with US control; 13 (69%) of 22 were positive for cancer. The results of the US for detecting neoplastic disease showed a sensitivity of 65 %, specificity of 86%, and overall accuracy of 82%. The overall accura cy for scintigraphy was 88% and for Tgb, 91%. CONCLUSION: We concluded that US can be included in the follow-up protocol for patients underg oing surgery for differentiated cancer of thyroid, as a valuable tool to localize the recurrence. This technique is particularly useful in t he evaluation of patients who are found to have elevated Tgb levels.