USE OF FINE-NEEDLE ASPIRATION BIOPSY AND FROZEN-SECTION IN THE MANAGEMENT OF THE SOLITARY THYROID-NODULE

Background, This study evaluates the indication for frozen section (FS x) in the management of the solitary thyroid nodule given the increasi ng use of fine-needle aspiration biopsy (FNAB). Methods. The charts of 561 patients who underwent thyroidectomy for a solitary nodule were r eviewed. Each patient underwent either FNAB, FSx, or both. Results wer e compared to the final diagnosis to evaluate their effectiveness in p redicting malignancy. Results, The sensitivity and specificity for FNA B alone (162 patients) were 86% and 91%, respectively, and for FSx (49 4 patients) 79% and 99%, respectively. The routine use of FSx with dia gnostic FNABs did not improve the accuracy over either test alone. Sen sitivity, specificity, and accuracy were essentially unchanged when th e use of FSx was limited to just atypical FNAB but dropped significant ly when FSx was not used. Conclusions. When results of FNAB and FSx ar e interpreted as benign or malignant, both are highly accurate predict ors of malignancy. Routine use of FSx and FNAB does not improve the se nsitivty or specificity in the detection of malignancy over that of ei ther examination alone. FSx proved useful in determining the extent of operation only when results of the FNAB were atypical.