ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION BIOPSY OF THYROID MASSES

The purpose of this study was to determine the impact of ultrasound-gu ided fine-needle aspiration biopsy (USFNA) in the cytological diagnosi s of nodular thyroid disease. It remains unclear exactly what role USF NA should play in the cytological diagnosis of nodular thyroid disease . All patients who underwent fine-needle aspiration (FNA) for nodular thyroid disease at Stanford University Medical Center from 1991 to 199 6 were included in the study. Histopathologic diagnoses were compared to cytological diagnoses for those patients who underwent surgery. FNA was performed on a total of 497 thyroid nodules. Palpation-guided FNA (pFNA) was performed on 370 nodules, and USFNA was done on 127. The, USFNAs were performed for the following reasons: 95 (75%) for nonpalpa ble or difficult-to-palpate nodules; 14 (11%) for previously failed FN A; and 18 (14%) for incidentally detected nodules. FNA had an unsucces sful biopsy rate of 16% and a sensitivity and specificity of 89% and 6 9%, respectively. USFNA had an unsuccessful biopsy rate of 7% and a se nsitivity and specificity of 100% and 100%, respectively. The cancer y ield at surgery for pFNA was 40%, and the cancer yield at surgery for USFNA was 59%. The complementary use of USFNA with pFNA improves the d iagnostic approach to nodular thyroid disease. The use of USFNA has in creased the cancer yield at surgery and the sensitivity of thyroid bio psy at our institution.