J Korean Soc Radiol.  2010 Feb;62(2):95-99. 10.3348/jksr.2010.62.2.95.

Ultrasonography-Guided Fine-Needle Aspiration Biopsy of Predominantly Cystic Thyroid Nodules

• Baek HJ
• Kim DW

• KMID: 2208944
• DOI: http://doi.org/10.3348/jksr.2010.62.2.95

Abstract

PURPOSE: The aim of this study is to present our biopsy technique and to determine the efficacy of the ultrasound- guided fine-needle aspiration biopsy (US-FNAB) for predominantly cystic thyroid nodules (PCTNs).
MATERIALS AND METHODS
This study included patients that underwent US-FNABs on PCTNs, and were sampled for the solid component following the aspiration of a cystic component through one needle puncture between January to December of 2008. We retrospectively reviewed the cytopathology results as well as any complication associated with the procedure.
RESULTS
Of the 76 PCTNs (range of maximal diameter: 0.4 cm-6.1 cm, mean: 2.39 cm) observed in the 75 patients (females: males = 63: 12, age range: 19-72, mean: 45.3 years old), the incidence rate of adequate and inadequate samples was 90.8% (69/76) and 9.2% (7/76) in the first US-FNAB, respectively. Further, 23 PCTNs were surgically removed in 22 patients, of which 15 PCTNs were benign and 8 were confirmed malignant nodules. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for USFNAB of PCTNs were 95.2%, 100%, 100%, 76.9%, and 95.8%, respectively.
CONCLUSION
The data suggest that our technique for US-FNAB of PCTNs was effective and accurate.

MeSH Terms

Biopsy
Biopsy, Fine-Needle
Humans
Incidence
Male
Needles
Punctures
Retrospective Studies
Sensitivity and Specificity
Thyroid Diseases
Thyroid Gland
Thyroid Nodule

Figure

• 

  Fig. 1 A 57-year-old man with a predominantly benign cystic thyroid nodule. (A) Transverse sonogram shows a predominantly cystic thyroid nodule in right lobe. (B) A needle tip (arrow) was observed in a cystic component of the nodule for aspiration of cystic component. (C) After aspiration of cystic component, sampling was performed in the solid component of the nodule (the needle tip: arrow).

Reference

1. Bellantone R, Lombardi CP, Raffaelli M, Traini E, de Crea C, Rossi ED, et al. Management of cystic or predominantly cystic thyroid nodules: the role of ultrasound-guided fine-needle aspiration biopsy. Thyroid. 2004; 14:43–47.

2. Yokozawa T, Miyauchi A, Kuma K, Sugawara M. Accurate and simple method of diagnosing thyroid nodules: the modified technique of ultrasound-guided fine needle aspiration biopsy. Thyroid. 1995; 5:141–145.

3. Kim SJ, Kim EK, Park CS, Chung WY, Oh KK, Yoo HS. Ultrasound-guided fine-needle aspiration biopsy in nonpalpable thyroid nodules: is it useful in infracentrimetric nodules? Yonsei Med J. 2003; 44:635–640.

4. Rausch P, Nowels K, Jeffrey RB. Ultrasonographically guided thyroid biopsy: a review with emphasis on technique. J Ultrasound Med. 2001; 20:79–85.

5. Kim DW, Lee EJ, Kim SH, Kim TH, Lee SH, Kim DH, et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules: comparison in efficacy according to nodule size. Thyroid. 2009; 19:27–31.

6. Gharib H, Papini E, Valcavi R, Baskin HJ, Crescenzi A, Dottorini ME, et al. American Association of Clinical Endocrinologists and Associazione Medici Endorinologi. Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 2006; 12:63–102.

7. Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, et al. Management of thyroid nodules detected at US: society of radiologists in ultrasound consensus conference statement. Radiology. 2005; 237:794–800.

8. Hamaker RA, Moriarty AT, Hamaker RC. Fine-needle biopsy techniques of aspiration versus capillary in head and neck masses. Laryngoscope. 1995; 105:1311–1314.

9. Ceresini G, Corcione L, Morganti S, Milli B, Bertone L, Prampolini R, et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules, coupled with on-site cytologic review, improves results. Thyroid. 2004; 14:385–389.

10. Kamal MM, Arjune DG, Kulkarni HR. Comparative study of fine needle aspiration and fine needle capillary sampling of thyroid lesions. Acta Cytol. 2002; 46:30–34.

11. Tublin ME, Martin JA, Rollin LJ, Pealer K, Kurs-Lasky M, Ohori NP. Ultrasound-guided fine-needle aspiration versus fine-needle capillary sampling biopsy of thyroid nodules: does technique matter? J Ultrasound Med. 2007; 26:1697–1701.

12. Haddadi-Nezhad S, Larijani B, Tavangar SM, Nouraei SM. Comparison of fine-needle-nonaspiration with fine-needle-aspiration technique in the cytologic studies of thyroid nodules. Endocr Pathol. 2003; 14:369–373.