Unsatisfactory Ultrasound-Guided Fine Needle Aspiration of Thyroid Nodule: Which Factors Limit Cytology Result?

  • Pratirop Poonotoke Department of Radiology, Lerdsin Hospital

Abstract

Objective: The purpose of this study is to focus on which factors affect or limit fine-needle aspirationcytology (FNAC) results of thyroid nodule, in order to increase the satisfactory cytologic results and to avoid unnecessary FNAC in patients with asymptomatic benign nodules and highly possible unsatisfactory results.

Materials and Methods: The records of 217 thyroid nodules in 179 patients referred to the radiology department at Lerdsin Hospital for US-guided FNAC between January 2010 and December 2013 were retrospectively reviewed. Cytologic specimens of the FNAC were classified as unsatisfactory (non-diagnostic) and satisfactory (diagnostic) results and analyzed by mean of Logistic regression analysis, based on patientûs age, gender, nodule size, number and solid-cystic composition of nodule.

Results: The cytologic result was satisfactory for diagnosis in 154 specimens (71%) and unsatisfactory in 63 specimens (29%). Patientûs age, gender, number and size of nodule of the unsatisfactory result group were not different from the satisfactory result group but the nodule composition was different. Percentage of the unsatisfactory aspiration increased as the cystic component increased, ranging from 15.3% in solid nodules to 59.3% in predominant cystic nodules (cystic >75%). Upon the binary logistic regression analysis, the predominant cystic nodule was the only significant predictor of unsatisfactory result (p-value < 0.001) while solid nodules, predominant solid nodules and solid-cystic nodules are not significant. Unsatisfactory FNAC result of the predominant cystic nodules was about 8 times higher than the solid nodule (crude odds ratio = 8.087, p-value < 0.001).

Conclusion: To optimize the usefulness of FNAC,we should realize that solid-cystic composition of the thyroid nodules influence the non-diagnostic and diagnostic cytology.

Downloads

Download data is not yet available.

References

Yeung MJ, Serpell JW. Management of the solitary thyroid nodule. Oncologist 2008;13:105-12.

Gupta M, Gupta S, Gupta VB. Correlation of fine needle aspiration cytology with histopathology in the diagnostic solitary thyroid nodule. J Thyroid Res 2010:1-5

Gbalec F, Cap J, Ryska A, Vasatko T, Ceeova V. Benign fine-needle aspiration cytology of thyroid nodule:to repeat or not to repeat? Eur J Endocrinol 2009;161:933-7.

Alexander EK, Heering JP, Benson CB, Frates MC, Doubilet PM, Cibas ES, et al. Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. J Clin Endocrinol Metab 87(11):4924-7.

Flanagan MB, Ohori NP, Carty SE, Hunt JL. Repeat thyroid nodule fine-needle aspiration in patients with initial benign cytologic results. Am J Clin Pathol 2006;125:698-702.

Deandrea M, Mormile A, Veglio M, Motta M, Pellerito R, Gallone G, et al. Fine-needle aspiration biopsy of the thyroid : comparison between thyroid palpation and ultrasonography. Endocr Pract 2002;8:282-28.

Morris LF, Ragavendra N, Yeh MW. Evidence-based assessment of the role of ultrasonography in the management of benign thyroid nodules. World J Surg 2008;32: 1253-63.

Al-Sindi KA, Bukhari MH, Saba K, Ali W, Arshad M, Zaidi NZ. Evaluation of non-palpable thyroid nodules by ultrasound guided fine needle aspiration cytology. Natural science 2013;5:214-20.

Kim MJ, Kim EK, Park SI, Kim BM, Kwak JY, Kim SJ, et al. US-guided fine-needle aspiration of thyroid nodules: indications,techniques,results. Radiographics 2008;28: 1869-89.

Suen KC. Fine-needle aspiration biopsy of the thyroid. CMCJ 2002;167(5):491-5.

Kim DH,Kim MK,Chae SW, Lee KB,Han EM, Kang SH, Sohn JH. The useful of SurePath(TM) Liquid-based smear in sono-guided thyroid fine needle aspiration; a comparison of a conventional smear and SurePath(TM)Liquidbased cytology. Korean J Cytopathol 2007;18(2):143-52.
Published
2019-03-11
How to Cite
1.
Poonotoke P. Unsatisfactory Ultrasound-Guided Fine Needle Aspiration of Thyroid Nodule: Which Factors Limit Cytology Result?. ASEAN-JR [Internet]. 11Mar.2019 [cited 5Jun.2020];19(2):100-7. Available from: http://asean-journal-radiology.org/index.php/ajr/article/view/27
Section
Original Article