Effect on Efficiency of Thyroid Nodules' Size for Ultrasound-Guided Fine-Needle Aspiration Biopsy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGQiong ¹ ,  PENGYu-lan ¹ , MABu-yun ¹ , JIANGYong ² , YUBo-yang ¹ , ZHANGXia ¹ , LANLin ¹

1. Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;
2. Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

PENGYu-lan, Email: yulanpeng@163.com

Keywords：

Thyroid nodule; Fine needle aspiration biopsy; Ultrasonography

DOI：

10.7507/1007-9424.20150215

Video：

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Objective To assess the effect of the size of thyroid nodules on the diagnostic rate of ultrasound guided aspiration cytology (US-FNAB). Methods The data of 1 142 (performed by two doctors, 571 each) thyroid nodules between March 2011 and April 2014 in our hospital were retrospectively analyzed. Yields of US-FNAB were divided into two levels of adequacy and inadequacy according to the classification standard of the Bethesda system. The thyroid nodules were classified into five groups according to the largest diameter:≤5 mm group, 5-10 mm group,10-20 mm group, 20-30 mm group, and <30 mm group. According to the grouping of the nodules and the efficiency of US-FNAB drawed curve, the adequacy rates of alone and total of two examiners in each group were analyzed, respectively. Results The adequacy rates of US-FNAB of alone and total of two examiners in≤5 mm group, 5-10 mm group,10-20 mm group, 20-30 mm group, and <30 mm group was 68.42%, 83.72%, 86.08%, 84.62%, and 73.53% (examiner 1); 68.75%, 70.53%, 81.05%, 86.15%, and 73.91% (examiner 2); 68.59%, 77.53%, 83.59%, 85.47%, and 73.75% (total of two examiners), respectively. The total adequacy rate of US-FNAB of two examiners in≤5 mm group was lower than that in 10-20 mm group (P<0.001) and 20-30 mm group (P=0.001). The adequacy rate of US-FNAB of examiner 1 in 5-10 mm group was higher than that examiner 2 (P=0.001). Conclusions The size of thyroid nodules significantly influences the adequate diagnostic rate of US-FNAB. The adequacy rates of US-FNAB of the largest diameter≤5 mm or <3mm were lower. The low adequacy rate of US-FNAB may be associated with cystic degeneration in the larger nodules.

Citation： ZHANGQiong, PENGYu-lan, MABu-yun, JIANGYong, YUBo-yang, ZHANGXia, LANLin. Effect on Efficiency of Thyroid Nodules' Size for Ultrasound-Guided Fine-Needle Aspiration Biopsy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(7): 832-835. doi: 10.7507/1007-9424.20150215 Copy

1.	Goldfarb M, Gondek S, Solorzano C, et al. Surgeon-performed ultrasound can predict benignity in thyroid nodules. Surgery, 2011, 150(3):436-441.
2.	American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 2009, 19(11):1167-1214.
3.	Redman R, Zalaznick H, Mazzaferri EL, et al. The impact of assessing specimen adequacy and number of needle passes for fine-needle aspiration biopsy of thyroid nodules. Thyroid, 2006, 16(1):55-60.
4.	Alexander EK, Heering JP, Benson CB, et al. Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. J Clin Endocrinol Metab, 2002, 87(11):4924-4927.
5.	Chow LS, Gharib H, Goellner JR, et al. Nondiagnostic thyroid fine-needle aspiration cytology:management dilemmas. Thyroid, 2001, 11(12):1147-1151.
6.	Mittendorf EA, Tamarkin SW, McHenry CR. The results of ultrasound-guided fine-needle aspiration biopsy for evaluation of nodular thyroid disease. Surgery, 2002, 132(4):648-654.
7.	Anderson TJ, Atalay MK, Grand DJ, et al. Management of nodules with initially nondiagnostic results of thyroid fine-needle aspiration:can we avoid repeat biopsy? Radiology, 2014, 272(3):777-784.
8.	Bohacek L, Milas M, Mitchell J, et al. Diagnostic accuracy of surgeon-performed ultrasound-guided fine-needle aspiration of thyroid nodules. Ann Surg Oncol, 2012, 19(1):45-51.
9.	Grani G, Calvanese A, Carbotta G, et al. Intrinsic factors affecting adequacy of thyroid nodule fine-needle aspiration cytology. Clin Endocrinol, 2013, 78(1):141-144.
10.	Degirmenci B, Haktanir A, Albayrak R, et al. Sonographically guided fine-needle biopsy of thyroid nodules:the effects of nodule characteristics, sampling technique, and needle size on the adequacy of cytological material. Clin Radiol, 2007, 62(8):798-803.
11.	Moon HJ, Kwak JY, Kim EK, et al. Ultrasonographic characteristics predictive of nondiagnostic results for fine-needle aspiration biopsies of thyroid nodules. Ultrasound Med Biol, 2011, 37(4):549-555.
12.	Choi SH, Han KH, Yoon JH, et al. Factors affecting inadequate sampling of ultrasound-guided fine-needle aspiration biopsy of thyroid nodules. Clin Endocrinol, 2011, 74(6):776-782.
13.	Schmidt T, Riggs MW, Speights VO Jr. Significance of nondiagnostic fine-needle aspiration of the thyroid. South Med J, 1997, 90(12):1183-1186.
14.	Cibas ES, Ali SZ. The Bethesda System for reporting thyroid cytopathology. Thyroid, 2009, 19(11):1159-1165.
15.	Rosen JE, Stone MD. Contemporary diagnostic approach to the thyroid nodule. J Surg Oncol, 2006, 94(8):649-661.
16.	Shrestha M, Crothers BA, Burch HB. The impact of thyroid nodule size on the risk of malignancy and accuracy of fine-needle aspiration:a 10-year study from a single institution. Thyroid, 2012, 22(12):1251-1256.
17.	Frates MC, Benson CB, Charboneau JW, et al. Management of thyroid nodules detected at US:Society of Radiologists in Ultrasound consensus conference statement. Radiology, 2005, 237(3):794-800.
18.	Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract, 2010, 16 Suppl 1:1-43.
19.	Mazzaferri EL, Sipos J. Should all patients with subcentimeter thyroid nodules undergo fine-needle aspiration biopsy and preoperative neck ultrasonography to define the extent of tumor invasion? Thyroid, 2008, 18(6):597-602.
20.	Moon WJ, Baek JH, Jung SL, et al. Ultrasonography and ultrasoundbased management of thyroid nodules:consensus statement and recommendations. Korean J Radiol, 2011, 12(1):1-14.
21.	Kim DW, Lee EJ, Kim SH, et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules:comparison in efficacy according to nodule size. Thyroid, 2009, 19(1):27-31.
22.	Moon H, Son E, kim EK, et al. The diagnostic values of ultrasound and ultrasound-guided fine needle aspiration in subcentimeter-sized thyroid nodules. Ann Surg Oncol, 2012, 19(1):52-59.
23.	Choi YS, Hong SW, Kwak JY, et al. Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules. Ann Surg Oncol, 2012, 19(7):2304-2309.
24.	Richards ML, Bohnenblust E, Sirinek K, et al. Nondiagnostic thyroid fine-needle aspiration biopsies are no longer a dilemma. Am J Surg, 2008, 196(3):398-402.
25.	施来银. 甲状腺粗针活检的临床应用. 西安医科大学学报, 1993, 14(1):93, 98.

1. Goldfarb M, Gondek S, Solorzano C, et al. Surgeon-performed ultrasound can predict benignity in thyroid nodules. Surgery, 2011, 150(3):436-441.
2. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 2009, 19(11):1167-1214.
3. Redman R, Zalaznick H, Mazzaferri EL, et al. The impact of assessing specimen adequacy and number of needle passes for fine-needle aspiration biopsy of thyroid nodules. Thyroid, 2006, 16(1):55-60.
4. Alexander EK, Heering JP, Benson CB, et al. Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. J Clin Endocrinol Metab, 2002, 87(11):4924-4927.
5. Chow LS, Gharib H, Goellner JR, et al. Nondiagnostic thyroid fine-needle aspiration cytology:management dilemmas. Thyroid, 2001, 11(12):1147-1151.
6. Mittendorf EA, Tamarkin SW, McHenry CR. The results of ultrasound-guided fine-needle aspiration biopsy for evaluation of nodular thyroid disease. Surgery, 2002, 132(4):648-654.
7. Anderson TJ, Atalay MK, Grand DJ, et al. Management of nodules with initially nondiagnostic results of thyroid fine-needle aspiration:can we avoid repeat biopsy? Radiology, 2014, 272(3):777-784.
8. Bohacek L, Milas M, Mitchell J, et al. Diagnostic accuracy of surgeon-performed ultrasound-guided fine-needle aspiration of thyroid nodules. Ann Surg Oncol, 2012, 19(1):45-51.
9. Grani G, Calvanese A, Carbotta G, et al. Intrinsic factors affecting adequacy of thyroid nodule fine-needle aspiration cytology. Clin Endocrinol, 2013, 78(1):141-144.
10. Degirmenci B, Haktanir A, Albayrak R, et al. Sonographically guided fine-needle biopsy of thyroid nodules:the effects of nodule characteristics, sampling technique, and needle size on the adequacy of cytological material. Clin Radiol, 2007, 62(8):798-803.
11. Moon HJ, Kwak JY, Kim EK, et al. Ultrasonographic characteristics predictive of nondiagnostic results for fine-needle aspiration biopsies of thyroid nodules. Ultrasound Med Biol, 2011, 37(4):549-555.
12. Choi SH, Han KH, Yoon JH, et al. Factors affecting inadequate sampling of ultrasound-guided fine-needle aspiration biopsy of thyroid nodules. Clin Endocrinol, 2011, 74(6):776-782.
13. Schmidt T, Riggs MW, Speights VO Jr. Significance of nondiagnostic fine-needle aspiration of the thyroid. South Med J, 1997, 90(12):1183-1186.
14. Cibas ES, Ali SZ. The Bethesda System for reporting thyroid cytopathology. Thyroid, 2009, 19(11):1159-1165.
15. Rosen JE, Stone MD. Contemporary diagnostic approach to the thyroid nodule. J Surg Oncol, 2006, 94(8):649-661.
16. Shrestha M, Crothers BA, Burch HB. The impact of thyroid nodule size on the risk of malignancy and accuracy of fine-needle aspiration:a 10-year study from a single institution. Thyroid, 2012, 22(12):1251-1256.
17. Frates MC, Benson CB, Charboneau JW, et al. Management of thyroid nodules detected at US:Society of Radiologists in Ultrasound consensus conference statement. Radiology, 2005, 237(3):794-800.
18. Gharib H, Papini E, Paschke R, et al. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract, 2010, 16 Suppl 1:1-43.
19. Mazzaferri EL, Sipos J. Should all patients with subcentimeter thyroid nodules undergo fine-needle aspiration biopsy and preoperative neck ultrasonography to define the extent of tumor invasion? Thyroid, 2008, 18(6):597-602.
20. Moon WJ, Baek JH, Jung SL, et al. Ultrasonography and ultrasoundbased management of thyroid nodules:consensus statement and recommendations. Korean J Radiol, 2011, 12(1):1-14.
21. Kim DW, Lee EJ, Kim SH, et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules:comparison in efficacy according to nodule size. Thyroid, 2009, 19(1):27-31.
22. Moon H, Son E, kim EK, et al. The diagnostic values of ultrasound and ultrasound-guided fine needle aspiration in subcentimeter-sized thyroid nodules. Ann Surg Oncol, 2012, 19(1):52-59.
23. Choi YS, Hong SW, Kwak JY, et al. Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules. Ann Surg Oncol, 2012, 19(7):2304-2309.
24. Richards ML, Bohnenblust E, Sirinek K, et al. Nondiagnostic thyroid fine-needle aspiration biopsies are no longer a dilemma. Am J Surg, 2008, 196(3):398-402.
25. 施来银. 甲状腺粗针活检的临床应用. 西安医科大学学报, 1993, 14(1):93, 98.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect on Efficiency of Thyroid Nodules' Size for Ultrasound-Guided Fine-Needle Aspiration Biopsy

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