Are scintigraphy and ultrasonography necessary before fine-needle aspiration cytology for thyroid nodules?

Dilip K. Sankhla, Samir S. Hussein, Haddia Bererhi, Omeima El Shafie, Nicholas J. Woodhouse, V. Nirmala

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3 Citations (Scopus)

Abstract

Objective: To evaluate the efficacy of scintigraphy, ultrasound and fine-needle aspiration in thyroid nodules and to establish the best diagnostic pathway in detecting thyroid cancer. Method: Two hundred and sixteen patients with thyroid nodules were examined using high-resolution ultrasonography, 99mTc thyroid scintigraphy and ultrasound-guided fine-needle aspiration. Of these, 113 patients subsequently underwent thyroidectomy. The remaining 103 were followed up for two years without any evidence of malignancy. Results: Cytopathology classified 71% of the aspirate as benign, 3% as positive for malignancy, 21% as suspected neoplasia and 5% as unsatisfactory. Fine- needle aspiration cytology had a sensitivity of 87.5% and specificity of 80%. On ultrasound 33% of malignant nodules were hypo-echoic and on scintigraphy 16% of solitary cold nodules were malignant. Neither test could reliably diagnose thyroid cancer. Conclusion: Ultrasound-guided fine-needle aspiration cytology should be the first test performed in euthyroid patients with a thyroid nodule. Scintigraphy and ultrasound imaging should be reserved for follow-up studies and patients who have suppressed levels of thyroid stimulating hormone.

Original languageEnglish
Pages (from-to)29-33
Number of pages5
JournalSultan Qaboos University Medical Journal
Volume3
Issue number1
Publication statusPublished - Apr 1 2000

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Keywords

  • Fi ne-needle aspiration cytology
  • Thyroid nodule
  • Thyroid scintigraphy
  • Ultrasonography

ASJC Scopus subject areas

  • Medicine(all)

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