Diagnostic accuracy of ultrasonography in goiters: a tertiary centre experience
DOI:
https://doi.org/10.18203/2320-6012.ijrms20174955Keywords:
Diagnosis, Thyroid, Thyroid nodules, UltrasonographyAbstract
Background: Thyroid diseases are highly prevalent in India, especially in the southern states. Evaluation of thyroid pathologies revolves mainly on imaging and cytology. Recent advances in thyroid imaging have greatly improved the diagnosis, treatment and follow-up in thyroid diseases. Though there are advanced modalities including Computed Tomography and Magnetic Resonance Imaging, Ultrasonography remains the cornerstone for the evaluation of thyroid gland, due to its ubiquitous availability and cost-effectiveness. The objectives of the study were to find out the diagnostic accuracy of ultrasonography in thyroid swellings and to find out the most reliable diagnostic feature of thyroid malignancy in ultrasonography.
Methods: This was an observational study, conducted on 71 patients admitted to the General surgical wards of Government Medical College, Trivandrum, with thyroid swellings, for a period of 18 months. For all these patients, ultrasound scan of the thyroid gland was done on an ultrasound machine with a 17/5 MHz linear transducer, by experienced faculty.
Results: Ultrasonography was found to have a sensitivity of 87.2% and a specificity of 79.2% in diagnosing thyroid pathologies. The most common malignancy of thyroid found in the study was papillary carcinoma and the most reliable ultrasound finding suggestive of malignancy was microcalcification.
Conclusions: As per the present study, it is concluded that high resolution ultrasonography is very useful in diagnosing the nature of thyroid swellings, with an accuracy rate of 84.5%. Ultrasonography is a valuable diagnostic tool in the evaluation of thyroid diseases and is the imaging modality of choice.
Metrics
References
Holden A. The role of colour and duplex Doppler ultrasound in the assessment of thyroid nodules. Australas Radiol. 1995;39:343-9.
Cibas ES, Ali SZ. NCI Thyroid FNA State of the Science Conference. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132(5):658-65.
Bukhari U, Sadiq S, Memon J, Baig F. Thyroid carcinoma in Pakistan: a respective review of 998 cases from an academic referral center. Hematol Oncol Stem Cell Ther. 2009;2:345-48.
Li RQ, Yuan GH, Chen M, Shao YM, Zhu SN, Zhang JQ, et al. Evaluation of Diagnostic Efficiency of Ultrasound Features on Malignant Thyroid Nodules in Chinese Patients. Chin Med J Engl. 2016;129(15):1784-8.
Salmaslioglu A, Erbil Y, Dural C, Issever H, Kapran Y, Ozarmagan S, et al. Predictive value of sonographic features in preoperative evaluation of malignant thyroid nodules in a multinodular goiter. World J Surg. 2008;32:1948-54.
Haugen BR, Alexander EK, Bible KC, Doherty G, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2015:1-411.
Kim DW, Park HK, Ha TK, Kim SH, Jung SJ, Kim DH, et al. Sonographically based diagnosis of contralateral malignancy in preoperative patients with papillary thyroid microcarcinoma. J Ultrasound Med. 2015;34(5):78995.
Dhanadia A, Shah H, Dave A: Ultrasonographic and FNAC correction of thyroid lesions. Gujarat Medical J. 2014;69:1.
Zhong LC, Lu F, Ma F, Xu HX, Li DD, Guo LH, et al. Ultrasound guided fine needle aspiration of thyroid nodules: does the size limit its efficiency? Int J Clin Exp Pathol. 2015;8(3):31559.
Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87:1941-6.
Cerbone G, Spiezia S, Colao A, Di Sarno A, Assanti AP, Lucci R, et al. Power-Doppler improves the diagnostic accuracy of color Doppler ultrasonography in cold thyroid nodules: follow-up results. Horm Res. 1999;52:19-24.
Lagalla R, Caruso G, Novara V, Cardinale AE. Flowmetric analysis of thyroid diseases: hypothesis on integration with qualitative color-Doppler study. Radiol Med. 1993;85:606-10.
Chammas MC, Gerhard R, Oliveira IR. Thyroid nodules: evaluation with power Doppler and duplex Doppler ultrasound. Otolaryngol Head Neck Surg. 2005;132:874-82.
Faria MAS, Casulari LA. Comparação das classificações dos nodules de tireoide ao Doppler colorido descritas por Lagalla e Chamas. Arq Bras Endocrinol Metab. 2009;53:811-7.
Cronan JJ. Thyroid nodules: is it time to turn off the US machines? Radiology 247, 602–604, doi: 10.1148/radiol.2473072233 (2008).
Bonavita JA, Mayo J, Babb J, Bennett J, Oweity T, Macari M, et al. Pattern recognition of benign nodules at ultrasound of the thyroid: which nodules can be left alone? AJR. Americ J Roentgenol. 2009;193:207-13.
Kim EK, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR. Americ J Roentgenol. 2002;178:687-91.
Wienke JR, Chong WK, Fielding JR, Zou KH, Mittelstaedt CA. Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. J Ultrasound Med. 2003;22:1027-31.
Zhu SL, Jiang YX, Yang X, Wu Q, Zhao RN, Li JC, et al. Onion Skin-liked Sign” in Thyroid Ultrasonography: A Characteristic Feature of Benign Thyroid Nodules. Chin Med J Engl. 2016;129(13):1533-7.
Alves MLD, Gabarra MHC. Comparison of power Doppler and thermography for the selection of thyroid nodules in which fine-needle aspiration biopsy is indicated. Radiol Bras. 2016;49(5):311-5.
Horvath E, Majlis S, Rossi R, Franco C, Niedmann JP, Castro A, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab. 2009;94:1748-51.
Park JY, Lee HJ, Jang HW, Kim HK, Yi JH, Lee W, et al. A proposal for a thyroid imaging reporting and data system for ultrasound features of thyroid carcinoma. Thyroid. 2009;19:1257-64.
Wei X, Li Y, Zhang S, Gao M. Thyroid imaging reporting and data system (TI-RADS) in the diagnostic value of thyroid nodules: a systematic review. Tumour Biol. 2014;35:6769-76.
Migda B, Słapa R, Bierca J, Slowińska-Srzednicka J, Migda A, Dobruch-Sobczak K, Jakubowski W. Differentiation of thyroid nodules in multinodular goiter with the application of technical ultrasound advances-initial results. Endokrynologia Polska. 2016;67(2):157-65.
Zhang YZ, Xu T, Gong HY, Li CY, Ye XH, Lin HJ, et al. Application of high-resolution ultrasound, real-time elastography, and contrast-enhanced ultrasound in differentiating solid thyroid nodules. Medicine. 2016;95(45):e5329.