Association of the Thyroid Nodules With FNA
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Abstract
Thyroid nodules are a common finding in clinical practice.
Although ultrasonography is an accepted method for evaluating
these nodules, Fine Needle Aspiration (FNA) is the procedure of
choice for assessing the risk of malignancy. This study aims to determine
the association between sonographic features of thyroid nodules based on
Thyroid Imaging Reporting and Data System classification and the cytology results.
In this prospective cohort study, 147 patients from Tehran Medical Imaging Center
who had thyroid nodules underwent ultrasonography-guided FNA,
and their sonographic features were recorded.
The pathologic findings were also obtained according to the Bethesda system.
inally, the association between sonographic features and cytological results was
analyzed.
Eighteen (12.3%) nodules were malignant, and 129 nodules (87.7%) were benign. The
association of TIRADS categories with the risk of malignancy is as follows:
TIRADS 1 (n=0, 0%), TIRADS 2 (n=10, 16.9%), TIRADS 3 (n=6, 10.5%), TIRADS 4 (n=2, 16.7%), and TIRADS 5 (n=0, 0%).
The bloody lamellae of thyroid nodules were significantly correlated with
the risk of malignancy (P<0.05).
However, there was no statistically significant association between
the risk of malignancy and gender (P=0.47), calcification (P=0.9),
firmness (P=0.19), halo sign (P=0.95), location of nodules (P=0.35),
and nodules' echogenicity (P=0.058).
Although there are trusted classifications such as TIRADS for
categorizing thyroid nodules, there is still uncertainty in utilizing them,
especially in the management of nodules classified as TIRADS 2,
.
in which various sonographic features are shared between benign and malignant nodules.
Although, based on the ACR guideline, we do not perform FNA
with all nodules that have TIRADS 2, regardless of the size or other characteristics
of the nodule,
there is a possibility that some of these nodules will be malignant in the future,
so it is considered.
It seems that the guideline should be revised regarding TIRADS 2,
and under certain circumstances,
these types of nodules should also be sampled under FNA ultrasound guidance
with some criteria such as size or other features,
because there may be problems in the future,
contrary to what the guideline currently recommends,
that sampling TIRADS 2 is not required.
be created and find out that some of these types of nodules are malignant
Although currently, the ACR guideline does not recommend performing
thyroid nodule FNA with TIRADS 2
unless the patient has a positive family history of thyroid cancer,
. especially if family history is the MTC type or MEN.
Author and compiler:
Dr. Alireza Arefzadeh
endocrinology and metabolism specialist in Tehran
specialist in endocrine diseases in Tehran
the best endocrinologist in Tehran
the best endocrinologist in Tehran
the best subspecialist in Iran
the best endocrinologist in Iran
the best endocrinologist in Tehran
the best endocrinologist in Iran
the best specialist Thyroid in Tehran
FNA
thyroid ultrasound