Surgeon Performed Thyroid Ultrasound – Proving Utility and Credibility in Selecting Patients for Fine Needle Aspiration According to the American Thyroid Association Guidelines. A Retrospective Study of 500 Patients

Abstract

Design

Case series with chart review.

Setting

Single academic center.

Participants

The data of all patients who underwent surgeon performed ultrasound (SUS(between 7/2009 and 9/2012 was retrospectively reviewed.

Main Outcome Measures

A correlation between sonographic features and a non-benign cytology\malignant pathology.

Results

Four hundred ninety eight nodules were included. Solid texture, irregular margins, hypoechogenicity and intranodular vascularity were significantly associated with malignancy when benign to non-benign cytology was compared, and when compared to malignant pathology. Lack of suspicious features was significantly associated with benign lesions, with a negative predictive value of 94%. Except for taller than wider shape, malignancy odds ratio was significantly higher for known suspicious features, reaching 4.81 for irregular borders (CI 2.42-9.55, p<0.001).

Conclusions

SUS has proven to be a reliable and consistent tool to assess the thyroid nodule risk stratification. Surgeons should recognize the potential of this tool and its implementation.

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