Study of Diagnostic Efficacy of Ultrasound Guided FNAC Vs Conventional FNAC for Thyroid Nodule at a Tertiary Care
Authors/Creators
- 1. Associate Professor, Department of Pathology, PDU Medical College, Churu, Rajasthan, India
- 2. Associate Professor, Department of Radio Diagnosis, SPMC, Bikaner, Rajasthan, India
- 3. Associate Professor, Department of Medicine, PDU Medical College, Churu, Rajasthan, India
- 4. Assistant Professor, Department of Medicine, PDU Medical College, Churu, Rajasthan, India
Description
Background: FNAC of thyroid is a minimally invasive, simple and cost effective method in the diagnosis and management of palpable thyroid lesions. As the conventional FNAC procedure is an unguided procedure, many times the quality of smear is also compromised in form of blood background or less cells or inadequate smear. Ultrasound-guided fine-needle aspiration (US-FNAC) is a relatively inexpensive, useful and relatively more sensitive diagnostic tool as compared to conventional FNAC for the evaluation of nonpalpable thyroid lesions. Methods: All thyroid FNAC both conventional and ultrasound guided between Jan 2021 to Dec 2022 were included in the study. The smears were processed as per protocol and examined to compare the quality of smears. Results: We received a total of 59 samples of FNAC of thyroid gland. Of these, 36 FNACs were conventional FNAC which were done without guidance (C-FNAC) and 23 FNACs were done under USG guidance (US-FNAC). There were 22 (37.29%) male patients and 37 (62.71%) females. The age of patients ranged from 13 years to 79 years with the median age of 43 years. Histological correlation is present in 12 patients (4 C-FNAC and 8 US-FNAC). Benign lesions were the most common with 57 (96.61%) cases and only 2 cases of malignant lesions were reported, with 1 case of follicular neoplasm and 1 case of Papillary carcinoma. Both the malignant lesions were reported on US guided FNAC. Out of the 36 cases that underwent C-FNAC 10 (27.78%) were given an inadequate report. In contrast, only 1 out of 23 patients (4.35%) were given an inadequate report when US-FNAC was done. The difference between the two were significant (p value = 0.025). Conclusions: The cytological criteria for identification of a lesion are well defined. USG-guided FNAC gives an added advantage of providing a more accurate diagnosis of the lesion or the lesions in thyroid. In our study USG-guided FNAC better tissue yield and better quality of smears in comparison to conventional FNAC and improved the sensitivity and diagnostic accuracy.
Abstract (English)
Background: FNAC of thyroid is a minimally invasive, simple and cost effective method in the diagnosis and management of palpable thyroid lesions. As the conventional FNAC procedure is an unguided procedure, many times the quality of smear is also compromised in form of blood background or less cells or inadequate smear. Ultrasound-guided fine-needle aspiration (US-FNAC) is a relatively inexpensive, useful and relatively more sensitive diagnostic tool as compared to conventional FNAC for the evaluation of nonpalpable thyroid lesions. Methods: All thyroid FNAC both conventional and ultrasound guided between Jan 2021 to Dec 2022 were included in the study. The smears were processed as per protocol and examined to compare the quality of smears. Results: We received a total of 59 samples of FNAC of thyroid gland. Of these, 36 FNACs were conventional FNAC which were done without guidance (C-FNAC) and 23 FNACs were done under USG guidance (US-FNAC). There were 22 (37.29%) male patients and 37 (62.71%) females. The age of patients ranged from 13 years to 79 years with the median age of 43 years. Histological correlation is present in 12 patients (4 C-FNAC and 8 US-FNAC). Benign lesions were the most common with 57 (96.61%) cases and only 2 cases of malignant lesions were reported, with 1 case of follicular neoplasm and 1 case of Papillary carcinoma. Both the malignant lesions were reported on US guided FNAC. Out of the 36 cases that underwent C-FNAC 10 (27.78%) were given an inadequate report. In contrast, only 1 out of 23 patients (4.35%) were given an inadequate report when US-FNAC was done. The difference between the two were significant (p value = 0.025). Conclusions: The cytological criteria for identification of a lesion are well defined. USG-guided FNAC gives an added advantage of providing a more accurate diagnosis of the lesion or the lesions in thyroid. In our study USG-guided FNAC better tissue yield and better quality of smears in comparison to conventional FNAC and improved the sensitivity and diagnostic accuracy.
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Additional details
Dates
- Accepted
-
2023-06-25
Software
References
- 1. Kochupillai N. Clinical Endocrinology in India-2. Current Science. 2000; 8:1061–67. 2. Available from : http://www.ias.ac.in/currsci/oct252000/n%20k ochupillai.PDF 3. Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: The Whickham survey. Clin Endocrinol (Oxf) 1977;7:481–93. 4. Popoveniuc G, Jonklaas J. Thyroid nodules. Med Clin North Am. 2012 Mar;96(2):329-49. 5. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008;22(6):901–11. 6. Gandolfi PP, Prisina A, Raffa M, Renda P, Rochetti O, Ruggeri C. The incidence of thyroid carcinoma in multinodular goiter: a retrospective analysis. Acta Biomedica Ateneo Parmense. 2004;75;114-7. 7. Kilfroy BA, Zheng T, Halford TR, Han X, Ward MH, Sjodin A. International patterns and trends in the thyroid cancer incidence 1973- 2002. 8. Klemi PJ, Joensuu H. FNAC in the diagnosis of the thyroid nodules. Acta Cytol 1991;35:434-38 9. Kelly NP, Lim JC, DeJong S, Harmath C, Dudiak C, Wojcik EM. Specimen adequacy and diagnostic specificity of ultrasound-guided fine needle aspirations of nonpalpable thyroid nodules. Diagn Cytopathol. 2006 Mar; 34(3):188-90. 10. Ashwini, B R et al. "Comparative study of conventional and ultrasound- guided fine needle aspiration cytology of thyroid in a tertiary care center of north Karnataka." International Journal of current research and review 4 (2012): 64-69. 11. Bajaj Y, De M, Thompson A. Fine needle aspiration cytology in diagnosis and management of thyroid disease. J Laryngol Otol. 2006;120:467–469. 12. Bagga PK, Mahajan NC. Fine needle aspiration cytology of thyroid swellings: How useful and accurate is it? Indian J Cancer. 2010; 47:437–442. 13. Gupta M, Gupta S, Gupta VB. Correlation of fine needle aspiration cytology with histo pathology in the diagnosis of solitary thyroid nodule. J Thyroid Res. 2010; 2010:379051. 14. Sajikumar, N. R. and Vani Ramkumar. "Comparison of conventional and ultrasonologically guided fine needle aspiration cytology of the solitary nodule of the thyroid gland." International Surgery Journal 4 (2017): 1550-1554. 15. Likhar, Komal Singh; Hazari, Rakesh A.; Gupta, Santosh G.; Shukla, Umashankar. Diagnostic accuracy of fine needle aspiration cytology in thyroid lesions: A hospital-based study. Thyroid Research and Practice 10(2):p 68-71, May–Aug 2013. 16. Dr. Poorva Kalsariya, Dr. Hemina Desai, Dr. Hansa Goswami. USG guided FNAC of thyroid improving diagnostic accuracy. Int J Clin Diagn Pathol 2022;5(2):26-30. 17. Danese D, Sciacchitano S, Farsetti A, Andreoli M, Pontecorvi A. Diagnostic accuracy of conventional versus sonography-guided fineneedle aspiration biopsy of thyroid nodules. Thyroid. 1998 Jan;8(1):15-21. 18. Sharma M, Mahore S. A Comparison of the Diagnostic Efficiency of Guided Fine Needle Aspiration Cytology Versus Conventional Fine Needle Aspiration Cytology of the Thyroid. Indian J Otolaryngol Head Neck Surg. 2019 Oct; 71(Suppl 1):152-156.