Comparative Analysis of Routine Fine Needle Aspiration Cytology with Ultrasound Guided Fine Needle Aspiration Cytology in Thyroid Lesions
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 1
Abstract
Introduction: Fine needle aspiration cytology of thyroid lesions is the single most sensitive, specific and cost-effective method of investigation of thyroid nodules. Most palpable thyroid nodules can readily be aspirated without ultrasound guidance. However, non-palpable nodules/ complex nodules containing large areas of cystic degeneration are preferably aspirated under sonographic guidance to increase diagnostic accuracy. With this background we aimed to evaluate and compare the diagnostic yield of routine FNAC (R-FNAC) with Ultrasound guided FNAC (US- FNAC) in thyroid lesions. Material and Methods: This was a cross sectional prospective study on all those patients who referred to the Department of Pathology for the evaluation of thyroid lesions from April 2016 to September 2016. Routine (R) FNAC and USG guided FNAC were conducted in randomly selected patient with thyroid lesions who give prior consent. Results: A total of 65 patients were aspirated by both routine as well as USG guided FNAC during a six month period. Both smears were evaluated using Bethesda system for reporting thyroid cytopathology 2007. Overall the diagnostic sample rate was increased from 76.9% (R-FNAC) to 95.38% (USFNAC). For benign lesions, the diagnostic accuracy was 74.94% and 94.54% for R-FNAC and US-FNAC respectively, with significant p value (p<0.004). With use of ultrasound guidance, the sensitivity, positive predictive value, and negative predictive value increased significantly. Among the malignant lesions, the diagnostic sample rates were 60% (R-FNAC) and 100% (US-FNAC) with a significant p value of <0.001. In addition, the inadequate specimen rate decreased from 23.1% (R-FNAC) to 4.62% (US-FNAC) Conclusion: US-FNAC improved the cytological diagnostic accuracy, sensitivity, and positive predictive value and reduced the false-negative rate in comparison with R-FNAC. US-FNAC will also avoid unnecessary repeat FNAC in cases of unsatisfactory specimens.
Authors and Affiliations
Monika B Gathwal, Chiranjeev Gathwal, Swaran Kaur, Ruchi Agarwal, Deepti Aggarwal, Vijeta Singh
Keywords
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