The Sensitivity and Specificity of Fine-Needle Aspiration in Thyroid Neoplasia

AbstractObjective:To evaluate and demonstrate the accuracy of fine-needle aspiration (FNA) in thyroid lesions in our department and to highlight probable causes of errors leading to unsatisfactory sampling, which may depend on the characteristics of the nodule.Methods:This is a retrospective study conducted on 319 diagnosed cases of thyroid nodules referred to the Surgery Unit of Puls hospital, Tîrgu Mureș in the January 2014 – December 2015 period, who underwent fine-needle aspiration. Histological examination was considered to be the gold standard; therefore we compared the cytological diagnosis with the histological one.Results:Of the 319 cases, 289 (90.6%) were female and 30 (9.4%) male patients; 210 cases (69.3%) were interpreted as benign, 46 cases (15.2%) as follicular lesion of undetermined significance, 4 cases (1.3%) as suspect for malignancy, 1 case (0.3%) as malignant sampling, and 42 cases (13.9%) as unsatisfactory. We compared the results of fine-needle aspiration cytology (FNAC) with the corresponding histopathological results (49 in total). FNAC achieved a sensitivity of 76.47%, a specificity of 83.1%, a positive predictive value of 35.1%, a negative predictive value of 96.7%, a false positive rate of 16.9%, a false negative rate of 23%, and an overall accuracy of 82.3%.Conclusions:The results of our study demonstrate the accuracy of the FNA technique in the first-line diagnosis of thyroid nodules.

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Diagnostic Accuracy of Fine Needle Aspiration Cytology of Thyroid Pathologies

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v19i2.27329 ◽

2020 ◽

Vol 19 (2) ◽

pp. 84-89

Author(s):

Shova Kunwar ◽

Barsha Bajracharya ◽

Kavita Karmacharya ◽

Amar Narayan Shrestha

Keyword(s):

Fine Needle Aspiration ◽

Predictive Value ◽

Fine Needle Aspiration Cytology ◽

False Negative ◽

False Negative Rate ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Thyroid Lesion ◽

Fine Needle ◽

Needle Aspiration Cytology

Introduction: Fine needle aspiration cytology is considered as the gold standard for the diagnosis of thyroid nodules. This study aimed to evaluate and compare the accuracy of fine-needle aspiration cytology in the diagnosis of thyroid lesion by comparing it with the corresponding histopathologic diagnosis after thyroidectomy. Methods: This is a retrospective study conducted over five years at a teaching hospital in Kathmandu. Eighty-nine cases of FNAC of thyroid nodule with subsequent histopathological reports were reviewed. The corresponding reports were compared and the accuracy of FNAC diagnosis was evaluated. Results: 87% of the cases were females and the majority of cases were in the age group 41 to 50 years. Among 89 cases, 55 were reported as benign on cytology and 34 were reported as malignant. On histopathological examination, out of 55 cases diagnosed as benign on cytology, 47 cases were diagnosed as benign whereas eight cases were diagnosed as malignant. HPE of 34 cases diagnosed as malignant on cytology showed that 29 were malignant and five were benign. The false-positive rate was 9.6% and the false-negative rate was 21.6%. The sensitivity was 78.3% and specificity was 90.3%. The positive predictive value and negative predictive value were 85.2% and 85.4% respectively. The accuracy of FNAC in differentiating benign from malignant thyroid lesions was 85.3%. Conclusions: The findings of this study showed that FNAC is a sensitive method for the diagnosis of a solid thyroid lesion

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Malignancy risk and false negative rate of fine needle aspiration cytology in thyroid nodules equal or greater than 4 cm

Endocrine Abstracts ◽

10.1530/endoabs.41.gp233 ◽

2016 ◽

Author(s):

Nagihan Bestepe ◽

Didem Ozdemir ◽

Tam Abbas Ali ◽

Fatma Dilek Dellal ◽

Aydan Kilicarslan ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

False Negative ◽

False Negative Rate ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Malignancy Risk ◽

Needle Aspiration Cytology

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Association between thyroid nodule size and malignancy rate

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0156 ◽

2020 ◽

Vol 102 (1) ◽

pp. 43-48

Author(s):

M Jinih ◽

F Faisal ◽

K Abdalla ◽

M Majeed ◽

AA Achakzai ◽

...

Keyword(s):

Thyroid Nodule ◽

Fine Needle Aspiration ◽

Thyroid Nodules ◽

False Negative ◽

False Negative Rate ◽

Needle Aspiration ◽

Fine Needle ◽

Nodule Size ◽

Malignancy Risk ◽

Negative Rate

Introduction The diagnostic performance of ultrasound-fine needle aspiration to identify thyroid nodules harbouring malignancy remains variable. The aim of this study was to determine thyroid nodule size and cytological classification as predictors of malignancy risk. Materials and methods We conducted a retrospective cohort analysis at an academic hospital involving 499 consecutive patients who underwent thyroid surgery between 2004 and 2015. Results A total of 503 thyroid nodules (499 patients, 84% female; mean age 50.8 years, standard deviation, SD, 15.4 years) were analysed. Of these, 19.5% were malignant. The mean (± SD) nodule size was 3.28 ± 1.63 cm and 3.27 ± 1.54 cm for benign and malignant nodules, respectively. The odds of malignancy for thyroid nodules less than 3.0 cm was similar to those for nodules of 3.0 cm or greater (0.26 compared with 0.29; p=0.77). Overall, the sensitivity and specificity of fine-needle aspiration in this cohort were 71.4% and 100%, respectively. The overall false negative rate was 5.4%. When the cut-off of 3.0 cm was used, the false negative rate in thyroid nodules less than 3.0 cm was 0% compared with 7.0% in nodules of 3.0 cm or greater. Thus, class (p<0.01) but not nodule size (p=0.49), was associated with higher malignancy risk. Conclusions Our results suggest that thyroid nodule size did not accurately predict the risk of thyroid malignancy irrespective of fine-needle aspiration cytology. Routine diagnostic thyroid lobectomy solely owing to thyroid nodule size of 3.0 cm or greater is currently not justified.

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Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules?

International Journal of Endocrinology ◽

10.1155/2016/3803647 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 11

Author(s):

Do Hoon Koo ◽

KwangSeop Song ◽

Hyungju Kwon ◽

Dong Sik Bae ◽

Ji-hoon Kim ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Predictive Value ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

False Negative ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology ◽

Accuracy Rates

Background. Fine-needle aspiration cytology (FNAC) is diagnostic standard for thyroid nodules. However, the influence of size on FNAC accuracy remains unclear especially in too small or too large thyroid nodules. The objective of this retrospective cohort study was to investigate the effect of nodule size on FNAC accuracy. Methods. All consecutive patients who underwent thyroidectomy for nodules in 2010 were enrolled. FNAC results (according to the Bethesda system) were compared to pathological diagnosis. The nodules were categorized into groups A–E on the basis of maximal diameter on ultrasound (≤0.5, >0.5–1, >1-2, >2–4, and >4 cm, resp.). Results. There were 502 cases with 690 nodules. Overall FNAC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.4%, 98.2%, 99.4%, 86.4%, and 96.0%, respectively. False-negative rates (FNRs) of groups A–E were 3.2%, 5.1%, 1.3%, 13.3%, and 50%, respectively. Accuracy rates of groups A–E were 96.8%, 94.8%, 99%, 94.7%, and 87.5%, respectively. Conclusion. Although accuracy rates of FNAC in thyroid nodules smaller than 0.5 cm are comparable to the other group, thyroid nodules larger than 4 cm with benign cytology carry a higher risk of malignancy, which suggest that those should be considered for intensive follow-up or repeated biopsy.

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False negative rate of fine‐needle aspiration in thyroid nodules: impact of nodule size and ultrasound pattern

Head & Neck ◽

10.1002/hed.25530 ◽

2019 ◽

Vol 41 (4) ◽

pp. 967-973 ◽

Cited By ~ 2

Author(s):

Hye Shin Ahn ◽

Dong Gyu Na ◽

Jung Hwan Baek ◽

Jin Yong Sung ◽

Ji‐Hoon Kim

Keyword(s):

Fine Needle Aspiration ◽

Thyroid Nodules ◽

False Negative ◽

False Negative Rate ◽

Needle Aspiration ◽

Fine Needle ◽

Nodule Size ◽

Negative Rate

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The false-negative rate of fine-needle aspiration cytology for diagnosing thyroid carcinoma in thyroid nodules

Langenbeck s Archives of Surgery ◽

10.1007/s00423-009-0470-3 ◽

2009 ◽

Vol 395 (2) ◽

pp. 127-132 ◽

Cited By ~ 38

Author(s):

Bekir Kuru ◽

Nese Ersoz Gulcelik ◽

Mehmet Ali Gulcelik ◽

Halil Dincer

Keyword(s):

Thyroid Carcinoma ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

False Negative ◽

False Negative Rate ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology

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Malignancy risk and false-negative rate of fine needle aspiration cytology in thyroid nodules ≥4.0 cm

Surgery ◽

10.1016/j.surg.2016.03.019 ◽

2016 ◽

Vol 160 (2) ◽

pp. 405-412 ◽

Cited By ~ 9

Author(s):

Nagihan Bestepe ◽

Didem Ozdemir ◽

Abbas Ali Tam ◽

Fatma Dilek Dellal ◽

Aydan Kilicarslan ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Thyroid Nodules ◽

False Negative ◽

False Negative Rate ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Malignancy Risk ◽

Needle Aspiration Cytology

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Diagnostic Accuracy of Intraoperative Frozen Sections in the Diagnosis of Central Nervous System Lesions: A Hospital-Based Study

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v19i3.1662 ◽

2020 ◽

Vol 19 (3) ◽

Author(s):

TT Win ◽

SE Tuan Sharif ◽

AA Mat Zin

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Predictive Value ◽

Frozen Section ◽

False Positive Rate ◽

False Negative ◽

False Negative Rate ◽

Low Grade ◽

Causes Of Errors ◽

Positive Rate

Introduction: Intraoperative frozen section (FS) is an important tool in the management of neoplastic and non-neoplastic central nervous system (CNS) lesions. Although the final pathological diagnosis is based on the findings in paraffin tissue sessions, interpreting FS of CNS lesion is to assist the neurosurgeon in making the accurate judgment regarding the nature of the lesion and tissue adequacy. This study was to evaluate the agreement between FS and paraffin sections (PS) results; and to highlight the possible causes of error in discrepancy between FS and PS. Materials & Methods: This is a retrospective study of 85 cases of FS. H&E stained sections of both FS and PS of all these cases were reviewed with their histopathological reports. FS and PS results were compared. Possible causes of errors were reviewed and recorded. Results: Out of 85 cases; 76 cases (89.4%) showed no discrepancy, 2 cases (2.4%) minor discrepancy and 7 cases (8.2%) discrepancy. Sensitivity and specificity of FS were 90.1% and 85.7% respectively. Positive predictive value was 97.0% and negative predictive value was 63.1%. The false positive rate was 14.2% and false negative rate was 36.8%. The overall accuracy of FS was 89.4%. Conclusion: Our results showed high accuracy and specificity of FS. Therefore, FS is still useful, an effective tool for neurosurgeon although there are some challenges for histopathologists in reporting FS. The commonest discrepancy was seen between reactive gliosis and low-grade glioma. Over-diagnosis or under-diagnosis of FS can be reduced by closed cooperation among pathologist, neurosurgeon and radiologist.

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Pediatric Thyroid Nodules: Disease Demographics and Clinical Management as Determined by Fine Needle Aspiration Biopsy

PEDIATRICS ◽

10.1542/peds.95.1.46 ◽

1995 ◽

Vol 95 (1) ◽

pp. 46-49

Author(s):

Stephen S. Raab ◽

Jan F. Silverman ◽

Tarik M. Elsheikh ◽

Patricia A. Thomas ◽

Paul E. Wakely

Keyword(s):

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Fine Needle Aspiration Biopsy ◽

False Negative ◽

Needle Aspiration ◽

Aspiration Biopsy ◽

Benign Nodule ◽

Fine Needle ◽

Minimal Invasiveness ◽

Needle Aspiration Biopsy

Objective. The prevalence of thyroid nodularity in children has been estimated to be 1.8%. The reported prevalence of specific diseases which comprise these nodules is conflicting as evidenced by a reported range of malignancy of 2 to 50% in solitary nodules. In order to better classify pediatric (<18 years old) thyroid disease and evaluate the utility of fine needle aspiration biopsy (FNAB) in this patient population, we retrospectively reviewed 66 FNABs from 64 thyroid nodules and 2 perithyroid lymph nodes from 57 patients. Methodology. Patients: The study was composed of 8 males and 49 females who ranged in age from 1 to 18 years old (mean = 13.1). Design: Surgical and/or clinical follow-up was obtained in all patients. The 66 FNAB diagnoses were initially classified into specific diseases. However, for the purpose of this review, the cases were classified as: 3 insufficient, 51 benign, 8 suspicious, and 4 malignant. Results. There were no "false positives" and one "false negative" (a papillary carcinoma was misdiagnosed as a benign nodule). Overall, 10 patients (18%) had malignant thyroid lesions, including 8 papillary carcinomas and 2 follicular carcinomas. Benign diagnoses included benign nodule, cyst, lymphocytic thyroiditis, granulomatous thyroiditis, hyperplasia, and abscess. Conclusions. The prevalence of malignancy in pediatric patients with thyroid nodules was 18%. We conclude that, because of its high diagnostic accuracy and minimal invasiveness, FNAB is useful in the management of pediatric thyroid nodules.

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