Relevance of Ultrasound in the Diagnosis and Management of Malignancy of the Thyroid Disorders

Abstract

BACKGROUND: The recent prevalence of ultrasonography has facilitated the early detection and qualitative evaluation of thyroid nodules – to differentiate between thyroid carcinoma and benign nodule, between metastatic lymph node and reactive node. It has moved from the suite of the radiologist to the surgeon’s office. AIM OF THE STUDY: The aim of the present study was to evaluate the relevance of SPUS in the diagnosis and surveillance of malignancy of the thyroid. METHODS: Surgeon performed ultrasound for 389 patients and the data of 350 patients who underwent total thyroidectomy was compared with the report of the RPUS, FNAC and HPE. The sensitivity, specificity, positive predictive value, negative predictive value for each was calculated. The nodule characteristics – echogenicity, margins and calcifications were analysed for correlation with malignancy. CONCLUSIONS: Surgeon who is more familiar with the anatomy and patho-physiology of thyroid disorders triages the nodule better. Multivariate analysis of nodule characteristics showed that heteroechogenicity, irregular margins and microcalcifications had a greater association with DTC after adjustment for the other characteristics