title: The results of ultrasound-guided fine-needle aspiration biopsy for evaluation of nodular thyroid disease.
abstract: BACKGROUND
  The purpose of this study was to determine whether ultrasonography (US) improves the accuracy and reduces the rate of nondiagnostic fine-needle aspiration biopsy (FNAB) of thyroid nodules.
  
  
  METHODS
  A review of 536 consecutive patients evaluated for nodular thyroid disease from 1990 to 2001 was completed to determine the results for US vs palpation-guided FNAB.
  
  
  RESULTS
  FNAB was used to evaluate 458 patients. US-guided FNAB was performed in 66 (12%) patients: 48 with a nonpalpable nodule, 14 with nondiagnostic standard FNAB, and 4 with a palpable nodule. US-guided FNAB was nondiagnostic in 15 (23%) patients. There were no false-positive or false-negative results. Standard FNAB was performed in 407 patients, 57 (14%) of whom had a nondiagnostic result. There were 2 (3%) false-positive and 3 (1.6%) false-negative results. In 14 patients with a nondiagnostic standard FNAB, US-guided FNAB yielded an adequate specimen in 7 (50%). Nodules evaluated by standard FNAB were 4.1 +/- 0.1 cm (mean +/- SEM) in size compared with 2.5 +/- 0.1 cm for nodules evaluated by US-guided FNAB (P <.05).
  
  
  CONCLUSIONS
  US improves the diagnostic yield in selected patients with nondiagnostic standard FNAB. The higher frequency of nondiagnostic US-guided FNAB was related to its selective use in patients with smaller nodules.
authors.affiliation: Department of Surgery, Uniformed Services, University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Mittendorf
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Tamarkin
authors.forename: Christopher R
authors.initials: CR
authors.lastname: McHenry
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D003937:Diagnosis, Differential; D006042:Goiter / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008499:Medical Records; D010173:Palpation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D013966:Thyroiditis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014463:Ultrasonography / Q000379:methods