title: Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules smaller than 5 mm in the maximum diameter: assessment of efficacy and pathological findings.
abstract: OBJECTIVE
  The aim of this study was to determine the efficacy of the use of an ultrasound-guided fine-needle aspiration biopsy (US-FNAB) to diagnose thyroid nodules smaller than 5 mm in the maximum diameter and to evaluate pathological findings of small thyroid malignancies.
  
  
  METHODS
  From May 2007 to April 2008, we evaluated the findings of US-FNABs of small thyroid nodules less than 5 mm in the maximum diameter. The cytopathological findings were retrospectively reviewed and the diagnostic performance of the use of an US-FNAB was examined in all patients.
  
  
  RESULTS
  Of 201 small thyroid nodules in 180 patients, there were 162 adequate specimens (81%). Among 180 patients, 75 patients underwent thyroid surgery and 50 malignant and 33 benign nodules were identified based on a pathological examination. All small malignant thyroid nodules were identified as papillary thyroid microcarcinomas (PTMCs). There were 34 (55%) true positive, 0 (0%) false positive, 23 (37%) true negative and five (8%) false negative results for malignancy after performing a first US-FNAB in 62 surgically confirmed nodules. The sensitivity (87%), specificity (100%), positive predictive value (100%), negative predictive value (82%), accuracy (92%), false positive rate (0%) and false negative rate (8%) for an US-FNAB were determined. In 23 patients with a primary PTMC, capsular invasion (9%, 2 of 23), a perithyroidal lymph node metastasis (30%, 7 of 23), the rate of multifocality (9%, 2 of 23) and bilaterality (4%, 1 of 23) were also determined.
  
  
  CONCLUSIONS
  An US-FNAB of thyroid nodules smaller than 5 mm in the maximum diameter is an effective diagnostic procedure.
authors.affiliation: Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. dwultra@lycos.co.kr
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Auh Whan
authors.initials: AW
authors.lastname: Park
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Lee
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Choo
authors.forename: Sang Hyo
authors.initials: SH
authors.lastname: Kim
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.forename: Jae Wook
authors.initials: JW
authors.lastname: Eom
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology*; D018084:Ultrasonography, Interventional