title: Ultrasound-guided fine-needle aspiration of thyroid nodules: does the size limit its efficiency?
abstract: OBJECTIVE
  The management criterion of thyroid nodules is to evaluate the risk of malignancy, based on cytological examinations. Ultrasound-guided fine-needle aspiration biopsy (US-FNAB) has a highly diagnostic value for thyroid nodules. The aim of this study was to compare the efficacy of US-FNAB for thyroid nodules with different sizes.
  
  
  METHODS
  From August 2013 to November 2013, 344patients with thyroid nodules who had undergone US-FNAB were divided into three groups, according to the largest diameter of their nodules (group A, ≤5.0 mm; group B, 5.1-10.0 mm; group C, >10.0 mm). All the nodules were subsequently verified by histology or follow-up findings. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of aspiration cytology in each group was compared.
  
  
  RESULTS
  Among 344 thyroid nodules diagnosed by cytology, the cytology was classified as nondiagnostic or unsatisfactory for 53 (15.4%) lesions, benign for 144 (41.9%) lesions, atypia of undetermined significance or follicular lesion of undetermined significance for 20 (5.8%) lesions, follicular neoplasm or suspicious for a follicular neoplasm for 26 (7.6%) lesions, suspicious for malignancy for 36 (10.5%) lesions, malignant for 65 (18.9%) lesions. There were 243 benign and 101 malignant nodules confirmed by the pathological or follow-up ultrasound. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were confirmed to be 87.5% (14/16), 92.5% (37/40), 91% (51/56), 82.3% (14/17), and 94.8% (37/39) in group A; 92.3% (36/39), 96.9% (94/97), 95.5% (130/136), 92.3% (36/39), and 96.9% (94/97) in group B; and 91.3% (42/46), 93.4% (99/106), 92.7% (141/152) 85.7% (42/49), and 96.1% (99/103), in group C. There were no statistical differences in accuracy, sensitivity, specificity, false positive accuracy, false negative rate of fine needle aspiration of thyroid nodules with different sizes (P>0.05).
  
  
  CONCLUSIONS
  US-FNAB has similar diagnostic efficacy to thyroid nodules with different sizes.
authors.affiliation: Department of Medcial Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Department of Medcial Ultrasound, Shanghai Sixth People's Hospital, Shanghai Jiaotong University School of Medicine Shanghai 200233, China.
authors.forename: Li-Chang
authors.initials: LC
authors.lastname: Zhong
authors.affiliation: Department of Medcial Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Institute of Thyroid Diseases, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Lu
authors.affiliation: Department of Medcial Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Department of Medcial Ultrasound, Shanghai Sixth People's Hospital, Shanghai Jiaotong University School of Medicine Shanghai 200233, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Ma
authors.affiliation: Department of Medcial Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Institute of Thyroid Diseases, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Hui-Xiong
authors.initials: HX
authors.lastname: Xu
authors.affiliation: Department of Medcial Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Institute of Thyroid Diseases, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Dan-Dan
authors.initials: DD
authors.lastname: Li
authors.affiliation: Department of Medcial Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Institute of Thyroid Diseases, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Le-Hang
authors.initials: LH
authors.lastname: Guo
authors.affiliation: Department of Medcial Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Institute of Thyroid Diseases, Tongji University School of Medicine Shanghai 200072, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Sun
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000175:diagnosis*; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: US-guided fine-needle aspiration biopsy; cytopathology; follow-up; thyroid carcinoma; thyroid nodules