title: Diagnostic validity of ultrasonography in thyroid nodules.
abstract: OBJECTIVE
  To determine the diagnostic validity of thyroid ultrasound in differentiating between benign and malignant thyroid nodules.
  
  
  METHODS
  The cross-sectional study was conducted at Aga Khan University Hospital, Karachi, from August 2011 to January 2013, and comprised all patients of either gender with thyroid nodules referred for ultrasound thyroid and fine needle aspiration cytology. Ultrasonography was performed by radiologists and ultrasound parameters were assessed and compared with cytology results in all nodules. Diagnostic validity of each ultrasound feature was calculated.
  
  
  RESULTS
  Of the 101 patients, 81(80%) were female. The overall mean age was 43±13 years (range: 15-73 years). On histocytopathology, 96(95%) nodules were benign and 5(4.9%) were malignant. The sensitivity and specificity of ultrasound features in predicting malignancy were calcification 80% and 68%; hypoechogenecity 80% and 52%; ill-defined lobulated margin 40% and 96%; solid 80% and 40%; taller than wider 50% and 63%. Each ultrasound feature had negative predictive value ranging from 95% to 98% in malignant nodules.
  
  
  CONCLUSIONS
  Identification of calcification, hypoechogenecity and solid with ill-defined margins in a thyroid nodule on ultrasound was helpful in suspecting thyroid malignancy and warranted urgent diagnostic fine needle aspiration cytology.
authors.affiliation: Section of Endocrinology, Department of Medicine, Karachi.
authors.forename: Nanik
authors.initials: N
authors.lastname: Ram
authors.affiliation: Department of Radiology, Aga Khan University Hospital, Karachi.
authors.forename: Saima
authors.initials: S
authors.lastname: Hafeez
authors.affiliation: Department of Radiology, Aga Khan University Hospital, Karachi.
authors.forename: Saqib
authors.initials: S
authors.lastname: Qamar
authors.affiliation: Section of Endocrinology, Department of Medicine, Karachi.
authors.forename: Syed Zubair
authors.initials: SZ
authors.lastname: Hussain
authors.affiliation: Department of Endocrinology, Liaquat National Hospital and Medical College, Karachi.
authors.forename: Ali
authors.initials: A
authors.lastname: Asghar
authors.affiliation: Department of Radiology, Aga Khan University Hospital, Karachi.
authors.forename: Zahid
authors.initials: Z
authors.lastname: Anwar
authors.affiliation: Section of Endocrinology, Department of Medicine, Karachi.
authors.forename: Najmul
authors.initials: N
authors.lastname: Islam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D002291:Carcinoma, Papillary; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D047368:Tumor Burden; D014463:Ultrasonography; D055815:Young Adult
keywords: Thyroid nodule, Ultrasonography, Validity.