Purpose: The aim of this study was to assess the diagnosis accuracy rate of neck ultrasonography (US) characteristics in thyroid cancer.
Materials and methods: A retrospective study of patients who underwent thyroid surgery for palpable thyroid nodules at the department of Otolaryngology Head and Neck surgery, Kaohsiung Medical University Hospital, Taiwan.
Results: Between January 1993 and December 2006, 378 patients with palpable thyroid nodules underwent thyroid total lobectomy or total thyroidectomy. Preoperation evaluations included neck US, ultrasound-guided fine-needle aspiration cytology (USGFNA) and technetium-99m scintigraphy. Postoperative histopathology revealed 297 are benign and 81 are malignant. Comparing preoperative surveys with postoperative histopathology, the outcome analyses included the sensitivity, specificity, accuracy rate, positive predictive value and negative predictive value. The sensitivity of US, USGFNA, and technetium-99m scintigraphy were, respectively, 51.9%, 75.0%, and 73.8%; the specificity were, respectively, 93.9%, 94.6%, and 25.3%; the accuracy rate were, respectively, 86.8%, 90.8%, and 35.0%; positive predictive value were, respectively, 63.6%, 76.9%, and 19.8%; negative predictive value were, respectively, 90.5%, 94.1%, and 79.5%.
Conclusions: The neck US is a useful method in the evaluation of thyroid nodules, and the US characteristics can be used to distinguish the risk of malignant thyroid nodules. We recommend neck US in all patients with thyroid nodules, and if any malignant characteristics were noted, USGFNA can be arranged.