Abstract
The Bethesda criteria are proposed for appropriate stratification of malignancy risk in thyroid nodules, but controversy exists regarding their accuracy and reliability in decision making. Additionally, previous studies have suggested higher rates of both malignancy and false negative fine needle aspiration biopsy (FNA) associated with increasing nodule size. This study aims to determine the accuracy of ultrasound (US)-guided FNA using the current Bethesda criteria in surgical practice. We also aimed to investigate the relationship between nodule size and malignancy. A retrospective analysis of US-guided FNAs by a single surgeon during a 4.5 year period. FNA results using Bethesda criteria were compared to final surgical pathology. 611 patients with thyroid nodules underwent US-guided FNA. FNA results in 375 subsequently excised thyroid nodules were recorded according to the Bethesda criteria: 192 (51%) benign, 65 (17%) atypia of unknown significance/follicular lesion of undetermined significance (AUS/FLUS), 42 (11%), suspicious for follicular neoplasm (SFN), 17 (5%) suspicious for malignancy (SM), 28 (8%) malignancy, and 31 (8%) non-diagnostic. Malignancy was confirmed by surgical pathology in 15%, 34%, 50%, 88%, 100%, and 39%...Continue Reading
References
Feb 15, 1993·Annals of Internal Medicine·H Gharib, J R Goellner
Dec 16, 2003·American Journal of Surgery·Guido M SclabasDouglas B Evans
Apr 10, 2004·Thyroid : Official Journal of the American Thyroid Association·Michael W YehOrlo H Clark
Jul 15, 2006·Thyroid : Official Journal of the American Thyroid Association·Mustafa CesurNuri Kamel
Nov 30, 2006·Journal of Surgical Oncology·Jennifer E Rosen, Michael D Stone
Dec 14, 2006·Advances in Surgery·Jennifer B OgilvieOrlo H Clark
Aug 8, 2007·Cancer·Jack YangPatricia G Wasserman
Aug 25, 2007·Annals of Surgery·Karl Y BilimoriaCord Sturgeon
Nov 14, 2007·Cancer·Leila YassaErik K Alexander
Dec 8, 2007·Surgery·Kelly L McCoyJohn H Yim
Apr 9, 2008·CytoJournal·Zubair W BalochAndrea Abati
Dec 2, 2008·Surgery·John R PorterfieldThomas J Sebo
Apr 22, 2009·Cancer·Ritu Nayar, Marina Ivanovic
Oct 29, 2009·Thyroid : Official Journal of the American Thyroid Association·UNKNOWN American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid CancerR Michael Tuttle
Nov 6, 2009·Thyroid : Official Journal of the American Thyroid Association·Edmund S Cibas, Syed Z Ali
Nov 6, 2009·Thyroid : Official Journal of the American Thyroid Association·Constantine G A TheoharisDavid C Chhieng
Jan 6, 2010·Diagnostic Cytopathology·William C Faquin, Zubair W Baloch
Dec 31, 2010·Thyroid : Official Journal of the American Thyroid Association·Chung-Che Charles WangRichard B Lanman
May 24, 2011·Journal of the American College of Surgeons·John I LewCarmen C Solorzano
Jun 1, 2011·ORL; Journal for Oto-rhino-laryngology and Its Related Specialties·Emad KandilBernard M Jaffe
Jun 3, 2011·Annals of Surgical Oncology·Linda BohacekEren Berber
Aug 13, 2011·Thyroid : Official Journal of the American Thyroid Association·Jung Hyun YoonEun-Kyung Kim
Sep 1, 2011·Surgery·Melanie GoldfarbJohn I Lew
Nov 19, 2011·American Journal of Clinical Pathology·Remmi S Singh, Helen H Wang
Dec 22, 2011·Yonsei Medical Journal·Ernest L Mazzaferri
Apr 25, 2012·World Journal of Surgery·Dhafir Al-azawiJulie A Miller
Dec 18, 2013·Thyroid : Official Journal of the American Thyroid Association·Allen S HoLuc G T Morris
Sep 15, 2014·Surgery·Aarti MathurMatthew T Olson
Citations
May 5, 2016·Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale·Sarah KhalifeRichard J Payne
Aug 1, 2016·American Journal of Surgery·Ahmed DeniwarEmad Kandil
Sep 13, 2016·Head & Neck·You-Bin LeeSun Wook Kim
Dec 8, 2016·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·J Matthew DebnamBeth S Edeiken-Monroe
Jul 7, 2017·Journal of Zhejiang University. Science. B·Massimo GiustiGianluca Ansaldo
Oct 4, 2018·Thyroid : Official Journal of the American Thyroid Association·Nicole A CiprianiRaymon H Grogan
Aug 4, 2018·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Yi-Ju WuChih-Che Lin
Apr 27, 2018·International Journal of Endocrinology and Metabolism·Beatriz Godoi CavalheiroClaudio Roberto Cernea
Feb 6, 2017·Langenbeck's Archives of Surgery·Augustas BeišaKęstutis Strupas
Dec 4, 2016·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Sandrine EstebeFranck Jegoux
Jun 12, 2019·Scientific Reports·Krzysztof KaliszewskiZdzisław Forkasiewicz
Mar 2, 2021·Journal of Clinical & Translational Endocrinology·Adnan ZahidUmal Azmat
Jul 12, 2020·Oral Oncology·Zaid Al-QurayshiGregory W Randolph