DIAGNOSTIC ACCURACY OF THYROID ULTRASOUND IN DETECTION OF MALIGNANCY IN THYROID NODULES
Background: Occurrence of thyroid nodules is a common clinical problem in Pakistan being endemic area for hypothyroidism. This study was carried out to evaluate the diagnostic accuracy of thyroid ultrasound in detection of malignancy in thyroid nodules keeping Fine Needle Aspiration Cytology (FNAC) as a gold standard. Methods: A descriptive cross-sectional validation study was conducted at Departments of Radiology and Pathology, Shaikh Khalifa Bin Zayed Al-Nahyan Hospital/ CMH, Muzaffarabad from Dec 2014 to Jun 2015. Patients referred for evaluation of thyroid nodules were included in the study. Ultrasound guided FNAC was performed under direct imaging guidance. The imaging findings and FNAC were compared to access the diagnostic accuracy of ultrasound in predicting malignancy in thyroid nodules. Results: A total of 175 patients were studied with age range between 20â€“70 years. Mean age of the patients was 44.05Â±14.8 years. Of these, 35.4% were males and 64.6% were females. On FNAC, 27.4% cases were positive and 72.6% cases were negative while on thyroid ultrasound 26.3% cases were positive and 73.7% cases were negative. True positive were 24.0%, false positive 2.3%, false negative 3.4%, and true negative were 70.3%. Thyroid ultrasound showed sensitivity 87.5%, specificity 96.8%, diagnostic accuracy 94.2%, positive predictive value 91.3% and negative predictive value 95.3%. Conclusion: High resolution ultrasound is a very useful tool in accessing and selecting thyroid nodules for biopsy with a high diagnostic accuracy.
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