Accuracy of fine needle aspiration cytology and thyroid imaging reporting and data system to predict the nature of nodular goiter and its comparison with postoperative histology

Authors

  • Pratha Anantha Ramani Department of General Surgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
  • Ginni Vijay Sainath Reddy Department of General Surgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
  • Changala Glen Christopher Department of Pathology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
  • Chevuri Babu Department of radiology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
  • Atla Bhagyalakshmi Department of Pathology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
  • C. Jayaraj Department of General Surgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
  • Simhadri Uday Kiran Department of General Surgery, Visakhapatnam, Andhra Pradesh, India
  • Murali Manohar Deevi Department of General Surgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20203254

Keywords:

Nodular goitre, FNAC, TIRADS, Papillary carcinoma, Follicular carcinoma, Thyroid

Abstract

Background: Aim of the study was to find accuracy of pre-operative fine needle aspiration cytology (FNAC) and thyroid imaging reporting and data system (TIRADS) in predicting the nature of nodular goitre and confirming it with post-operative biopsy. Objective of the study was to assess the sensitivity and specificity of FNAC compared with post-operative biopsy and to assess the sensitivity and specificity of TIRADS compared with post-operative biopsy.

Methods: This retrospective study was carried out at tertiary hospital, King George Hospital, Visakhapatnam over a period of 1 year from march 2018 to march 2019. Sensitivity and specificity are calculated based on formulae.

Results: Sample size calculated with 90% confidence interval for population of vizag is 96, a sample of 100 patients were taken in this study. Of the 100 cases, 16 had thyroid carcinoma. 15 of them were papillary carcinoma and 1 follicular carcinoma. 8 cases matched with cytology report after post op biopsy and 8 we mismatched with cytology report after post op biopsy. The incidence of malignancy in clinically and cytologically benign goitre is 8.69. In our study sensitivity of FNAC is 50%, specificity is 100% and accuracy of test is 92% and TIRADS has a sensitivity of 100% and specificity of 72.62% and an accuracy of 77%.

Conclusions: The current study has showed the disparity we see in thyroid neoplasms in FNAC test and TIRADS, which were proved to be different diagnosis in clinical and histopathology, so even if cytology is benign, we can’t rule out malignancy. FNAC and TIRADS combined have more sensitivity and specificity than individual tests.

Author Biographies

Pratha Anantha Ramani, Department of General Surgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Department of General Surgery,

associate professor

Ginni Vijay Sainath Reddy, Department of General Surgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Department of General Surgery,

post gradute.

Changala Glen Christopher, Department of Pathology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Department of pathology,

post gradute.

Chevuri Babu, Department of radiology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Department of radiology,

post gradute.

Atla Bhagyalakshmi, Department of Pathology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Department of general surgery,

professor and head of department of general surgery.

C. Jayaraj, Department of General Surgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Department of pathology,

professor and head of department of pathology.

Simhadri Uday Kiran, Department of General Surgery, Visakhapatnam, Andhra Pradesh, India

Department of General Surgery,

post graduate

Murali Manohar Deevi, Department of General Surgery, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

Department of General Surgery,

post graduate

References

Trends in thyroid cancer incidence in India. Available at 0.1200/JCO.2018.36.15_suppl.e18095. Accessed on 12 May 2020.

Gangadharan P, Nair MK, Pradeep VM. Thyroid cancers in Kerala. In: Shah AH, Samuel AM, Rao RS, editors, Thyroid Cancer. An Indian Perspective. Mumbai: Quest Publications. 1999:17-32.

Whelan SL, Parkin DM, Masuyer E. Patterns of cancer in five continents. IARC Sci Publ. 1990;102:152-3.

Hanumanthappa MB, Gopinathan S, Suvarna R. Incidence of malignancy in multi-nodular goitre: prospective study at a tertiary academic Centre. J Clin Diagn Res. 2012;6:267-70.

Mulaudzi TV, Ramdial PK, Madiba TE, Callaghan RA. Thyroid carcinoma at King Edward VIII Hospital, Durban, South Africa.

East Afr Med J. 2001;78(5):242-5.

Priyadarshi N, Mistry D, Kharadi N. Study of management of solitary thyroid nodule. J Sci Res. 2013;2(3):181-4.

Venkatarao B, Subramanyam S, Kollu S. Study of association between serum TSH and thyroid nodules. J Evid Med Healthcare. 2016;3(94):5181-4.

Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: The Whickham survey. Clin Endocrinol. 1977;7:481-93.

Popivanov P, Boianov M, Temelkova N, Manolov D, Chavrakov G. Fine needle aspiration biopsy and cytologic diagnosis in thyroid disease: A 3 years’ experience. Vutr Boles. 2000;32(3):31-5.

Tabaqchali MA, Hanson JM, Johnson SJ, Wadehra V, Lennard TWJ, Proud G. Thyroid aspiration cytology in Newcastle: a six year cytology/histology correlation study. Ann R Coll Surg Engl. 2000;82:149-55.

Nanjappa BA, Mohanty A, Aroul T, Smile S, Kotasthane D. Thyroid carcinoma (TC) in nodular goiter. Thyroid Disorders Ther. 2012;1:115.

Merla J, Kalyanaraman S. Thyroid cancer and nodular goitre of thyroid: an analysis of patients in rural South Tamil Nadu. Thyroid Res Pract. 2017;14:106-11.

Sushel C, Khanzada TW, Zulfikar I, Samad A. Histopathological pattern of diagnoses in patients undergoing thyroid operations. Rawal Med J. 2009;34(1):1-7.

Pang HN, Chen CM. Incidence of cancer in nodular goitres. Ann Acad Med. 2007;36:241-3.

Stoffer RP, Welch JW, Hellwig CA, Chesky VE, Mccusker EN. Nodular goiter. Incidence, morphology before and after iodine prophylaxis, and clinical diagnosis. Arch Intern Med. 1960;106:10-4.

Pelizzo MR, Piotto A, Rubello D, Casara D, Fassina A, Busnardo B. High prevalence of occult papillary thyroid carcinoma in a surgical series for benign thyroid disease. Tumori. 1990;76:255-7.

Safirullah J, Mumtaz N, Khan A. Role of fine needle aspiration cytology (FNAC) in the diagnosis of thyroid swellings. J Postgraduate Med Inst. 2004;18(2):196-201.

Bindman SR, Lebda P, Feldstein VA. Risk of thyroid cancer based on thyroid ultrasound imaging characteristics: results of a population-based study. JAMA Intern Med. 2013;173(19):1788‐96.

Downloads

Published

2020-07-23

Issue

Section

Original Research Articles