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The precision of ultrasonography and fine needle aspiration cytology in the evaluation of thyroid nodules in correlation with histopathology: A retrospective study

--- Background and Objectives: The incidence of palpable thyroid nodules is approximately 4%–7% in the population. Most thyroid nodules are benign in nature but malignancy should be ruled out, which is quite less frequent. In such cases, a reliable diagnostic modality to evaluate and differentiate the malignant thyroid nodules is required. This retrospective study was conducted with the objective to evaluate the accuracy of Fine Needle Aspiration Cytology (FNAC) and Ultrasonography (USG) for diagnosis of euthyroid nodules & to differentiate malignant thyroid nodules from the benign nodules in comparison to histopathological diagnosis. Methodology: It’s a retrospective study that included 132 patients who underwent USG and FNAC of positive rate, false-negative rate and accuracy of USG of thyroid lesions were 78.95%, 91.15%, 60%, 96.26%, 8.85%, 21.05%, 89.39% respectively. FNAC diagnosis was recorded as per the Bethesda System. Out of 132 patients, FNAC was nondiagnostic/ unsatisfactory due to scanty cellularity in 4(3.03%) patients. Benign nodules were seen in 81(61.36%) patients. On histopathology examination, benign and malignant nodules were seen in 113 (85.60%) and 19 (14.39%) patients respectively. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), false-positive rate, false negative rate and accuracy for FNAC was 89.47 %, 73.45 %, 36.96 %, 97.65 %, 26.55 %, 10.53 %, 75.76% respectively. USG and FNAC findings were strongly associated (p-value <0.001). Conclusion: The overall accuracy of USG and FNAC was acceptable in our study in correlation with the previous studies reported in the literature. USG and FNAC are the accurate modalities for the assessment of thyroid nodule variants. The combination of these modalities upsurges the accurateness to rule out malignant nodules so as to decrease the number of avoidable surgeries for benign lesions.