Matthew C. Leinung, MD; Andrew Gianoukakis, MD; Daniel W. Lee, MD
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Leinung MC, Gianoukakis A, Lee DW. Ultrasonography in Management of Nodular Thyroid Disease. Ann Intern Med. 2001;135:383. doi: 10.7326/0003-4819-135-5-200109040-00023
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Published: Ann Intern Med. 2001;135(5):383.
TO THE EDITOR:
Since up to 67% of patients with no history of thyroid disease are found to have nodules on ultrasonography, routine use of this test will lead to the discovery of many clinically insignificant lesions (1). The finding by Marqusee and colleagues (2) that clinical management changed after ultrasonography in 63% of patients merely reflects the sensitivity of ultrasonography and the study's design. The authors performed routine fine-needle aspiration for lesions that were at least 1 cm in diameter. Fine-needle aspiration has a positive predictive value of 50% and a false-positive rate of 3% (3) and therefore leads to unnecessary surgical procedures. Of the 209 nodules for which biopsies were performed in this study, 35 (17%) were suspicious or atypical, and 18 of these patients proceeded to surgery. Malignancy was confirmed in 6, indicating that 12 unnecessary surgeries took place (1).
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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