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Usefulness of Ultrasonography in the Management of Nodular Thyroid Disease

Ellen Marqusee, MD; Carol B. Benson, MD; Mary C. Frates, MD; Peter M. Doubilet, MD, PhD; P. Reed Larsen, MD, FRCP; Edmund S. Cibas, MD; and Susan J. Mandel, MD, MPH
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Copyright ©2004 by the American College of Physicians

Ann Intern Med. 2000;133(9):696-700. doi:10.7326/0003-4819-133-9-200011070-00011
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Background: Fine-needle aspiration biopsy is the standard diagnostic test for evaluating possible malignancy in a thyroid nodule.

Objective: To evaluate the role of routine ultrasonography in the management of nodular thyroid disease.

Design: Retrospective chart review.

Setting: Multidisciplinary thyroid nodule clinic (endocrinology and radiology).

Patients: Patients with suspected nodular thyroid disease or suspected recurrent thyroid cancer referred between October 1995 and March 1997. All patients had thyroid ultrasonography and ultrasonography-guided fine-needle aspiration biopsy of nodules at least 1 cm in maximum diameter.

Measurements: Medical records, ultrasonography findings, cytology reports, and histologic reports were reviewed. Ultrasonography findings were compared with the referring physician's findings on physical examination.

Results: 223 patients were seen in the clinic. A total of 209 fine-needle aspiration biopsies were performed on 156 patients. Among 50 of 114 patients referred for a solitary nodule, ultrasonography detected additional nonpalpable nodules at least 1 cm in diameter in 27 and determined that no nodules required aspiration in 23. Of 59 patients referred for a diffuse goiter or a multinodular gland, ultrasonography detected discrete nodules at least 1 cm in diameter that required aspiration in 39 and determined that aspiration was unnecessary in 20.

Conclusions: Ultrasonography altered the clinical management for 63% of the patients (109 of 173) referred to the thyroid nodule clinic after abnormal results on thyroid physical examination.





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Ultrasonography in the Management of Thyroid Nodules

Copyright ©2004 by the American College of Physicians


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