• Vol. 43 No. 6, 320–324
  • 15 June 2014

Surgeon-Performed Ultrasound-Guided Fine-Needle Aspiration Cytology (SP-US-FNAC) Shortens Time for Diagnosis of Thyroid Nodules

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ABSTRACT

Introduction: Ultrasound-guided fine-needle aspiration cytology (US-FNAC) of thyroid nodules is an important diagnostic procedure. In most hospitals, patients are referred to radiologists for US-FNAC, but this often results in a long waiting time before results are available. Surgeon-performed US-FNAC (SP-US-FNAC) during the initial patient consultation attempts to reduce the waiting time but it is not known whether this is as accurate as radiologist-performed US-FNAC (RP-US-FNAC). The aim of this study is to compare the clinical efficiency between SP-US-FNAC and RP-US-FNAC.

Materials and Methods: A retrospective study was performed on patients from the Department of General Surgery, Tan Tock Seng Hospital (TTSH) who underwent an US-FNAC from August 2011 to May 2012. All cases of SP-US-FNAC were performed by a single surgeon. This study compared the rates of positive diagnoses achieved by SP-US-FNAC and RP-US-FNAC as well as the time interval to reach a cytological diagnosis by each group.

Results: A total of 40 cases of SP-US-FNAC and 72 cases of RP-US-FNAC were included in the study. SP-US-FNAC resulted in 28 (70%) positive diagnoses and 12 (30%) non-diagnoses while RP-US-FNAC resulted in 47 (65.3%) positive diagnoses and 25 (34.7%) non-diagnoses. These results were comparable (P = 0.678). The median time taken to reach a cytological diagnosis was 1 working day for SP-US-FNAC and 29.5 working days for RP-US-FNAC resulting in a shorter interval to reaching a cytological diagnosis for SP-US-FNAC (P <0.001).

Conclusion: In the workup of thyroid nodules, SP-US-FNAC is as accurate as RP-US-FNAC but significantly reduces the time taken to reach a cytological diagnosis. This leads to greater clinical efficiency in the management of patients with thyroid nodules, which in turn leads to other benefits such as decreased patient anxiety and increased patient satisfaction.


Fine-needle aspiration cytology (FNAC) is an efficient and reliable diagnostic test that is important in the evaluation of thyroid nodules. This is to exclude the possibility of a cancer, even though the vast majority of thyroid nodules are actually benign. FNAC is known to have high rates of sensitivity, specificity and diagnostic accuracy, and this has been further improved with the introduction of ultrasound guidance in FNAC. Ultrasound-guided FNAC (US-FNAC) has been proven to be superior to palpation-guided FNAC in many studies worldwide. This is due to increased sensitivity and specificity, as well as decreased rate of false negatives and sample inadequacy. This ultimately decreases the need for repeat FNAC, which incurs time and monetary cost to patients.

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