Contrast-enhanced ultrasound improves the potency of fine-needle aspiration in thyroid nodules with high inadequate risk

Tinghui Yin; Bowen Zheng; Yufan Lian; Haifeng Li; Lei Tan; Shicheng Xu; Yong Liu; Tao Wu; Jie Ren

doi:10.1186/s12880-022-00805-6

Contrast-enhanced ultrasound improves the potency of fine-needle aspiration in thyroid nodules with high inadequate risk

BMC Med Imaging. 2022 May 2;22(1):83. doi: 10.1186/s12880-022-00805-6.

Authors

Tinghui Yin^#¹, Bowen Zheng^#¹, Yufan Lian¹, Haifeng Li², Lei Tan¹, Shicheng Xu¹, Yong Liu², Tao Wu³, Jie Ren⁴

Affiliations

¹ Department of Medical Ultrasonic, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
² Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
³ Department of Medical Ultrasonic, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China. wutao22@mail.sysu.edu.cn.
⁴ Department of Medical Ultrasonic, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China. renj@mail.sysu.edu.cn.

^# Contributed equally.

Abstract

Background: This study aims to determine the clinical value of contrast enhanced ultrasound (CEUS) for fine-needle aspiration (FNA) of high inadequate risky thyroid nodules.

Methods: During April 2018 and April 2021, consecutive 3748 thyroid nodules underwent FNA were retrospectively analyzed. CEUS guided FNA (CEUS-FNA) was applied in 115 nodules with high inadequate risk in Lingnan Campus. Ten nodules underwent CEUS-FNA presented non-enhancing, and would be further analyzed independently. Other 105 partial or total enhancing nodules were included as CEUS-FNA group, and 210 nodules with high inadequate risk in Tianhe Campus were match as the US-FNA control group. FNA specimens were collected for liquid-based preparation. Cytological results were classified following the Bethesda System for Reporting Thyroid Cytopathology.

Results: The overall FNA specimen inadequate rate in our center was 6.6%. All of the ten non-enhancing nodules under CEUS have an inadequate result in cytopathological analyzes. The subsequent postoperative pathology and follow-up ultrasonography showed the non-enhancing nodules were benign or stable without further malignant features. Total specimen inadequate rate of high inadequate risk thyroid nodules in CEUS-FNA group was significantly lower than US-FNA group (6.7% vs. 16.7%, P = 0.014). Further stratified analyzed shown that FNA under US guidance, the inadequate rates in cystic, predominantly cystic, predominantly solid and solid sub-groups were 28.1%, 17.1%, 10.0% and 9.2% (P = 0.019). In contrast, the inadequate rates in cystic, predominantly cystic, predominantly solid and solid sub-groups were 7.4%, 6.7%, 5.6% and 6.7% (P = 0.996) in CEUS-FNA group.

Conclusions: CEUS can improve the specimen adequacy of FNA in high inadequate risk thyroid nodules by avoiding unnecessary FNAs of the non-enhancing nodules, and accurately locating the viable tissue and precise guidance in real-time. CEUS is a recommend modality for FNA guidance of high inadequate risk thyroid nodules.

Keywords: Adequacy; Biopsy; Contrast-enhanced ultrasound; Fine-needle aspiration; Thyroid nodules.

MeSH terms

Biopsy, Fine-Needle / methods
Humans
Retrospective Studies
Thyroid Nodule* / diagnostic imaging
Thyroid Nodule* / pathology
Ultrasonography