A Novel and Reliable Method to Reduce Unnecessary Thyroid Biopsies (FNAC)

Document Type



Imaging and Diagnostic Radiology (East Africa)



Thyroid nodules are common and many are encountered incidentally. Image characterization of thyroid nodules as either benign or malignant still remains a challenge and many undergo unnecessary fine needle aspiration cytology (FNAC). The aim of this study is to reliably identify benign thyroid nodules by adopting an ultrasound scoring criterion that can preclude further investigation by FNAC.

Material & Methods

205 nodules in prospective patients undergoing ultrasound-guided FNAC were evaluated and labeled as benign, borderline or malignant using an ultrasound index scoring system. The results were compared with FNAC findings and accuracy of ultrasound was calculated using cytology/histology as the final diagnosis.


All 153 nodules labeled as benign on ultrasound were confirmed to be benign on histology (accuracy of 100%). Of all the ultrasound characteristics that were analyzed, the most significant ones were nodule shape, margins, vascularity and microcalcification.


If ultrasound characterization of a thyroid nodule using our index scoring system is benign, FNAC need not be performed. This would preclude FNAC in 75% of cases and is a useful triaging tool.

Publication (Name of Journal)

Ultrasound in Medicine and Biology