Ensuring patient safety when implementing a new diagnostic pathway for thyroid nodules

被引:2
作者
Brimioulle, M. [1 ]
Al-Lami, A. [2 ]
Marzouk, S. [2 ]
Emerson, H. [3 ]
Balfour, A. [2 ]
Dhar, V. [2 ]
Nixon, I. J. [2 ]
机构
[1] Brighton & Sussex Univ Hosp, Royal Sussex Cty Hosp, Ear Nose & Throat Dept, Brighton, E Sussex, England
[2] East Kent Hosp Univ Fdn Trust, William Harvey Hosp, Ear Nose & Throat Dept, Ashford, Kent, England
[3] Medway Maritime Hosp, Ear Nose & Throat Dept, Gillingam, England
关键词
Otolaryngology; Thyroid gland; Thyroid nodule; Ultrasonography; Fine-needle biopsy; ULTRASOUND; US; MALIGNANCY; BENIGN; DIFFERENTIATION; FEATURES; RISK;
D O I
10.1308/rcsann.2018.0031
中图分类号
R61 [外科手术学];
学科分类号
摘要
INTRODUCTION The aim of this study was to determine whether ultrasound alone is sufficient to safely exclude malignancy in thyroid nodules in a district general hospital setting, to comply with the latest British Thyroid Association guidelines. METHODS This retrospective study investigated the quality of ultrasound reporting and the correlation between ultrasound report and histology for individual thyroid nodules. Cases were selected from the thyroid multidisciplinary meeting and included all patients having undergone surgery for a thyroid malignancy in a one-year period. RESULTS Forty-seven patients were included in the study. Ultrasound reports were reviewed and assessed, in which 21 clinicians were involved; 36% of scans included a summary of whether the nodule(s) overall appeared benign, equivocal, suspicious or malignant; 4% of reports included a U classification; 81% of reports commented on cervical lymph nodes. Ultrasound was compared with histology. The sensitivity of ultrasound in correctly identifying nodules requiring further investigation was of 56% and specificity was 81%. Positive predictive value was 81% and negative predictive value was 56%. DISCUSSION These findings suggest that, in a district general hospital setting without a dedicated head and neck radiologist, using only ultrasound and limiting fine-needle aspiration cytology to identify suspicious nodules may not be safe, as a high number of nodules appearing benign on ultrasound may ultimately prove to be malignant.
引用
收藏
页码:366 / 370
页数:5
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