Accuracy of Neck U/S in Comparison with Frozen Section in Suspicious solitary thyroid nodule.

Abstract

Background:The vast majority of the population, particularly women, frequently develop thyroid nodules. The therapeutic incidence is between 4% and 7%, but because of the extensive use of ultrasound (US), the incidence has climbed to approximately 67%. Today's surgeons use ultrasonography and frozen sections as their primary diagnostic tools when determining whether a lesion is cancerous.

Aim:The objective of the current survey was to compare the accuracy of ultrasound against frozen section in the detection of malignant, suspicious solitary thyroid nodules as well as evaluate the clinical pathology records. Materials and Methods:Using a normalised data collection format, the medical records of all individuals with suspicious solitary thyroid nodules attending This study was conducted at Al-Zahraa  and Al-Azhar University Hospital, New Damietta, and was prospectively evaluated. Nodules were classified using the ACR TIRADS scoring system. The overall histology diagnosis was contrasted with the ultrasonography and frozen section findings. The following metrics were estimated: sensitivity, specificity, positive and negative predictive values, and likelihood proportions.

Results: There were 50 participants with solitary thyroid nodules; their ages ranged from 28 to 76, with a mean age of 53.4 ± 8.0 years. An anterior neck swelling (60%) was the most typical STN presenting symptom. Pain (20%), hoarseness (16%), and dysphagia (16%) were the other indications that were most prevalent. According to the results of the ultrasound examination, all patients proved to have suspicious thyroid nodules. Solitary thyroid nodules appear on the right side of the thyroid (68%) and the left side of the thyroid (30%), with one (2%) isthmic case. According to the TIRADS score, 18% of patients were mildly suspicious, 20% were moderately suspicious, and 58% of cases were highly suspicious. According to the FS classification, 70% of the suspicious solitary patients had malignant tumours, 10% had benign tumours, and indeterminate nodules were detected in 20% of the studied cases. The frozen section analysis showed a sensitivity of 67% compared to 89% in the ultrasound analysis. The specificity score showed that frozen sections recorded 96.6%, while ultrasound analysis recorded 93%.

Conclusion:To conclude, we can depend on US scanning for the diagnosis of malignant solitary thyroid nodules as a predictable tool in the absence of FS. However, in the presence of FS, it can support the diagnosis of malignant thyroid nodules.