Ultrasound-Guided Fine-Needle: Aspiration of Thyroid Nodules

Abstract

There are multiple benefits in performing a diagnostic ultrasound examination prior to a thyroid nodule fine-needle aspiration (FNA). These benefits include determining the size and position of a nodule, which allows better selection of needle length and needle size. In patients with a multinodular goiter, ultrasound assures biopsy of the dominant nodule or the nodules most likely to be malignant—those having microcalcifications, increased vascularity, marked hypoechogenicity, blurred irregular borders, or other characteristics associated with malignancy. Finally, ultrasound may redirect the FNA to other areas of suspicion, such as an enlarged, suspicious lymph node or an incidental parathyroid adenoma. Once a physician acquires the skill to perform thyroid ultrasonography, it is a simple progression to combine the two procedures into an ultrasound-guided FNA (UGFNA).