Correlative evaluation of findings between ultrasonography, fine needle aspiration cytology and histopathology in cases of goitre

Background: Thyroid imaging reporting and data system (TIRADS) criteria is followed in ultrasonography (USG), based on the risk of malignancy depending on the presence of suspicious ultrasound features. Patients in the high-risk category of TIRADS undergo fine needle aspiration cytology (FNAC), with the Bethesda classification used to determine the risk of malignancy. There is dearth of data comparing sonographic classification of thyroid nodule and its cytological association with respect to final histopathological diagnosis in India. Methods: Prospective observational study on correlation of USG, FNAC and HPE of thyroid swellings conducted in department of otolaryngology at Jaipur national university institute for medical science and research centre, Jaipur, Rajasthan from June 2022 to April 2024 on 50 patients with palpable thyroid lump. Results: In the present study, USG has a sensitivity of 63.63%, specificity of 97.44%, a positive predictive value (PPV) of 87.5%, a negative predictive value (NPV) of 90.4% and an overall accuracy of 84.00%. FNAC shows a sensitivity of 72.7%, specificity of 89.7%, PPV of 66.7%, NPV of 92%, and an overall accuracy of 86%. Conclusions: Benign lesions on both FNAC and USG were almost in concurrence with HPE in our study. The results of FNAC for diagnosing malignancy in our study were almost at par with the results of HPE and outweighed the results of USG. Surgical management should be based on FNAC finding even if USG shows benign features. It should be essential part of armamentarium of evaluation of thyroid swelling. This combined approach provides a robust framework and enhances the accuracy for distinguishing between benign and malignant thyroid lesions, ultimately contributing to improved patient care and outcomes. However, the histopathological examination will remain the gold standard.