Is a Surgeon-performed Ultrasound Good Enough in Diagnosing Thyroid Malignancy?

BACKGROUND: The widespread availability of ultrasonography has facilitated the evaluation of thyroid nodules, to differentiate between malignant and benign nodules and between metastatic and reactive lymph nodes. From the radiologists’ suite, ultrasound has moved into the surgeon's office. AIM: The aim of the present study was to evaluate the relevance of surgeon-performed ultrasound (SPUS) in the diagnosis of malignancy of the thyroid. METHODS: SPUS for 389 consecutive patients attending the outpatient department of endocrine surgery in a tertiary care institute in Chennai. The SPUS data of 350 patients who underwent total thyroidectomy were compared with the report of radiologist-performed ultrasonogram, fine-needle aspiration cytology, and histopathology examination. RESULTS: SPUS ranked the maximum with a Spearman's correlation of 0.886 (P < 0.0001). The sensitivity and specificity of positive-predictive value and negative-predictive value of SPUS were 98.53%, 95.72%, 96.81%, and 98%, respectively. CONCLUSION: SPUS is a very useful clinical adjunct in diagnosing malignancy of the thyroid and saves the patient time and resource in visiting another consultant. A surgeon who is more familiar with the anatomy and pathophysiology of thyroid disorders triages the nodule better.