Ultrasound-Guided Fine Needle Aspiration Biopsy Of The Thyroid: What To Expect?

Oct 21, 2022

What is an Ultrasound-Guided FNA of the Thyroid?

The thyroid gland is in front of the neck and takes a butterfly shape, with two lobes connected by a narrow band of tissues. It is an endocrine gland that produces thyroid hormones.

In some cases, hard nodules can form inside this gland. One can notice this as a small bump in your gland area, or a healthcare provider might see it during an exam or on another test. While these nodules are not dangerous, the majority of the time, they can cause thyroid cancer in some rare cases.

An ultrasound-guided fine needle aspiration (FNA) of the thyroid uses special sound waves to assist in locating a nodule and removing a small tissue sample from the thyroid gland. The sample is then sent to a pathology lab for examination.

The procedure tests whether the nodule is benign (non-cancerous) or malignant (cancerous). It is a painless, non-invasive procedure that leaves little to no scarring and does not involve exposure to ionizing radiation.

What To Expect

This procedure is straightforward and requires very little preparation. The healthcare provider will give a thorough guide on the medication that needs to be stopped before the procedure – mostly blood thinners. Besides that, the procedure doesn’t call for any dietary limitations.

Some people, such as children, might need medicine or sedation to help them relax before the procedure. A local anesthetic injection is unnecessary as the needle is so small, making the process almost painless.

The Procedure

The procedure is done with the help of an ultrasound machine which uses high-frequency sound waves to provide an ongoing image of the nodule. It helps in guiding the needle to exactly the right spot and prevents damage to other structures surrounding the gland.

A gel-like substance will be applied to the neck over the thyroid nodule to use the ultrasound detector. The procedure begins by inserting the thin fine-gauge needle into the thyroid gland and then slowly advancing into the nodule itself. The needle is attached to a syringe that applies suction and removes some cells from the nodule. Sometimes this process may have to be repeated a few times to obtain samples from different parts of the nodule.

Then the needle is removed, and the collected cells are placed on a slide and sent to the pathology lab for examination. While this procedure is usually completed in less than 30 minutes, it may take several days to get the test results from the pathology lab.

Post-procedure, a small bandage is placed over the needle insertion site, which can be removed after a few hours. There are no restrictions after the procedure, and most people will be able to continue with their daily routine.

Analyzing Test Results

The results of the needle biopsy of the thyroid have an accuracy rate of 95% accuracy. If the thyroid nodule does not show any cancerous signs, then further treatment is not necessary. However, in some cases, thyroid hormone pills can be prescribed to decrease the likelihood of nodules growing back.

In contrast, if the results appear cancerous, surgical treatment may be needed. Luckily, thyroid cancer is one of the curable types of cancer, and an experienced endocrinologist can personalize a successful treatment plan with reliable options for better results.

If it is difficult to strongly determine if the nodule is cancerous, a repeat biopsy will be required.

The GluCare Approach

The vast majority, or at least more than 95% of thyroid nodules, are benign (non-cancerous). So not everyone who has a thyroid nodule needs a fine needle aspiration biopsy. Sometimes, a thyroid imaging/ thyroid scan (thyroid scintigraphy) can provide sufficient information about the structure and functions of the thyroid gland to know if the nodule is due to cancer or not.

At Glucare, we use special AI-based thyroid imaging to evaluate the sonographic calcifications of thyroid nodules. This approach is more sensitive and objective than relying only on physicians alone to diagnose thyroid malignancies. Unlike traditional methods, it further improves diagnostic performance and reliability, reaching an accuracy similar to that of an expert radiologist. The test results thereby help us avoid uncertain image interpretation, indeterminate diagnosis, and the need to perform unnecessary biopsies and surgeries.

As per the results, a biopsy is recommended only when the imaging results come out abnormal, there is a nodule that is larger than one-half inch thick, there is a solid nodule without clear borders that appears to have calcium on it, or if there is extreme pain and the thyroid is enlarging at a rapid pace.

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