Predicting Malignancy in a Solitary Thyroid Nodule: A Prospective Study on the Role of Color Doppler Ultrasonography

Palpable thyroid nodules are fairly common. While many are benign, the clinician faces the challenge of detecting the 4 to 14% of malignant lesions. Fine needle aspiration cytology (FNAC) of thyroid nodules seems to have eclipsed all other techniques for diagnosis of thyroid cancer, but has its limitations when a nodule is inaccessible or in the case of follicular neoplasm. This study from a hospital from Indian west coast shows that vascular flow pattern of extensive peripheral and central flow (Type-3) or a central flow only (Type-4) and a resistive index (RI) of >0.75 on power Doppler sonography shows a healthy sensitivity and excellent specificity for predicting malignancy. The utility becomes even more apparent among follicular neoplasms where FNAC can offer little help in distinguishing malignancy.