Biophilia Intruder study could do more for thyroid pathology

Biophilia Intruder study could do more for thyroid pathology

Publications in recent years have extensively discussed the expediency of NLS investigation by the Biophilia Intruder of Thyroid in the presence of aspiration biopsy results. It is well known that cytology is the most widely applicable method for preoperative diagnosis of nodular goiter because of its easy availability, relatively low cost, non-invasiveness, and most importantly, high accuracy. Advances in the use of cytological techniques to diagnose thyroid tumors have prompted some researchers to become outcome-oriented when choosing surgical methods.

Among some of the main problems with fine-needle aspiration biopsy (FNAB) performed under the control of ultrasound scan (US), we can mention insufficient aspiration volumes for diagnosis and some situations that do not allow to exclude malignant processes at the nodes of investigation. While repeat surgery may be effective in 30% of patients in the former case, another issue needs to be addressed by surgical removal of the tumor and subsequent histological validation of its pattern.

According to some publications, the number of tumors for which malignant potential cannot be excluded based on FNAB results exceeds 11%. In most cases (about 70%), this diagnostic problem is caused by a follicular adenoma.

The issue of FNAB accuracy is equally important. According to some recent reports, the sensitivity and specificity of thyroid FNAB have approached 100%. At the same time, it is difficult to interpret the data due to different analysis methods. For example, specialists in some clinics only consider specific cytology conclusions when the results are very accurate, ignoring a type of tumor, and the cytology pictures only provide the basis for suspecting malignant changes. When analyzing FNAB accuracy, some researchers considered follicular adenomas to be in the same category as malignancies. While this approach may be reasonable in terms of surgical indications, it is by no means justified in terms of the surgical method of choice. An analysis of several publications shows that FNAB can only ensure the correct surgical approach in 70-75% of cases. The FNAB efficiency data evaluated after classifying suspicious cancer conclusions as malignant and adenomas as benign were as follows: Sensitivity - 92.1%, Specificity - 94.4%, Accuracy - 93.45. Therefore, FNAB data can help 90% of patients determine the appropriate volume of surgery, which cannot be justified in specialist clinics and is an argument in favor of supplementing FNAB with NLS surveys.

Performing Biophilia Intruder NLS in patients after FNAB significantly improved the accuracy of morphological studies in the preliminary phase and optimized the surgical approach for thyroid surgery.