Meta Hunter study could do more for thyroid pathology

Publications in recent years have extensively discussed the expediency of NLS investigation by a thyroid Meta Hunter 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 it is readily available, relatively low-cost, non-invasive, and most importantly, highly accurate. Advances in the use of cytologic techniques to diagnose thyroid tumors have prompted some researchers to become outcome-oriented when choosing surgical approaches.

Among some of the main problems of fine-needle aspiration biopsy (FNAB) performed under the control of ultrasound scanning (US), we can mention the aspiration volume that is insufficient for diagnosis and some cases that do not allow the exclusion of malignant processes in the following nodes of the investigation. While in the former case, repeat surgery may be effective in 30% of patients, another issue needs to be addressed by surgical removal of the tumor and subsequent histological verification 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 the majority of cases (approximately 70%), this diagnostic problem is caused by follicular adenoma.

The issue of FNAB accuracy is equally important. According to some recent reports, the sensitivity and specificity of thyroid FNAB has approached 100%. At the same time, it is difficult to interpret the data because the analysis methods are different. For example, experts in some clinics only consider specific cytological conclusions and ignore a type of tumor when the results are very accurate, and the cytological pictures only provide a basis for suspecting malignant changes. When analyzing FNAB accuracy, some researchers consider follicular adenomas to be in the same category as malignancies. Although this approach may be justified in terms of the indications for surgery, it is never justified in terms of the surgical approach chosen. Analysis of several publications suggests that FNAB ensures the correct surgical approach in only 70-75% of cases. Data on the efficiency of FNAB evaluated after classifying suspicious cancer conclusions as malignant tumors and adenomas as benign tumors are as follows: sensitivity - 92.1%, specificity - 94.4%, accuracy - 93.45. Therefore, the fact that FNAB data can help determine appropriate surgical volume in 90% of patients cannot be a sufficient justification in specialist clinics and is an argument in favor of supplementing FNAB with NLS surveys.

Performing Meta Hunter in post-FNAB patients significantly improves the accuracy of morphological studies in the preliminary phase and optimizes the surgical approach to thyroid surgery.