Palpable throid nodules can be detected in about 5-7% of the population. According to the British Thyroid Association guidelines, definitive investigation of thyroid nodules is by ultrasound (US) and fine needle aspiration cytology (FNAC). Using US, nodularity of the throid can be detected in upto 50% of the population and approximately 4-7% of the thyroid nodules are malignant.
Due to the use of imaging modulaties, incidental throid nodules which are asymptomatic are increasing, being detected and investigated, resulting in an increase burden for the NHS and patients.
Real Time Ultrasound (RTE) is a recently developed technology that can be used as an adjunct to US- guided FNAC. RTE combines the diagnostic advantages of US-FNAC with an assessment of the stiffness of the nodule to increase the accuracy of thyroid cancer diagnosis.
In view of conflicting results from some of the retrospective and prospective case series and the fact that most results are single institution reports, a randomised controlled trial (RCT) is required to provide evidence of the role of RTE in the diagnosis of thyroid nodules. If proven effective in reducing the false positive rates and the need for FNAC it has the potential to reduce healthcare costs and patient distress significantly. In addition, ElaTION will attempt to answer some of the important outstanding questions in thyroid ultrasonography mainly the efficacy of ultrasound- only protocols and the need for repetition of Thy2 US FNAC in the diagnosis of thyroid nodules.
The aim of ElaTION is to determine if RTE- guided FNAC reduces the number of patients who have a non-diagnostic first FNAC result, compared to conventional US only guided FNAC.