When Do You Need an Ultrasound-Guided Thyroid Biopsy?

Ultrasound uses a small hand-held transducer (wand) that emits sound waves to display images of the thyroid gland. The technologist and specialized radiologist use these images to interpret the findings. During a thyroid ultrasound, we examine:

  • The size of the thyroid gland
  • The thyroid gland’s texture
  • Nearby lymph nodes
  • Any nodules
  • The vessels of the thyroid gland

Radiologists use thyroid ultrasound to check any physiologic change in your clinical examination. A thyroid gland with excess vascularity can indicate hyperthyroidism, while low vascularity to the thyroid can be seen with hypothyroidism. Radiologists may also order an ultrasound if you have symptoms such as difficulty swallowing or hoarseness. Ultrasound may not be needed if you have a normal-sized gland.

Sometimes a single thyroid nodule enlarges and not the whole gland, which may necessitate a thyroid ultrasound-guided biopsy of the thyroid gland. Although most thyroid nodules appear benign (noncancerous), some have suspicious characteristics, such as an irregular shape or suspicious calcifications requiring a thyroid needle biopsy.

What to Expect With an Ultrasound-Guided Thyroid Biopsy

We want to make you as comfortable as possible during your thyroid biopsy. Here’s what you can expect on the day of the procedure.
Before the Biopsy
We recommend not taking blood thinners such as Aspirin or Motrin as they can increase bruising. On the day of the thyroid biopsy, we clean the neck with a sterile, antiseptic solution called Hibiclens. Please let us know if you have any allergies to topical solutions or medication. Hibiclens is pink, and people rarely have an allergy to pink dyes. We don’t typically use betadine because allergies are more common with that. The radiologist may use a small amount of lidocaine to anesthetize the skin to minimize discomfort from the procedure. Most people feel a slight pinching sensation and possibly pressure from the biopsy, but experiencing pain is uncommon.
During the Biopsy
  • The technologist uses an ultrasound transducer or probe to localize the thyroid nodule.
  • The radiologist will then use a fine needle (smaller than you have probably seen before) to take the sample. The procedure is sometimes called a Fine Needle Aspiration (FNA) or a Fine Needle Biopsy (FNB). The radiologist directs the fine needle under ultrasound guidance to the nodule.
  • Using ultrasound guidance, the radiologist performs  several passes with the fine needle to gather cells for further analysis. The radiologist will watch the entire procedure in real-time as they are performing the procedure, which ensures that the targeting and sampling are precise.
  • We prepare the cells on slides in preservative solutions for additional evaluation by the pathologist. We place a small amount of the sample in an extra collection tune in case the pathologist needs to perform additional testing. The pathologist or cytologist is a medical specialist who studies the structure and function of cells and analyzes the cells. Cytologists look at the cells under the microscope to determine if they are normal (benign), atypical, or look suspicious. Sometimes, the specialist needs more information. The specialist will test the extra cells tube for the cells' genetic makeup. This secondary process is slower and may take seven to ten days to return.
After the Biopsy

We recommend not taking blood thinners such as Aspirin or Motrin as they can increase bruising. We will provide you with Tylenol and a small portable ice pack to apply to the fine needle aspiration/biopsy site if needed. Complications from a Fine Needle Aspiration/ Biopsy of the Thyroid are rare. If you experience any bleeding, increased swelling, or sudden change of voice, please call us or seek medical attention.

The results of the Fine Needle Aspiration Biopsy of the Thyroid are usually available within two working days. The results may take longer in some cases if the pathologist needs more time for testing. The time required to complete the evaluation is unrelated to the final result. We allow the time necessary for the pathologist to make an accurate diagnosis. The results usually return as benign (normal). Sometimes the findings return as suspicious for malignancy (cancer). Occasionally, the thyroid biopsy results may be atypical. If the results prove to be atypical or malignant, then your doctor will advise a consultation with a specialist in thyroid surgery. The surgeon may recommend removing part of the thyroid gland or observation.

We request a thyroid ultrasound follow-up within six months from the procedure date. The follow-up ensures the stability of the finding that we biopsied, even for a benign result. Your care team at The Women’s Imaging Center ensures the continuity of screening to diagnosis to treatment when indicated. The care team and navigator coordinate your care with other specialists based on the recommendation of your referring clinician and within the continuity of care following the National Comprehensive Cancer Network (NCCN) guidelines.

Ultrasound-Guided Thyroid Biopsy in Denver

Meet Our Specialists

When it comes to reading imaging tests, experience matters. At The Women’s Imaging Center, our radiologists are fellowship-trained and have received the highest awards for excellence in women’s imaging. We are here to provide answers when you need a thyroid biopsy.

Kelly McAleese, M.D.

Timothy Colt, M.D.

Barbara Jaegar, M.D.

John Lewin, M.D.


Frequently Asked Questions About Ultrasound-Guided Thyroid Biopsy

What is an ultrasound-guided thyroid biopsy?

Ultrasound-guided thyroid biopsy is a medical procedure that involves using ultrasound imaging to guide the insertion of a needle into the thyroid gland to obtain a tissue sample for examination.

What happens during an ultrasound-guided thyroid biopsy?

During the procedure, the patient lies on their back. The skin over the thyroid gland is cleaned and a local anesthetic is injected to numb the area. The ultrasound probe is then placed on the neck to locate the nodule or abnormality to be biopsied. A thin needle is inserted through the skin and into the nodule, guided by the real-time ultrasound image on a screen. Once the needle is in the correct position, several samples of tissue are collected and sent to a laboratory for analysis.

Can an ultrasound-guided thyroid biopsy detect cancer?

Thyroid nodules are common, and most are benign. However, a small percentage of nodules may be cancerous, and it is important to evaluate them to determine the appropriate treatment.

Ultrasound-guided biopsy is a safe and effective way to diagnose thyroid cancer. The procedure is minimally invasive and can be performed in an outpatient setting. It typically takes less than 30 minutes to complete and has a low risk of complications.

If you have a suspicious thyroid nodule, your doctor may recommend an ultrasound-guided biopsy to determine whether it is cancerous. The biopsy results can help your doctor determine the best course of treatment for you.

Insurance Options We Honor

At the Women's Imaging Center, we accept most major insurance providers and provide affordable self-pay options. If you have any questions about whether we accept your insurance, please contact us at 303-321-2273.

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