Aim: To evaluate the role of thyroid Doppler in screening of thyroid nodules for the risk of malignancy.

Methodology: A descriptive observational study conducted in Yashoda Hospital, Secunderabad,

Telangana, India from May 2014 –Sept 2015 for screening thyroid nodules for the risk of malignancy. Patients were examined using B mode ultrasound, power Doppler and pulsed Doppler. Fine needle aspiration biopsy was performed for nodules ≥ 10 mm. Thyroid cytopathology was reported using the Bethesda system.

Results: 247 subjects were screened and 134 subjects were considered for final analysis (25 males and 109 females). For Benign tumors, mean age was 45.29 ± 14.64 years and for Malignant tumors mean age was 35.50 ± 15.74 years. The mean anteroposterior diameter for benign nodules was 19.31 ± 4.93 mm and for malignant nodules was 25.11 ± 5.89 mm. The incidence of malignancy in this study was 18/134 (13.43 %). Among them 66.66% were papillary carcinoma, 27.77% follicular carcinoma (histopathology results), 5.55% anaplastic carcinoma. 8/18 (44.44 %) malignant nodules were seen in multinodular disease. Majority of the nodules were hypoechoic (37.31%) or mixed (41.79%). Micro–calcifications were seen in 13 of 134 (9.7%) nodules among them 12 (92.30%) were malignant. This study demonstrated that the risk of malignancy increases as intra–nodular blood flow increases.Furthermore, for resistive index (RI) of 0.69, the sensitivity to detect malignancy was 72.22 % and specificity of 93.10%. Malignant nodules had higher RI than benign nodules.

Conclusion – The B mode ultrasound features including Hypoechogenicity, Microcalcifications and Antero–posterior diameter versus transverse diameter act as a guide to select nodules potentially requiring surgery. Inclusion of doppler in routine ultrasound imaging gives extra information on nature of thyroid nodule. Ultrasound is imaging of choice for thyroid nodules.