Ultrasound-Guided Fine-Needle Aspiration Biopsy of the Thyroid: Methods to Decrease the Rate of Unsatisfactory Biopsies in the Absence of an On-Site Pathologist

Canadian Association of Radiologists Journal - Tập 64 - Trang 220-225 - 2013
Cyrille Naïm1, Ramy Karam2, Donald Eddé3
1University of Montreal Hospital Center, University of Montreal Faculty of Medicine, Montreal, Quebec, Canada
2University of Montreal Faculty of Medicine, Montreal, Quebec, Canada
3Department of Radiology, Jean-Talon Hospital, University of Montreal Hospital Center, Montreal, Quebec, Canada

Tóm tắt

Purpose The rate of unsatisfactory samples from ultrasound-guided fine-needle aspirations of thyroid nodules varies widely in the literature. We aimed to evaluate our thyroid ultrasound-guided fine-needle aspiration biopsy technique in the absence of on-site microscopic examination by a pathologist; determine factors that affect the adequacy rate, such as the number of needle passes and needle size; compare our results with the literature; and establish an optimal technique. Materials and Methods We performed a retrospective review of cytopathology reports from 252 consecutive thyroid ultrasound-guided fine-needle aspiration biopsies performed by a radiologist between 2005 and 2010 in our hospital's radiology department. Sample adequacy, the number of needle passes, and needle size were determined. There was an on-site cytologist who prepared slides immediately after fine-needle aspiration but no on-site microscopic assessment of sample adequacy to guide the number of needle passes that should be performed. Cytopathology biopsy reports were classified as either unsatisfactory or satisfactory samples for diagnosis; the latter consisted of benign, malignant, and undetermined diagnoses. Results Seventy-seven biopsies were performed with 1 needle pass, 124 with 2 needle passes, and 51 with 3 needle passes. The rates of unsatisfactory biopsies were 33.8%, 23.4% (odds ratio [OR] 0.599 [95% confidence interval {CI}, 0.319-1.123]; P = .110), and 13.7% (OR 0.312 [95% CI, 0.124-0.788]; P = .014), respectively. Conclusion In a hospital in which there is no on-site pathologist, a 3-pass method increases the specimen satisfactory rate by 20% compared with 1 pass, achieves similar rates to the literature, and provides a basis for further improvement of our practice.

Tài liệu tham khảo

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Thông tin xuất bản

Canadian Association of Radiologists Journal

Tập 64

220-225

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