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Hellenic Journal of Surgery

, Volume 85, Issue 6, pp 380–385 | Cite as

Surgeon-performed ultrasound-guided thyroid fine-needle aspiration biopsy: Evaluation of 470 biopsies

  • Oktay IrkorucuEmail author
  • Enver Reyhan
  • Kamuran Cumhur Değer
  • Pelin Demirtürk
  • Hasan Erdem
  • Filiz Ekşi Haydardedeoğlu
  • Süleyman Çetinkünar
  • Mehmet Aziret
  • Ersoy Arslan
Clinical Study

Abstract

Background

Ultrasound-guided FNAB of thyroid nodules is considered to be the most reliable and feasible test for the diagnosis of thyroid malignancy. We aimed specifically to assess the accuracy of surgeon-performed ultrasound (SPUG)-guided FNAB on a per-nodule basis, with a subanalysis of nodule size and on-site evaluation.

Materials and Method

During the study period, 470 thyroid FNABs were performed. In the first 155 biopsies, the attending pathologist determined the adequacy of the specimen based on the number of cells. Nodules were categorised as group A: nodule size <1.99 cm and group B: nodule size >2 cm in width. The FNAB results were classified and described according to the Bethesda system.

Results

The overall non-diagnostic rate of ultrasound-guided thyroid FNAB in this study was 10% (47 of 470). The percentage of non-diagnostic cases was 12.06% (38 of 315) in patients without on-site evaluation and 5.8% (9 of 155) in patients with on-site evaluation; this difference did not reach statistical significance (p = 0.051). The nondiagnostic FNAB rates were 10.6% (42 of 395) and 6.6% (5 of 75) with respect to nodule sizes <1.9 cm and >2 cm. Although nodules smaller than 1.9 cm had higher non-diagnostic FNAB rates, these results were not statistically significant (p = 0.401).

Conclusion

In conclusion, this study demonstrates that ultrasound-guided FNAB in the hands of an experienced surgeon can be performed with a low non-diagnostic FNAB rate.

Key words

Thyroid nodule FNA non-diagnostic cancer 

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References

  1. 1.
    DeMay RM. The art and science of cytopathology, Vol II. Chicago: ASCP press; 1995. p 703–778Google Scholar
  2. 2.
    Wu HH-J, Jones JN, Osman J. Diagn Cytopathol 2006;34:93–96PubMedCrossRefGoogle Scholar
  3. 3.
    Neven M, Irena T, Nina D, Vlado P, Zvonko K. Diagnostic relevance of fine-needle aspiration cytology for follicular lesions of the thyroid: retrospective study. CMJ 2002; 43:606–609Google Scholar
  4. 4.
    Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid. Ann Intern Med 1993; 118:282–289PubMedCrossRefGoogle Scholar
  5. 5.
    Khan I, Naz S, Akhter ZM, Aziz N. J Ayub Med Coll Abbottabad 2010; 22:179–181Google Scholar
  6. 6.
    Suen KC. CMAJ, 2002; 167:491–495PubMedCentralPubMedGoogle Scholar
  7. 7.
    Kim MJ, Kim EK, Park SI, et al. RadioGraphics 2008; 28:1869–1889PubMedCrossRefGoogle Scholar
  8. 8.
    Goldfarb M, Gondek S, Solorzano C, et al. Surgery 2011; 150:436–441PubMedCrossRefGoogle Scholar
  9. 9.
    Ballard RB, Rozycki GS. The use of ultrasound in the acute setting. Surg Clin North Am 1998; 78:337–365PubMedCrossRefGoogle Scholar
  10. 10.
    O’Malley ME, Weir MM, Hahn PF, et al. US-guided fineneedle aspiration biopsy of thyroid nodules: adequacy of cytologic material and procedure time with and without immediate cytologic analysis. Radiology 2002; 222:383–387PubMedCrossRefGoogle Scholar
  11. 11.
    Ducatman BS, Hogan CL, Wang HH. A triage system for processing fine needle aspiration cytology specimens. Acta Cytol 1989; 33:797–799.PubMedGoogle Scholar
  12. 12.
    Goellner JR, Gharib H, Grant CS, et al. Fine needle aspiration cytology of the thyroid. Acta Cytol 1987; 31:587–590PubMedGoogle Scholar
  13. 13.
    Jo VY, Stelow EB, Dustin SM, et al. Manignancy risk for fine-needle aspiration of thyroid lesions according to the Bethesta System for reporting thyroid cytopathology. Am J Clin Pathol 2010; 134:450–456PubMedCrossRefGoogle Scholar
  14. 14.
    Seiberling KA, Dutra JC, Gunn J. Ultrasound-guided fine needle aspiration biopsy of thyroid nodules performed in the office. Laryngoscope 2008; 118:228–231PubMedCrossRefGoogle Scholar
  15. 15.
    Bohacek L, Milas M, Mitchell J, Siperstein A, Berber E. Diagnostic accuracy of surgeon-performed ultrasound-guided fine-needle aspiration of thyroid nodules. Ann Surg Oncol 2012; 19:45–51PubMedCrossRefGoogle Scholar
  16. 16.
    Danese D, Sciacchitano S, Farsetti A, et al. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid 1998; 8:15–21PubMedCrossRefGoogle Scholar
  17. 17.
    Sabel MS, Haque D, Velasco JM, Staren ED. Use of ultrasoundguided fine needle aspiration biopsy in the management of thyroid disease. Am Surg 1998; 64:738–741PubMedGoogle Scholar
  18. 18.
    Eedes CR, Wang HH. Cost-effectiveness of immediate specimen adequacy assessment of thyroid fine-needle aspirations. Am J Clin Pathol 2004; 121:64–69PubMedCrossRefGoogle Scholar
  19. 19.
    Bhatki AM, Brewer B, Robinson-Smith T, Nikiforov Y, Steward DL. Adequacy of surgeon-performed ultrasoundguided thyroid fine-needle aspiration biopsy. Otolaryngol Head Neck Surg 2008;139:27–31PubMedCrossRefGoogle Scholar
  20. 20.
    Khurana KK, Richards VI, Chopra PS, Izquierdo R, Rubens D, Mesonero C. The role of ultrasonography-guided fineneedle aspiration biopsy in the management of nonpalpable and palpable thyroid nodules. Thyroid 1998; 8:511–515.PubMedCrossRefGoogle Scholar
  21. 21.
    Tambouret R, Szyfelbein WM, Pitman MB. Ultrasoundguided fine-needle aspiration biopsy of the thyroid. Cancer 1999; 87:299–305PubMedCrossRefGoogle Scholar
  22. 22.
    Mittendorf EA, Tamarkin SW, McHenry CR. The results of ultrasound-guided fine-needle aspiration biopsy for evaluation of nodular thyroid disease. Surgery 2002; 132:648–653PubMedCrossRefGoogle Scholar
  23. 23.
    Mehrotra P, Viswanathan H, Johnson SJ, Wadehra V, Richardson DL, Lennard TW. Ultrasound guidance improves the adequacy of our preoperative thyroid cytology but not its accuracy. Cytopathology 2006;17:137–144PubMedCrossRefGoogle Scholar
  24. 24.
    Li WB, Zhu QL, Zhang B, Jiang YX, Yang D. Ultrasound-guided fine needle aspiration in the diagnosis of thyroid nodule. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2010; 32:76–80PubMedGoogle Scholar
  25. 25.
    Law MT, Taylor M, Bennett IC. Surgeon-performed ultrasound guided needle biopsy of the thyroid: A safe and effective diagnostic procedure. World Journal of Endocrine Surgery 2011; 3:116–121CrossRefGoogle Scholar
  26. 26.
    Baloch ZW, LiVolsi VA. Fine needle aspiration of thyroid nodules:past, present and future. Endocr Pract 2004; 10:234–241PubMedCrossRefGoogle Scholar
  27. 27.
    Rozycki GS. Surgeon-performed ultrasound: its use in clinical practice. Ann Surg 1998; 228:16–28PubMedCrossRefGoogle Scholar
  28. 28.
    Cakmak GK, Emre AU, Tascılar O, Gultekin FA, Ozdamar SO, Comert M. Diagnostic Adequacy of Surgeon-Performed Ultrasound-Guided Fine Needle Aspiration Biopsy of Thyroid Nodules. Journal of Surgical Oncology 2013; 107:206–210CrossRefGoogle Scholar

Copyright information

© Hellenic Surgical Society 2013

Authors and Affiliations

  • Oktay Irkorucu
    • 1
    • 4
    Email author
  • Enver Reyhan
    • 1
  • Kamuran Cumhur Değer
    • 1
  • Pelin Demirtürk
    • 2
  • Hasan Erdem
    • 1
  • Filiz Ekşi Haydardedeoğlu
    • 3
  • Süleyman Çetinkünar
    • 1
  • Mehmet Aziret
    • 1
  • Ersoy Arslan
    • 1
  1. 1.Department of General SurgeryAdana Numune Research and Training HospitalAdanaTurkey
  2. 2.Department of PathologyAdana Numune Research and Training HospitalAdanaTurkey
  3. 3.Department of EndocrinologyAdana Numune Research and Training HospitalAdanaTurkey
  4. 4.Adana Numune Eğitim ve Araştırma HastanesiGenel Cerrahi Servisi Yüregir/Adana/TurkeyAdanaTurkey

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