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Effect of needle gauge on thyroid FNA diagnostic rate

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Abstract

Purpose

Thyroid Bethesda classification system provides 6 diagnostic categories, the first being a sample deemed non-diagnostic or insufficient and requiring a subsequent second biopsy. Our objective was to evaluate differences in non-diagnostic fine needle aspiration (FNA) of thyroid nodules conducted with a 23-gauge(G) needle vs. those conducted with a 25 G needle.

Methods

Data from 298 aspiration procedures using either 23 G or 25 G needles were collected, including cytological findings, ultrasound characteristics and patient demographics. The samples were classified as diagnostic or non-diagnostic according to final cytology.

Results

There was no statistically significant difference between the 25 G and 23 G needles in terms of non-diagnostic rates (35.7%, 31.9%; p = 0.494). Nodules defined as cystic had higher non-diagnostic rates (p < 0.05). Older patients as well as cystic nodules were associated with a higher non-diagnostic rate (OR = 1.018, p = 0.047, OR = 13.533, p = 0.0001, respectively), while nodule size was associated with lower non-diagnostic rates (OR = 0.747, p = 0.017).

Conclusions

The use of 25 G needle did not produce a lower non-diagnostic rate when compared to 23 G needle. Larger nodules might increase diagnostic rates, while older patients and cystic nodules are prone to inadequate samples. Patients and caregivers should be aware that FNA of small or cystic nodules as well as nodules in older patients may result in a higher non-diagnostic rate. Further research comparing other needles gauges should be conducted.

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Data will be available upon request.

Abbreviations

FNA:

fine needle aspiration

US:

ultrasound

TBSRTC:

The Bethesda System for Reporting Thyroid Cytopathology

ACR TIRADS:

American College of Radiology Thyroid Imaging Reporting and Data System

G:

gauge

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Acknowledgements

We wish to thank Mrs. Orly Yakir and Mr. Basem Hijazi for statistical analysis. We wish to thank Mrs. Tobie Kuritsky for editorial assistance. The article was written as part of the requirements of the Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel, for an MD degree of S.S.

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Authors and Affiliations

  1. Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel

    Sivan Saraph & Ohad Ronen

  2. Department of Pathology, Galilee Medical Center, Nahariya, Israel

    Hector Cohen

  3. Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel

    Ohad Ronen

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  1. Sivan Saraph
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Correspondence to Ohad Ronen.

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All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. And the study was approved by the local ethical committees.

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Saraph, S., Cohen, H. & Ronen, O. Effect of needle gauge on thyroid FNA diagnostic rate. Endocrine 74, 625–631 (2021). https://doi.org/10.1007/s12020-021-02797-9

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