The Relationships of the Type of Needle and the Flushing of the Needle with the Satisfactory Rate of Thyroid Nodule Fine Needle Biopsy

  • Chonman Ieong Radiology Department of Centro Hospitalar Conde de S. Januário
  • MeiLeng Ieong Radiology Department of Centro Hospitalar Conde de S. Januário
DOI: https://doi.org/10.18686/aem.v11i4.338
Keywords: Thyroid Nodules, Fine Needle Biopsy, Needle Flushing

Abstract

Objective: To explore the factors that affect the satisfactory rate of fine needle aspiration biospy(FBAB)sampling of thyroid nodules and the effects of different needle types and needle flushing methods on the satisfactory rate of FNAB sampling. Methods: The clinical data of 190 patients with thyroid nodules (200 nodules in total) who underwent FNAB from June 2020 to December 2020 were analyzed. The relationship of the satisfaction rate of sampling with the type of puncture needle and the flushing method of the puncture needle was analyzed. Results: In 200 thyroid nodules, we found that the nondiagnostic rate (37%) with a larger needle (22G) was lower than that with a smaller needle (25G) (55%), and the difference was statistically significant (P < 0.05). In the analysis of the comparison of the satisfaction rate of the flushing of the puncture needle, it was found that the nondiagnostic rate of the flushing method was lower (24%) than that of the nonflushing method (68%), with a statistically significant difference (< 0.05). In the randomized test according to the size of the puncture needle and the flushing method, the nondiagnostic rates of the four groups (25G needle with flushing group, 25G needle without flushing group, 22G needle with flushing group and 22G needle without flushing group) were 34%, 76%, 14% and 60%, respectively. Moreover, there was no significant change in the diagnosis rate of benign and malignant lesions in the obtained samples (p=0.912). Conclusion: In fine-needle biopsy of thyroid nodules, a larger needle should be used in combination with the flushing method to reduce the nondiagnostic rate and improve the pathological diagnosis rate.

References

[1] Guth S, Theune U, Aberle J, et al. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination[J]. Eur J Clin Invest, 2009, 39(8):699–706.

[2] Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Difffferentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Difffferentiated Thyroid Cancer[J]. Thyroid, 2016, 26(1):1–133.

[3] Nam SY, Han BK, Ko EY, et al. BRAF V600E mutation analysis of thyroid nodules needle aspirates in relation to their ultrasongraphic classification: a potential guide for selection of samples for molecular analysis[J]. Thyroid, 2010, 20(3):273–279.

[4] Naïm C, Karam R, Eddé D. 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[J]. Can Assoc Radiol J, 2013, 64(3):220–225.

[5] Tangpricha V, Chen BJ, Swan NC, et al. Twenty-one-gauge needles provide more cellular samples than twenty-five-gauge needles in fine-needle aspiration biopsy of the thyroid but may not provide increased diagnostic accuracy[J]. Thyroid, 2001, 11(10):973–976.

[6] Ucler R, Kaya C, Çuhacı N, et al. Thyroid nodules with 2 prior inadequate fine-needle aspiration results: effect of increasing the diameter of the needle[J]. Endocr Pract, 2015, 21(6):595–603.

[7] Álvarez, Manuel Penín, et al. "El lavado de la aguja aumenta la rentabilidad diagnóstica de la punción-aspiración con aguja fina de tiroides." Endocrinología y Nutrición 60.3 (2013): 115-118.

[8] Kitahara CM, Sosa JA. The changing incidence of thyroid cancer[J]. Nat Rev Endocrinol, 2016, 12(11):646–653.

[9] Kim MJ, Kim EK, Park SI, et al. US-guided fine-needle aspiration of thyroid nodules: indications, techniques, results[J]. Radiographics, 2008, 28(7):1869–1886.

[10] Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology[J]. Thyroid, 2009, 19(11):1159–1165.

[11] Pusztaszeri M, Rossi ED, Auger M, et al. The Bethesda System for Reporting Thyroid Cytopathology: Proposed Modifications and Updates for the Second Edition from an International Panel[J]. Acta Cytol, 2016, 60(5):399–405.

[12] Lee MJ, Hong SW, Chung WY, et al. Cytological results of ultrasound-guided fine-needle aspiration cytology for thyroid nodules: emphasis on correlation with sonographic findings[J]. Yonsei Med J, 2011, 52(5):838–844.

[13] Lee YH, Baek JH, Jung SL, et al. Ultrasound-guided fine needle aspiration of thyroid nodules: a consensus statement by the korean society of thyroid radiology [J]. Korean J Radiol, 2015 16(2):391– 401.
Published
2023-03-02
Issue
Vol 11, No 4 (2022)
Section
Original Research Article

Copyright (c) 2023 Junwen Yang, Meiling Yang

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