A Comparative Study of Fine Needle Aspiration and Fine Needle Non-Aspiration Biopsy on Suspected Thyroid Nodules

Abstract

Ultrasonography-guided fine needle aspiration (FNA) and fine needle non-aspiration (FNNA) biopsy were performed consecutively on 104 patients (mean age 50 +/- 15 years) affected by multinodular and uninodular goiter. Both techniques were executed on the same patients in the same clinical session beginning with the first (FNA) on half of the patients (randomly selected) and vice versa. The cytological findings on cell samples were divided into four groups: colloidal (benign), follicular (suspicious), malignant, and inadequate. The overall cytologic findings obtained with the two techniques were as follows (FNA % vs FNNA %): inadequate, 16.3% vs 5.8%; colloidal, 69.2% vs 76.9%; follicular, 9.6% vs 10.5%; and malignant, 4.8% vs 6.7%. A statistically significant difference between FNA and FNNA cytology was found only on the number of inadequate results (p = 0.015). Interestingly, the frequency of inadequate specimens for FNNA showed a significantly different distribution depending on the sequence (first or second) in which the technique was executed. In conclusion, FNA and FNNA are useful and cost-effective techniques for the pre-operative assessment of patients with thyroid nodules. However, due probably to its minimally invasive procedure, FNNA produces specimens of better quality and reduces inadequate results. For these reasons FNNA should be preferable to FNA for the cytological evaluation of thyroid nodules.

Should We Apply Suction During Fine Needle Cytology of Thyroid Lesions? A Prospective Study of 200 Cases

“…Kamal MM et al, [15] had statistically significant difference for the parameter of 'amount of cellularity'. Romitelli F et al, [14] reported statistically significant result only in case of number of inadequate smears, which were more by aspiration technique. In studies by Mair S et al, [10] and Maurya AK et al, [18] there was no statistically significant difference in the two techniques.…”

“…Order of Sampling: In our study for all the 200 cases we performed first FNS technique followed by FNA. In the study by Mair S et al, [10] and Romitelli F et al, [14] and Kamal MM et al, [15] in half cases they performed FNA technique first and vice-versa and came up with the result that there was no statistically significant difference between the scores of FNA and FNS whether performed as the first or second technique.…”

“…Diagnostic accuracy: We have not evaluated the two techniques based on the diagnosis as done in some studies by Raghuveer CV et al, [8] and Romitelli F et al, [14]. In both the studies the diagnostic accuracy was better for FNS as compared to FNAC.…”

Comparison of aspiration VS non- aspiration techniques in fineneedle cytology of thyroid lesions

“…Whereas other observed a statistically significant difference in the total score in favour of non -aspiration as compared with aspiration technique, FNNAC producing a better quality of specimen. (10,11) In the present study, more diagnostically superior and less diagnostically adequate sample were obtained more by non -aspiration technique in comparison to aspiration technique. It was observed that the percentage of inadequate sampling was more with non -aspiration (38%) than with aspiration (34%) technique in contrast to the observations of Santos and Leiman (4) and Ciatto et al (12) .…”

Role of Fine Needle Aspiration Versus Non-Aspiration Cytology In Diagnosis of Thyroid Lesions

“…There is another technique, however, fine needle capillary (FNC) sampling/ fine needle non-aspiration cytology (FNNAC) which avoids aspiration but still permits cytologic review of the masses. This technique depends solely on capillary action of the fine needle, therefore is less painful, less traumatic and thus much more patient friendly (4).Several studies have reported conflicting results between FNAC and FNNAC (5,6,7). Some studies have reported that FNNAC produces better specimens for cytological diagnosis (7).…”