Biopsje cienkoigłowe guzków tarczycy pod kontrolą USG — porównanie wydajności próbki za pomocą różnych technik pobierania próbek, rozmiarów igieł, z/bez analizy cytologicznej na miejscu

Abstract

Introduction: The aim of this study was to compare the diagnostic adequacy of thyroid samples obtained by aspiration or capillary biopsy techniques, with 22 or 27 gauge needles, and with or without onsite cytological analysis (OCA). Material and methods: Four hundred patients with thyroid nodules underwent ultrasound (US)-guided fine-needle biopsies. Patients were divided into eight groups according to needle size (22 vs. 27 gauge), biopsy technique (aspiration vs. capillary), and whether or not OCA was performed. Sample adequacy rates were calculated for each group and subgroups and compared using chi-square tests. Results: When all nodes were evaluated (n = 400), the adequacy rate was significantly greater with the capillary than with the aspiration technique (97% vs. 91.5%, p = 0.032) and when OCA was than was not performed (97% vs. 91.5%, p = 0.032). When only solid nodules were evaluated (n = 205) the adequacy rate was also significantly greater with the capillary than with the aspiration technique (98.9% vs. 89.7%, p = 0.008) and when OCA was than was not performed (97.9% vs. 89.6%, p = 0.014). In contrast, the adequacy rate was similar for 22 and 27 gauge needles (94.2% vs. 93.1%, p = 0.733). Conclusions:Optimal results were obtained with the capillary technique and OCA. The capillary technique and OCA should be the preferred approach in thyroid nodule biopsy, optimising adequacy rates and patient comfort. (Endokrynol Pol 2015; 66 (4): 295-300)

Comparison of Ultrasound-Guided Fine-Needle Cytology Quality in Thyroid Nodules with 22-, 23-, and 25-Gauge Needles

“…Regarding the unsatisfactory rates, Tanaka et al found that there was no statistical difference between 22 G and 25 G needles [ 19 ]. In terms of adequacy, there was no statistically significant difference between 21 G and 27 G needles [ 8 ], between 22 G and 27 G needles [ 20 ], and among 23 G, 25 G, and 27 G needles [ 21 ]. Therefore, more cellular specimens did not necessarily result in increased diagnostic accuracy.…”

Comparison of Cytological Adequacy between 23- and 25-Gauge in Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules: A Single-Center Prospective Study

“…Another factor that may influence the representativeness of the samples is the gauge of the needle used. However, there are few and conflicting reports on this topic, so the contribution of the needle gauge to the cytological adequacy remains unclear [10][11][12][13][14][15][16][17][18][19].…”

“…Regarding the procedure, various techniques for thyroid FNA have been proposed, but consensus for the optimal method has not been established. Despite the current advances in all aspects of cancer diagnosis, there are still no uniform standards for which type of FNA needle will allow the best adequacy rate [10][11][12][13][14][15][16][17][18][19].…”

“…In clinical practice, needles between 21-and 27-gauge are usually selected according to the institution and physician [10][11][12][13][14][15][16][17][18][19]. Few reports exist on the cytological adequacy obtained with different-sized needles and the results were controversial.…”

Ultrasound-Guided Fine-Needle Aspiration Versus Fine-Needle Capillary Sampling in Evaluation of Lymph Node Metastasis of Thyroid Cancer

“…It was suggested that the sampling adequacy was related to the needle size, lymph node dimension, and operator's experience etc. (11)(12)(13). The values of FNA and FNC with different needle gauges have been extensively investigated in the previous studies (14)(15)(16)(17).…”