Simultaneous Fine-Needle Aspiration and Core Biopsy of Thyroid Nodules and Other Superficial Head and Neck Masses Using Sonographic Guidance

Strauss, Edward B.; Iovino, Alan; Upender, Sunil

doi:10.2214/ajr.07.3530

Cited by 26 publications

(23 citation statements)

References 7 publications

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“…Sonographically guided thyroid nodule CB has been shown to be accurate, safe, and well tolerated (15,17,19,(26)(27)(28). There are several theoretical reasons why sonographically guided CB might be useful when thyroid nodule FNA is nondiagnostic: CB can provide more tissue than a nondiagnostic FNA and cellular architecture is retained, facilitating accurate histologic diagnosis (26,29,30).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Thyroid Nodule Core Biopsy: Clinical Utility in Patients with Prior Nondiagnostic Fine-Needle Aspirate

Samir

Vij

Seale

et al. 2012

Thyroid

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Background: Five percent to 20% of thyroid nodule fine-needle aspiration (FNA) samples are nondiagnostic. The objective of this study was to determine whether a combination of FNA and core biopsy (CFNACB) would yield a higher proportion of diagnostic readings compared with FNA alone in patients with a history of one or more prior nondiagnostic FNA readings. Methods: We conducted a retrospective study of 90 core biopsies (CBs) performed in 82 subjects (55 women and 27 men) between 2006 and 2008 in an outpatient clinic. Results: CFNACB yielded a diagnostic reading in 87%. The diagnostic reading yield of the CB component of CFNACB was significantly superior to the concurrent FNA component, with CB yielding a diagnosis in 77% of cases and FNA yielding a diagnosis in 47% ( p < 0.0001). The combination of CB and FNA had a higher diagnostic reading yield than either alone. In 69 nodules that had only one prior nondiagnostic FNA, CB was diagnostic in 74%, FNA was diagnostic in 52%, CFNACB was diagnostic in 87%, and CB performed significantly better than FNA ( p = 0.0135). In 21 nodules with two or more prior nondiagnostic FNAs, CFNACB and CB were diagnostic in 86%, FNA was diagnostic in 29%, and CB was significantly better than FNA ( p = 0.0005). Clinical, ultrasound, or histopathologic follow-up was available for 81% (73/90) of the CFNACB procedures. No subject with a benign CFNACB reading was diagnosed with thyroid malignancy in the follow-up period (range 4-37 months, mean 18 months), although one subject had minimal increase in nodule size and was awaiting repeat sonography at study conclusion. Conclusion: Thyroid nodule CFNACB is safe and clinically useful in selected patients when a prior FNA reading is nondiagnostic. CFNACB is superior to either CB or FNA alone. CFNACB should be strongly considered as an alternative to surgery in individuals with two prior nondiagnostic FNAs.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Thyroid Nodule Core Biopsy: Clinical Utility in Patients with Prior Nondiagnostic Fine-Needle Aspirate

Samir

Vij

Seale

et al. 2012

Thyroid

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“…To select the lesions to biopsy, the authors apply the criteria of the Washington consensus [13] with small modifications. Specifically, where measurements refer to the largest diameter, we take biopsies of all calcified lesions >1 cm, solid lesions >1 cm, and those with mixed cystic and solid components >1.5 cm, including cystic lesions with mural nodules.…”

Section: Obtaining the Samplementioning

confidence: 99%

Histological Diagnosis of Thyroid Disease Using Ultrasound-Guided Core Biopsies

2012

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Background: Thyroid core biopsies obtained with ultrasound (US)-guided needles are an alternative to conventional fine-needle aspiration and, according to various authors, have greater sensitivity and specificity. The technique is inexpensive, rapid and reliable with a low rate of complications, similar to conventional fine-needle aspiration procedures. Objectives: This paper critically reviews the methodology for obtaining samples and processing them in the pathology laboratory. Methods: Accumulated experience with 1,065 cases of US-guided core biopsy of the thyroid gland in a 15-year period. Results: US-guided core biopsy is a useful, inexpensive and safe method in the histological diagnosis of thyroid gland pathology. Thyroid samples obtained this way are not a substitute for fine-needle aspiration cytology. Indeed, some authors assert that the best results are obtained by combining the two approaches, the methods being complementary. Conclusions: To take best advantage of the findings from these techniques, pathologists must know which types of diagnoses can be made and the fundamentals of how and, lastly, what cannot be diagnosed and the reasons why. Best results are obtained with a multidisciplinary approach in a hospital committee composed of endocrinologists, surgeons, radiologists and pathologists, who analyse and provide a background on each case.

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“…Cutting needle biopsy is widely accepted as a safe and effective technique for obtaining adequate tissue for the histopathological assessment of head and neck lesions [7][8][9][10][11], including lymph nodes [12,13], salivary glands [14] and thyroid gland [15][16][17][18].…”

Section: Fine Needle Aspiration Cytology Vs Core Biopsymentioning

confidence: 99%

“…Despite the benefit of ultrasound guidance, samples obtained from FNAC of thyroid nodules are inadequate for diagnosis in 15-20% of patients [16]. Strauss et al [17] proposed the use of a modified coaxial system for simultaneous FNAC and core biopsy of thyroid nodules when FNAC alone has failed to yield tissue adequate for diagnosis. Kwak et al [18] advocated the use of ultrasound-guided core needle biopsy as a safe and accurate method for diagnosing thyroid lymphoma and may be a suitable replacement for diagnostic thyroid surgery.…”

Section: Fine Needle Aspiration Cytology Vs Core Biopsymentioning

confidence: 99%

Use of end-cutting needles in ultrasound-guided biopsy of neck lesions

et al. 2011

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The management of a neck mass is dictated by its nature, location and extent. Pathological diagnosis by fine needle aspiration cytology (FNAC) or core biopsy is often required before proceeding to definitive treatment. It is not uncommon for the cytology result to come back as inadequate for various reasons. The unique design of the end-cutting biopsy needle in our experience makes it a good choice for use in obtaining both transcutaneous and intraoral biopsy under ultrasound guidance of neck lesions and serves as a useful alternative or adjunct to FNAC. Although there is, as yet, only a limited evidence base about end-cutting in comparison to side-cutting needles, they carry several potential advantages. Key Points • End-cutting needles are safe to use for lesions close to vital structures.• End-cutting needles yield sufficient tissue samples in a single pass.• End-cutting biopsy needles are a useful adjunct to FNAC.

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Simultaneous Fine-Needle Aspiration and Core Biopsy of Thyroid Nodules and Other Superficial Head and Neck Masses Using Sonographic Guidance

Abstract: The use of a modified coaxial guiding needle and biopsy gun is a simple, safe, and effective method for obtaining tissue from thyroid nodules and is applicable to sampling other superficial masses as well.

Cited by 26 publications

References 7 publications

Ultrasound-Guided Percutaneous Thyroid Nodule Core Biopsy: Clinical Utility in Patients with Prior Nondiagnostic Fine-Needle Aspirate

Ultrasound-Guided Percutaneous Thyroid Nodule Core Biopsy: Clinical Utility in Patients with Prior Nondiagnostic Fine-Needle Aspirate

Histological Diagnosis of Thyroid Disease Using Ultrasound-Guided Core Biopsies

Use of end-cutting needles in ultrasound-guided biopsy of neck lesions

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