The impact of rapid on‐site evaluation on thyroid fine‐needle aspiration biopsy: A 2‐year cancer center institutional experience

Pastorello, Ricardo; Destefani, Camila; Pinto, Pedro Henrique Nicolau; Credidio, Caroline; Reis, Rafael X.; Rodrigues, Thiago de A.; Toledo, Maryane C. de; Brot, Louise De; Costa, Felipe D’Almeida; Nascimento, Antonio G.; Pinto, Clóvis Antônio Lopes; Saieg, Mauro

doi:10.1002/cncy.22051

Cited by 27 publications

(22 citation statements)

References 54 publications

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“…The reported literature appears to be controversial about that. Some studies reported significant improvements after application of ROSE with up to 30% drop in the inadequacy rate [7,10,20]. Others failed to find a statistically significant improvement in the adequacy rates after application of ROSE [8,14].…”

Section: Discussionmentioning

confidence: 99%

“…In their meta-analysis, Witt et al concluded that ROSE was associated with improved sample adequacy rate from 83 to 92% with the largest effect noted in studies with lowest initial -without ROSE-adequacy rates [11]. A large study conducted by Pastorello et al reported significant improvement in adequacy rates from 69.4% without ROSE to 93.4% with ROSE and a decrease in the mean number of thyroid needle passes from 3.0 to 1.5 [20]. Another study by Chamorro et al (2018) evaluated 552 thyroid nodules with 30.5% decrease in non-diagnostic samples after implementation of ROSE [7].…”

Section: Discussionmentioning

confidence: 99%

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Rapid On-site Evaluation (ROSE) for Fine Needle Aspiration of Thyroid: Is It Helpful?

et al. 2021

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Introduction: Thyroid nodules are very common. Many are detected incidentally due to increased head and neck imaging. The majority are benign; however, malignancy can’t be excluded in many cases and tissue sampling is needed. Ultrasound guided fine needle aspiration is an easy and effective way to sample g thyroid nodules. Inadequate sampling was reported in 10-40% of the cases. Rapid On-site Evaluation (ROSE) was proposed to assess obtained sample for adequacy. The aim of this study is to identify the benefit of applying ROSE with US-FNA of thyroid nodules within our institution. Materials and methods: Patients who underwent FNA for thyroid nodules with ROSE availability documented in their procedure note between January 2017 to December 2018 were retrospectively included. All procedures were done by experienced radiologists. Aspirated material was Diff Quik stained for immediate evaluation. The final cytological diagnosis and specimen adequacy was based on The Bethesda system for reporting thyroid cytopathology. Specimen adequacy was compared between ROSE and non-ROSE groups. Results: 442 thyroid nodules were biopsied. ROSE was available for 65 nodules. Non-diagnostic rate with ROSE was 10.8% compared to 13.8% without ROSE with the difference being statistically insignificant. ROSE availability improved sample adequacy of nodules less than 3 cm with statistically significant difference of 100.0% with ROSE vs. 87% without ROSE. Conclusion: The current study does not justify the routine use of ROSE. However, ROSE availability is beneficial with smaller sized thyroid nodules and less experienced radiologists performing the procedure. Doi: 10.28991/SciMedJ-2021-0301-1 Full Text: PDF

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rapid On-site Evaluation (ROSE) for Fine Needle Aspiration of Thyroid: Is It Helpful?

et al. 2021

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“…Rapid on-site evaluation is useful to decrease inadequacy rates and is recommended in the American Thyroid Association Management Guidelines. 14 Many studies have shown that rapid on-site evaluation is effective at decreasing inadequacy rates; 12,15 however, obtaining a sufficient amount of material with just one needle pass for a target lesion is highly desirable. In the present study, the vibrating device resulted in a remarkably small number of needle passes, as well as a satisfactory rate of obtaining adequate samples at the first needle pass.…”

Section: Discussionmentioning

confidence: 99%

A New Device for Fine‐Needle Aspiration Cytology Consisting of a Vibrating Linear Resonant Actuator

et al. 2020

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Objective: To evaluate the efficacy of a new device for fine-needle aspiration cytology (FNAC) consisting of a vibrating linear resonant actuator (LRA). Study Design: Prospective clinical study. Methods: The LRA frequency was optimized by visualization of the needle motion using a high-speed camera. The FNAC device consists of a vibrating motor fixed to the stopper of a 5-ml syringe and piston. Upon insertion of the syringe needle into a thyroid nodule (with the stopper attached to the syringe piston), sufficient negative pressure with 1-ml suction was maintained. Subsequently, samples were obtained using vibration generated by an LRA or an eccentric rotating mass (ERM). Surgically resected thyroid specimens from 10 patients were evaluated. The number of follicular groups required for adequate diagnosis and the number of larger follicular groups were counted. Next, 254 thyroid nodules from 187 patients were also evaluated by FNAC. The inadequacy rate was determined, and final cytology was classified according to thyroid Bethesda categories. Results: The optimized LRA frequency was 155 Hz. Both the LRA and ERM devices resulted in sufficient amounts of diagnostic material and achieved low inadequacy rates. The number of large follicular groups obtained was significantly greater with the LRA device compared with the ERM device. Conclusions: The vibrating device using an LRA for thyroid FNAC resulted in sufficient amounts of thyroid follicular groups and achieved low inadequacy rates. In addition, the LRA device allowed for collection of larger follicular groups sufficient to diagnose appropriate thyroid Bethesda categories.

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“…In their study, nearly all procedures were performed by radiology residents with assistance from experienced physicians. Therefore, it is difficult to determine if the improved ND rate in the ROSE group is due to ROSE itself or related to the inexperience of the group [14]. A similar finding by Shield et al, which examined results of 3032 thyroid biopsy specimens, showed a ND rate of 6 % with ROSE and 17 % without (p < 0.0001).…”

Section: Non-diagnostic Rates By Procedural Volume and Rosementioning

confidence: 90%

Factors affecting thyroid nodule fine needle aspiration non‐diagnostic rates: a retrospective association study of 1975 thyroid biopsies

et al. 2021

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Background Thyroid nodules are common in clinical practice, and it is important to distinguish benign nodules, the vast majority, from malignant ones. Non-diagnostic (ND) samples have the potential to delay or mis-diagnose or lead to unnecessary surgeries, and it is important to examine what factors influence the ND rate. Prior literature has suggested that the impact of bedside cytology on ND rate is dependent on the initial adequacy rate, whereby higher ND rates benefit most from bedside cytology. We aim to compare the impact of bedside adequacy review between specialist groups who perform high volume thyroid biopsies with low initial ND rates. Methods We reviewed the cytopathology results of 1975 thyroid nodule FNAs performed between January 1, 2017 to December 31, 2017 in a multi-centre Canadian city, and the corresponding histopathology reports of 340 resected nodules. Descriptive variables were used to describe the data along with chi-squared testing and univariate logistic regression. Results The FNA biopsies were performed by three different speciality groups, which differed by procedural volume: radiology performed the most at 1171, pathology performed 655 and surgery performed 103. We could not define the operator for 45 of the nodules. The ND rate was lowest in the speciality groups with highest procedural volume, 3.4 % in pathology and 8.3 % in radiology, compared to 37.9 % in surgery (p < 0.001). Completion of bedside cytology rapid onsite evaluation (ROSE) significantly reduced the ND rate from 16.7 to 4.2 % for all samples (p < 0.001). When ROSE was compared with non-ROSE within a high procedural group (radiology), it further reduced the ND rate from 12.5 to 5.1 % (p < 0.001). Of the 340 resected nodules, 10.7 % (18) were in the ND category, of which 28 % (5/18) of these were found to be malignant (4 papillary carcinoma and 1 lymphoma). Conclusions The results from this study demonstrate that thyroid FNAs performed with bedside ROSE can significantly reduce the ND rate compared with non-ROSE, even in experienced groups with low initial ND rates. It is therefore imperative that care providers managing patients with thyroid nodules ensure that thyroid FNAs are referred to specialized individuals/groups who do high volume, and ideally with the use of bedside ROSE, whether provided by a cytotechnologist or a pathologist.

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The impact of rapid on‐site evaluation on thyroid fine‐needle aspiration biopsy: A 2‐year cancer center institutional experience

Cited by 27 publications

References 54 publications

Rapid On-site Evaluation (ROSE) for Fine Needle Aspiration of Thyroid: Is It Helpful?

Rapid On-site Evaluation (ROSE) for Fine Needle Aspiration of Thyroid: Is It Helpful?

A New Device for Fine‐Needle Aspiration Cytology Consisting of a Vibrating Linear Resonant Actuator

Factors affecting thyroid nodule fine needle aspiration non‐diagnostic rates: a retrospective association study of 1975 thyroid biopsies

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