The value of onsite adequacy assessment of thyroid fine-needle aspirations is a function of operator experience

Ghofrani, Mohiedean; Beckman, Danita; Rimm, David L.

doi:10.1002/cncr.21715

Cited by 101 publications

(108 citation statements)

References 8 publications

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“…In addition, it has been proven that on-site adequacy evaluation can reduce inadequate samples significantly. 19,20 The issue regarding the number of follicular cells required for adequacy has been debated over the years; and, to date, no consensus has been reached. 2 Until a standardized, practical guideline is established, each individual cytopathologist will have to use criteria with which he or she is comfortable.…”

Section: -15mentioning

confidence: 99%

Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlations

Yang

Schnadig

Logroño

et al. 2007

Cancer

605

522

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Objective Both increased production of reactive oxygen and nitrogen intermediates (RONI) and reduced levels of complement may play a role in the increased apoptosis and reduced clearance of apoptotic cells in systemic lupus erythematosus (SLE). The objective of this study was to evaluate both processes in a parallel, prospective, longitudinal manner. Methods Sixty‐seven SLE patients were evaluated during multiple visits, and 31 healthy control subjects were evaluated once or twice. Clinical and laboratory features of SLE disease activity were determined, and blood was collected for measurement of serum nitrate plus nitrite (NOx) levels and for isolation of peripheral blood mononuclear cells (PBMCs). PBMCs were cultured with a nitric oxide (NO) donor and SLE or control plasma, with or without heat inactivation, cobra venom factor (CVF), or lipopolysaccharide plus interferon‐γ treatment. Cells were analyzed for apoptotic index (AI), cellular subsets, and RONI production. Results The PBMC AI was associated with SLE and was inversely associated with complement levels over time. Changes in the AI with addition of a NO donor was longitudinally associated with serum NOx levels, and stimulation of SLE PBMCs led to parallel increases in RONI production and apoptosis. Addition of SLE plasma resulted in a greater PBMC AI, an effect that was increased with heat inactivation and was corrected with CVF treatment. Conclusion These data suggest that the greater AI observed in SLE PBMCs relates to increased PBMC RONI production and reduced complement levels. The longitudinal nature of these parallel associations within individuals suggests that these processes are dynamic and additive.

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Section: -15mentioning

confidence: 99%

Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlations

Yang

Schnadig

Logroño

et al. 2007

Cancer

605

522

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“…Rapid on-site adequacy assessment (ROSAA) during the FNA procedure provides immediate feedback and allows for repeat aspirates to ensure specimen adequacy. Studies evaluating the added diagnostic value of ROSAA have consistently demonstrated that the procedure decreases the rates of nondiagnostic specimens and false-negative cytology and the number of needle passes found to be necessary [4,9,10,14,15,16,17]. …”

Section: Introductionmentioning

confidence: 99%

“…Although safe and cost-effective, the most important limitation of thyroid FNA is its high rate of nondiagnostic cytology with reported rates of up to 34% [1,2,6,7,8,9,10,11]. The established definition for adequate cytology is the presence of at least 6 groups of follicular cells, each containing 10-15 cells, preferably obtained from at least 2 aspirates of a nodule [2,12,13].…”

Section: Introductionmentioning

confidence: 99%

Thyroid Ultrasound-Guided Fine-Needle Aspiration: The Positive Influence of On-Site Adequacy Assessment and Number of Needle Passes on Diagnostic Cytology Rate

et al. 2016

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Objective: Nondiagnostic cytology is the most important limitation of thyroid ultrasound-guided fine-needle aspiration (US-FNA). This study aimed to identify factors associated with the adequacy rate of thyroid US-FNA. Study Design: Consecutive thyroid US-FNAs (2006-2013) were retrospectively included. Attending radiologists, radiology fellows and radiology residents performed US-FNA, usually involving 2-3 needle passes. In more recent years, rapid on-site adequacy assessment (ROSAA) was performed to ensure specimen adequacy. US characteristics, procedural variations and cytology results were extracted from US and pathology reports and statistically evaluated. Results: Diagnostic cytology was obtained in 64.6% of 1,381 thyroid US-FNAs. Factors associated with nondiagnostic cytology were ROSAA (74.6% diagnostic cytology, OR 0.55, 95% CI 0.42-0.71), ≥3 clinic visits for US-FNA of the same thyroid nodule (54.7%, OR 1.56, 95% CI 1.16-2.10) and increased intranodular vascularization (51.8%, OR 1.73, 95% CI 1.17-2.57). With ROSAA, an increasing number of needle passes demonstrated improving adequacy rates. The adequacy rate was not operator-dependent. Conclusion: This study demonstrates that ROSAA improves the adequacy rate of thyroid US-FNA. Without ROSAA, we recommend performing at least 3 needle passes. Less diagnostic cytology is obtained from nodules with increased intranodular vascularization or from those undergoing US-FNA ≥3 times.

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“…It can be used in place of open biopsy in most patients to facilitate preoperative decision-making and/or to avoid unnecessary invasive procedures for patients with primary or metastatic lesions. However, some reports have questioned the added benefit of adequacy assessment in situations in which the FNAC is performed under ultrasound guidance [4]. …”

Section: Introductionmentioning

confidence: 99%

On-Site Toluidine Blue Staining and Screening Improves Efficiency of Fine-Needle Aspiration Cytology Reporting

2012

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Objective: We investigated the role of on-site toluidine blue staining and screening in fine-needle aspiration cytology (FNAC) reporting for patients with thyroid nodules, palpable breast lumps and palpable lymph nodes. Study Design: A total of 200 consecutive patients with a palpable lymph node or a lump in the breast or thyroid referred to the outpatient department for FNAC were included in this study. We used toluidine blue to stain FNAC slides for the evaluation of smear adequacy. The toluidine blue-stained slides were compared with the same slides after being decolorised and Papanacolaou (PAP)-stained. Results: Out of 200 cases, 28 (14%) were deemed unsatisfactory on the first attempt as assessed by rapid staining. These included 16 (38%) of 42 thyroid cases, 10 (10.4%) of 96 breast lump cases and 2 (3.2%) of 62 lymph node cases. A repeat FNAC in the same sitting on these 28 patients showed adequate material in 24 (12%) of them. Therefore, for 98%, a decision could be made at the very first visit to plan further management. Conclusions: We concluded that toluidine blue offers excellent cytological details for the preliminary identification of the lesion and to decide on the adequacy of the material for definitive diagnosis on FNAC slides.

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The value of onsite adequacy assessment of thyroid fine-needle aspirations is a function of operator experience

Cited by 101 publications

References 8 publications

Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlations

Fine-needle aspiration of thyroid nodules: A study of 4703 patients with histologic and clinical correlations

Thyroid Ultrasound-Guided Fine-Needle Aspiration: The Positive Influence of On-Site Adequacy Assessment and Number of Needle Passes on Diagnostic Cytology Rate

On-Site Toluidine Blue Staining and Screening Improves Efficiency of Fine-Needle Aspiration Cytology Reporting

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