Thyroid FNA performed by cytopathologists accompanied by radiologists guiding the ultrasound provide high-level quality results: A retrospective observational study

Borges, Felipe Abrantkoski; Camilo-Júnior, Deolino João; Yamamoto, Fábio Massahito; Xavier‐Júnior, José Cândido Caldeira

doi:10.1016/j.anndiagpath.2022.151912

Cited by 3 publications

(6 citation statements)

References 19 publications

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“…At our institution, USFNAs of extrathyroidal lesions are infrequent, with most USFNAs performed on thyroid nodules, and most extrathyroidal lesions biopsied by palpation alone. As noted previously, the practice pattern of pathologist‐performed USFNAs can vary significantly by institution 8–13,15–17 . This stems from a need to balance efficient utilization of time, resources, and billing.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…As USFNAs have grown in popularity, institutions have utilized it in different formats. Some describe pathologists performing USFNAs while working alongside radiologists, 15 while others describe clinics where the imaging, biopsy and assessments are performed by pathologist from start to finish 8,9,11–13,17 . Our institution practices in the latter model, but unlike the institutions that appear to have moved to ultrasound‐guided FNAs of essentially all lesions, 8,9 ultrasound at our institution is often reserved for extrathyroidal lesions that demonstrate features that may lead to more challenging biopsies by palpation alone.…”

Section: Discussionmentioning

confidence: 99%

“…Performing USFNAs has become an increasingly important component of the scope of practice for interventional cytopathologists, but practice patterns are variable among institutions. [8][9][10][11][12][13][15][16][17] There is limited published data on the utilization and performance characteristics of pathologist-performed USFNAs, and most reports have focused on thyroid biopsies. [10][11][12][13] Our review of pathologist-performed USFNAs at a single tertiary care academic medical center shows that even for extrathyroidal lesions, this is a useful tool that can be employed with high accuracy and low non-diagnostic rates.…”

Section: Discussionmentioning

confidence: 99%

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Pathologist‐performed ultrasound‐guided fine needle aspiration biopsies of extrathyroidal sites: An observational study

Kliassov

McKenzie

Dash

et al. 2022

Diagnostic Cytopathology

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Background Pathologist‐performed ultrasound‐guided fine needle aspiration (USFNA) biopsies have become an increasingly important component of the interventional cytopathologist's toolbox. However, its application varies between institutions, and there is limited literature describing its performance characteristics when utilized in extrathyroidal sites. Here we review our institutional experience within our pathologist‐run FNA clinic. Methods A retrospective review was conducted of pathologist‐performed USFNAs of extrathyroidal sites over a 9‐year period. Data collected included lesion site, size, patient age, patient gender, diagnostic category, and corresponding results from surgical resection when available. The diagnosis on surgical resection was considered the gold standard for determining discordance rates. Results A total of 143 pathologist‐performed USFNAs of extrathyroidal lesions were performed from October 2011 to October 2020. These encompassed a wide range of sites, with most biopsies from the head and neck. The mean recorded size was 2.2 cm, with a range of 0.6–6 cm. Larger lesions (over 2 cm) were more likely to be noted in challenging locations, demonstrate difficult features, or be cystic. Most (n = 133) biopsies were sufficient for diagnosis, with a non‐diagnostic rate of 7% (n = 10). Accuracy when compared to subsequent surgical resection was high, with sensitivity of 89%, specificity of 93%, positive predictive value of 94%, and negative predictive value of 87%. Conclusion Our experience supports that pathologist‐performed USFNA of extrathyroidal lesions—even those with challenging features—can result in excellent diagnostic yield and accuracy. The addition of USFNA to the interventional cytopathologists' repertoire can be a valuable tool to enhance patient care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pathologist‐performed ultrasound‐guided fine needle aspiration biopsies of extrathyroidal sites: An observational study

Kliassov

McKenzie

Dash

et al. 2022

Diagnostic Cytopathology

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“…O protocolo para diagnóstico de nódulos tireoidianos inclui a avaliação clínica do paciente, ultrassonografia (US) e punção aspirativa por agulha fina (PAAF) (Borges et al 2022). Entretanto, mesmo que a PAAF seja considerada o método padrão ouro para a caracterização dos nódulos de tireoide, a técnica é subjetiva, apresentando de 5 a 10% de resultados falsos negativos (San Laureano et al, 2020) e 15 a 30% de resultados indeterminados, fazendo com que na maioria das vezes seja necessária a realização da ressecção do nódulo (Oczko-Wojciechowska et al, 2020;Seneldir et al, 2020;Hejaz et al 2022).…”

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Busca De Marcadores Moleculares Preditivos Do Acometimento De Linfonodos Em Carcinomas Papilíferos De Tireoide

et al. 2022

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O câncer de tireoide é a neoplasia que mais cresce em incidência todos os anos, sendo o carcinoma papilífero de tireoide (CPT) o subtipo mais comum. Em muitos casos estes tumores podem se tornar agressivos, ocasionando metástases linfonodais. A determinação de marcadores moleculares pela análise de expressão gênica é uma importante ferramenta para a determinação do prognóstico destes tumores. Considerando o papel dos genes NEDD9, B3GNT7, PHB, BAD, PAXIP1, PPM1D e PIK3R5 na etiologia de diversos cânceres, este estudo consistiu em verificar pela técnica de RT-qPCR se os mesmos podem ser marcadores moleculares preditivos do acometimento de linfonodos e se estão relacionados ao desenvolvimento destes tumores. No presente estudo não foi observada expressão diferencial significativa dos genes analisados entre os grupos amostrais de CPT versus MCPT (microcarcinomas) e entre os grupos de CPT linfonodo positivo versus CPT linfonodo negativo, indicando que estes genes não estão relacionados ao desenvolvimento tumoral e não podem ser considerados marcadores preditivos de metástases em linfonodos em CPT.

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Accuracy of ultrasound‐guided fine‐needle aspiration cytology in evaluation of thyroid nodules using different ultrasonographic and cytological features

Al‐Yousofy,

Hamood,

Almatary

et al. 2024

Cytopathology

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BackgroundFine‐needle aspiration cytology (FNAC) is a reliable method for preoperative evaluation of thyroid nodules particularly if ultrasound‐guided (USG‐FNAC). The main purpose of this study is to evaluate the efficacy of USG‐FNAC and its accuracy.MethodsWe retrospectively studied 212 thyroidectomy cases with preoperative ultrasonography and FNAC data during the period 2015–2022 using TI‐RADS for final ultrasound diagnosis and Bethesda system for cytological diagnosis.ResultsThe studied cases were 200 females and 12 males. Thyroid cancer was more prevalent under 20 years old (78.5%). Papillary thyroid carcinoma comprises 84% of all cancer cases. Significant ultrasound features (p‐value <0.05) favour malignancy were hypoechogenicity (66%), mixed echogenicity (84%), irregular border (61%), microcalcification (68%) and rim halo (63.6%). Malignancy was found in 21% of TI‐RADS‐2, 65% of TI‐RADS‐4 and 100% of TI‐RADS‐5. There is a significant difference between different categories of Bethesda system. All cases in Cat‐VI were malignant (100%). Malignancy was also found in 81% of Cat‐V, 20% of Cat‐IV, 33% of Cat‐III, 16% of Cat‐II and 43% of Cat‐I. Cytological features consistent with malignancy were as follows: grooving (94%), nuclear irregularities (89%), nuclear pseudoinclusion (89%) and little colloid (82%). In our study, USG‐FNAC sensitivity was 83%, specificity 85%, PPV 85%, NPV 83% and accuracy 84%.ConclusionUltrasound features in favour of malignancy in thyroid nodules are hypoechoic or complex echogenicity, irregular border, punctuate calcification and presence of rim halo. Cytological features in favour of malignancy are grooving, nuclear irregularities, nuclear pseudoinclusion and little or absent colloid.

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Thyroid FNA performed by cytopathologists accompanied by radiologists guiding the ultrasound provide high-level quality results: A retrospective observational study

Cited by 3 publications

References 19 publications

Pathologist‐performed ultrasound‐guided fine needle aspiration biopsies of extrathyroidal sites: An observational study

Pathologist‐performed ultrasound‐guided fine needle aspiration biopsies of extrathyroidal sites: An observational study

Busca De Marcadores Moleculares Preditivos Do Acometimento De Linfonodos Em Carcinomas Papilíferos De Tireoide

Accuracy of ultrasound‐guided fine‐needle aspiration cytology in evaluation of thyroid nodules using different ultrasonographic and cytological features

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