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Cianci P, Tumolo R, Conversano I, Travaglia D, Trigiante G, Lantone G, Lizzi V, Cappiello M, Montagna M, Curci FP, Restini E. Needle size for thyroid fine needle aspiration cytology. A single institution experience. Front Surg 2024; 11:1368614. [PMID: 39035112 PMCID: PMC11258859 DOI: 10.3389/fsurg.2024.1368614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/10/2024] [Indexed: 07/23/2024] Open
Abstract
Background Fine needle aspiration cytology (FNAC) is an invasive diagnostic technique which is widely used for the cytological diagnosis of thyroid nodules. This procedure is generally widely tolerated by patients, albeit often accompanied by local pain and discomfort. Despite various proposals of execution methods, no approach is universally accepted,especially regarding the size of the needle to be used for sampling. Needle gauge preferences vary across regions, with 25-gauge needles more common in Western countries and 22-gauge needles favored in Asian countries. Complications associated with larger needles have been studied but remain inconclusive. Materials and methods Over one year, we conducted 300 FNAC procedures under ultrasound guidance, employing both 22-gauge and 25-gauge needles. In no patient was local anesthesia performed before starting the procedure, which in all was performed by the same operator. Similarly the cytological examination of the material taken was performed by a single operator. Patients, 105 males and 195 females, were divided into two groups of 150 each based on the needle size used. Results Patients treated with 22-gauge needles reported higher levels of pain during the procedure and increased discomfort afterward. Similarly, a greater incidence of hematomas and vasovagal reactions was noted in this group. However, the cell sample obtained and diagnostic response rates were consistent across both groups. Conclusion On the basis of our observations we concluded that the size of the needle used is irrelevant for the purposes of the diagnostic result, as long as the procedure is performed by expert personnel. However, the 25-gauge needle is preferable because it's more tolerated and accepted by patients. Our results do not represent a single and conclusive verdict, but they could represent the starting point for further research.
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Affiliation(s)
- Pasquale Cianci
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
| | - Rocco Tumolo
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
| | - Ivana Conversano
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
| | - Damiano Travaglia
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
| | - Giuseppe Trigiante
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
| | - Giuliano Lantone
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
| | - Vincenzo Lizzi
- Department of Medical and Surgical Sciences, Azienda Ospedaliero-Universitaria Policlinico Riuniti, Foggia, Italy
| | - Miriam Cappiello
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
| | - Marco Montagna
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
| | - Fabio Pio Curci
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
| | - Enrico Restini
- Department of Surgery and Traumatology, ASL BAT, Lorenzo Bonomo Hospital, Andria, Italy
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Puga FM, Ferreira IP, Brandão JR, Fonseca L, Couto de Carvalho A, Freitas C. Comparison of Cytological Adequacy between 23- and 25-Gauge in Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules: A Single-Center Prospective Study. Acta Cytol 2024; 68:121-127. [PMID: 38599193 DOI: 10.1159/000538290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/08/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Approximately 15% of fine-needle aspiration (FNA) of thyroid nodules are considered nondiagnostic. Several factors are potentially involved, including clinical and nodule features but also the gauge (G) of the needle used. However, few studies have compared the cytological adequacy obtained with different gauge needles and the data are controversial. We aimed to evaluate cytological adequacy results using 23- or 25-G needles. METHODS This study is an observational and prospective study of thyroid nodules submitted to ultrasound-guided FNA. The procedure was performed randomly using 23- or 25-G needles. The samples were reported by different cytopathologists who were blinded to the information of the gauge of the needle used. Statistical analysis was performed to compare cytological adequacy of FNA between the two groups. RESULTS A total of 177 thyroid nodules were included - 98 (55.4%) using 23-G and 79 (44.6%) using 25-G needles. The 23-G group presented a higher rate of cytological adequacy (69.4% [68/98] vs. 46.8% [37/79], p = 0.002). No differences were found between the two groups regarding patient or nodule characteristics. On logistic regression, 23-G needles correlated with better cytological adequacy (unadjusted OR 2.57 [95% CI: 1.39-4.77]), even after adjusting for nodule dimension, location, and type of cytology (slides +/- additional liquid-based cytology) (adjusted OR 2.44 [95% CI: 1.23-4.84]). CONCLUSION The gauge of the needle used was found to be an independent predictor of cytological adequacy, with 23-G needles providing more adequate samples. Further investigation is needed to confirm our results in order to stablish the optimal diagnosis technique.
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Affiliation(s)
- Francisca Marques Puga
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Inês Poças Ferreira
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - José Ricardo Brandão
- Serviço de Anatomia Patológica, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Liliana Fonseca
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - André Couto de Carvalho
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Cláudia Freitas
- Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Universitário de Santo António, Porto, Portugal
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3
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Blom M, Magarey MJR, Flatman S. Diagnostic adequacy and accuracy of surgeon-performed ultrasound guided fine needle aspiration in lateral neck masses. ANZ J Surg 2024; 94:117-121. [PMID: 38205558 DOI: 10.1111/ans.18857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/19/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Surgeon-performed ultrasound guided fine needle aspiration (SUS-FNA) reduces the time to diagnosis and treatment of head and neck pathology. Although it has been validated in the investigation of thyroid pathology, there is a paucity of evidence to support its use in lateral neck masses. This study aims to determine the accuracy and adequacy of SUS-FNA in the investigation of lateral neck masses. METHODS A retrospective cohort analysis was performed of patients who underwent a SUS-FNA for lateral neck mass between June 2018 and October 2022 at a single institution. Pathologist reports were reviewed to determine the rate of FNA sample adequacy. A comparison was made between FNA cytology results and final histopathological diagnosis following surgical excision in a subset of patients to determine FNA accuracy. RESULTS A total of 110 SUS-FNAs were performed on lateral neck masses. Diagnostic adequacy of SUS-FNA was determined to be 91% (100/110). When analysing the subset of patients who proceeded to surgical excision, the diagnostic accuracy of SUS-FNA was determined to be 88% (38/43). CONCLUSION SUS-FNA results in high adequacy rates with good diagnostic accuracy in the investigation of lateral neck masses. This tool has great potential in reducing treatment delay in the management of head and neck cancer.
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Affiliation(s)
- Megan Blom
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Matthew J R Magarey
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Medical Education, University of Melbourne, Melbourne, Victoria, Australia
| | - Samuel Flatman
- Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Kreager BC, Wu H, Chang WY, Moon S, Mitchell J, Peng C, Huang CC, Muller M, Tian J, Jiang X. High-Performance PMN-PT Single-Crystal-Based 1-3 Composite Transducer Integrated with a Biopsy Needle. BIOSENSORS 2024; 14:74. [PMID: 38391993 PMCID: PMC10887013 DOI: 10.3390/bios14020074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024]
Abstract
To address the need for high-resolution imaging in lung nodule detection and overcome the limitations of the shallow imaging depth associated with high-frequency ultrasound and the complex structure of lung tissue, we successfully integrated 50 MHz ultrasound transducers with 18-gauge biopsy needles. Featuring a miniaturized size of 0.6 × 0.5 × 0.5 mm3, the 50 MHz micromachined 1-3 composite transducer was tested to perform mechanical scanning of a nodule within a lung-tissue-mimicking phantom in vitro. The high-frequency transducer demonstrated the ability to achieve imaging with an axial resolution of 30 μm for measuring nodule edges. Moreover, the integrated biopsy needle prototype exhibited high accuracy (1.74% discrepancy) in estimating nodule area compared to actual dimensions in vitro. These results underscore the promising potential of biopsy-needle-integrated transducers in enhancing the accuracy of endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNA) for clinical applications.
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Affiliation(s)
- Benjamin C. Kreager
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; (B.C.K.); (H.W.); (S.M.); (J.M.); (M.M.)
| | - Huaiyu Wu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; (B.C.K.); (H.W.); (S.M.); (J.M.); (M.M.)
| | - Wei-Yi Chang
- CTS Advanced Materials, 4925 Indiana Ave, Lisle, IL 604532, USA; (W.-Y.C.); (J.T.)
| | - Sunho Moon
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; (B.C.K.); (H.W.); (S.M.); (J.M.); (M.M.)
| | - Josh Mitchell
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; (B.C.K.); (H.W.); (S.M.); (J.M.); (M.M.)
| | - Chang Peng
- School of Biomedical Engineering, ShanghaiTech University, Shanghai 201210, China;
| | - Chih-Chung Huang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan;
| | - Marie Muller
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; (B.C.K.); (H.W.); (S.M.); (J.M.); (M.M.)
| | - Jian Tian
- CTS Advanced Materials, 4925 Indiana Ave, Lisle, IL 604532, USA; (W.-Y.C.); (J.T.)
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; (B.C.K.); (H.W.); (S.M.); (J.M.); (M.M.)
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Llanos C, Holmes E, White C, Jasensky AK, Fitzgerald E. Diagnostic quality of ultrasound-guided fine-needle aspirates samples from the canine liver and spleen is not significantly affected by using 22-, 23-, and 25-gauge needles. Vet Radiol Ultrasound 2023; 64:966-972. [PMID: 37549956 DOI: 10.1111/vru.13290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023] Open
Abstract
Ultrasound-guided fine-needle aspirates (FNA) of the liver and spleen for cytological analysis are a commonly performed procedure in canine veterinary practice. Based on our review of the literature, this is the first published study investigating whether needle size affects the diagnostic quality of hepatic and splenic samples. The aim of this prospective analytical study was to compare the diagnostic quality of ultrasound-guided FNA cytological samples of canine liver and spleen based on cellularity, blood contamination, and overall cell preservation between three different needle sizes (22-, 23-, and 25-gauge). A total of 282 splenic aspirates from 94 dogs and 348 hepatic aspirates from 116 dogs were enrolled in the study and examined by two board-certified veterinary clinical pathologists. In this study, no significant differences in diagnostic quality were identified between different needle gauge sizes when sampling canine liver and spleen. Blood contamination was higher using 22-gauge needles compared with 25-gauge needles (P = 0.024) when sampling the liver.
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Affiliation(s)
- Cesar Llanos
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hertfordshire, UK
| | - Emma Holmes
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, UK
| | | | - Anne-Katherine Jasensky
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, UK
| | - Ella Fitzgerald
- Department of Clinical Science and Services, Royal Veterinary College, University of London, Hertfordshire, UK
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Rechter M, Saraph S, Cohen H, Ronen O. Nondiagnostic Test Result Rates Following Thyroid Extra-Fine-Needle Aspiration. Am J Clin Pathol 2023; 159:98-102. [PMID: 36469111 DOI: 10.1093/ajcp/aqac136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/06/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The first Bethesda classification category of thyroid fine-needle aspiration biopsy (FNAB) is nondiagnostic (ND), which indicates that the specimen's cellularity is inadequate for evaluation. This work investigated the effect of needle diameter size on ND rates by comparing diagnostic outcomes of FNAB samples collected with 23-, 25-, and 27-gauge needles. METHODS This was a retrospective analysis of samples collected from patients undergoing FNAB between 2018 and 2021. It was conducted in an otolaryngology department in a university teaching hospital. RESULTS Of the 699 aspirations, 144, 335, and 220 were performed using 23-, 25-, and 27-gauge needles, respectively. ND rates increased significantly when using 27-gauge compared with 23- to 25-gauge needles (P = .002), and a significantly lower ND rate was found for the 25-gauge needle compared with the 27-gauge needle (P = .001). Furthermore, increased nodule size was associated with reduced ND rate (odds ratio, 0.801; 95% confidence interval, 0.691-0.929). CONCLUSIONS The 25-gauge needles are superior to 27-gauge needles in reducing ND rates of thyroid nodule FNAB specimens. Future prospective studies should be performed to confirm these findings.
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Affiliation(s)
- Michael Rechter
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Sivan Saraph
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Hector Cohen
- Department of Pathology, Galilee Medical Center, Nahariya, Israeland
| | - Ohad Ronen
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel
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7
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Wildman-Tobriner B, Ho LM, Bowman AW. Needle types used in abdominal cross-sectional interventional radiology: a survey of the Society of Abdominal Radiology emerging technology commission. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:2623-2631. [PMID: 34128102 DOI: 10.1007/s00261-021-03145-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/11/2021] [Accepted: 05/22/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE To identify commonly used needle types in cross-sectional interventional radiology (CSIR) and to review features and safety profiles of those needles. METHODS Members of the Society of Abdominal Radiology (SAR) emerging technologies commission (ETC) on CSIR were sent a 13-question survey about what needles they use for common CSIR procedures: random and targeted solid organ biopsy, ultrasound-guided paracentesis, and ultrasound-guided thyroid fine needle aspiration (FNA). Results were compiled with descriptive statistics, and features of the most commonly used needles were reviewed. RESULTS 19 surveys were completed (response rate 57.6%, 19/33) from 16 institutions. For solid organ biopsies, the majority of respondents reported using an 18-gauge needle with an automatic firing mechanism and a variable throw length option. The most commonly used needle for both random and targeted biopsies was the Argon BioPince (26.3%, 5/19) The three most commonly used needles for solid organ biopsies all featured automatic firing, variable throw length options, and 18-gauge size. A 5 French Cook Yueh needle was most the most commonly used paracentesis needle (36.8%, 7/19). For thyroid FNA, all respondents used spinal needles, and 25-gauge was the most common size (72.2%, 13/18). CONCLUSION Abdominal radiologists use a variety of needles when performing common interventional procedures. Members of the SAR CSIR ETC commonly use automatic, 18-gauge, variable throw length needles for solid organ biopsies, 5 French catheter style needles for paracentesis, and 25-gauge spinal needles for thyroid FNA.
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Affiliation(s)
| | - Lisa M Ho
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
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8
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Sengul I, Sengul D. Apropos of quality for fine-needle aspiration cytology of thyroid nodules with 22-, 23-, 25-, even 27-gauge needles and indeterminate cytology in thyroidology: an aide memory. Rev Assoc Med Bras (1992) 2022; 68:987-988. [PMID: 36134824 PMCID: PMC9574989 DOI: 10.1590/1806-9282.20220498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/14/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ilker Sengul
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery - Giresun, Turkey.,Giresun University, Faculty of Medicine, Department of General Surgery - Giresun, Turkey
| | - Demet Sengul
- Giresun University, Faculty of Medicine, Department of Pathology - Giresun, Turkey
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9
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Sengul D, Sengul I. Minimum minimorum: thyroid minimally invasive FNA, less is more concept? Volens nolens? REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2022; 68:275-276. [PMID: 35442348 DOI: 10.1590/1806-9282.20211181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Demet Sengul
- Giresun University, Faculty of Medicine, Department of Pathology - Giresun, Turkey
| | - Ilker Sengul
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery - Giresun, Turkey.,Giresun University, Faculty of Medicine, Department of General Surgery - Giresun, Turkey
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10
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Sengul I, Sengul D. Big gain, no pain: Thyroid minimally invasive FNA (Thy MIFNA): Proposal of novelty in terminology. Rev Assoc Med Bras (1992) 2021; 67:1749-1750. [PMID: 34909944 DOI: 10.1590/1806-9282.20210922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ilker Sengul
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery - Giresun, Turkey.,Giresun University, Faculty of Medicine, Department of General Surgery - Giresun, Turkey
| | - Demet Sengul
- Giresun University, Faculty of Medicine, Department of Pathology - Giresun, Turkey
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11
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Sengul I, Sengul D, Veiga ECDA. Revisiting optimal needle size for thyroid fine-needle aspiration cytology: not much finer, less non-diagnostic? Rev Assoc Med Bras (1992) 2021; 67:1213-1214. [PMID: 34816907 DOI: 10.1590/1806-9282.20210671] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ilker Sengul
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery, Department of General Surgery - Giresun, Turkey
| | - Demet Sengul
- Giresun University, Faculty of Medicine, Department of Pathology - Giresun, Turkey
| | - Eduardo Carvalho de Arruda Veiga
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Obstetricia e Ginecologia - São Paulo (SP), Brazil
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12
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Comparison of Ultrasound-Guided Fine-Needle Cytology Quality in Thyroid Nodules with 22-, 23-, and 25-Gauge Needles. ACTA ACUST UNITED AC 2021; 2021:5544921. [PMID: 34211823 PMCID: PMC8205598 DOI: 10.1155/2021/5544921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/29/2021] [Indexed: 01/21/2023]
Abstract
Objective To compare the cytology quality of ultrasound-guided fine-needle biopsy in thyroid nodules with 22-, 23-, and 25-gauge (G) needles prospectively. Methods A total of 240 consecutive nodules underwent ultrasound-guided fine-needle aspiration (USG-FNA) and 240 nodules underwent ultrasound-guided fine-needle capillary (USG-FNC) were included in this prospective study from October 2014 to February 2016. Each nodule was sampled using 22 G, 23 G, and 25 G needle according to designed orders, and 1240 smears were finally obtained. Cytology quality was scored by a cytologist blinded to needle selection. Results In USG-FNA, the average scores and standard deviations were 5.50 ± 2.87 for 25 G needles, 4.82 ± 2.95 for 23 G needles, and 5.19 ± 2.81 for 22 G needles. In USG-FNC, the average scores and standard deviations of each group were 5.12 ± 2.69 for 25 G, 4.60 ± 2.90 for 23 G, and 4.90 ± 2.90 for 22 G needles. The specimen quality scores of 25 G group were significantly higher than that of 23 G group (P < 0.017) in both USG-FNA and USG-FNC. However, the differences were not statistically significant in nondiagnostic rate using different gauge of needles (P > 0.017 for all). Conclusions 25 G needles obtained the highest scores of sample quality in thyroid FNA and FNC comparing with 22 G and 23 G needles. 25 G needle should be first choice of thyroid FNA and FNC in routine work.
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Shumrick CM, Simmonds JC, Ogden LL, Snowden CA, Dhingra JK. A Blinded Randomized Trial Comparing 2 Needle Gauges for Fine-Needle Biopsy of Thyroid Nodules. OTO Open 2021; 5:2473974X211013732. [PMID: 33997588 PMCID: PMC8113655 DOI: 10.1177/2473974x211013732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/23/2021] [Indexed: 01/21/2023] Open
Abstract
Objective To compare diagnostic capability and patient pain between 25-gauge (25G) and 27G needles for ultrasound-guided fine-needle biopsy of thyroid nodules. Study Design Prospective blinded randomized trial. Setting Thyroid clinic in otolaryngology practice in a community. Methods A prospective randomized blinded trial was conducted on 148 thyroid nodules in 107 patients undergoing ultrasound-guided fine-needle biopsy. Needle gauge was randomized to individual nodule. Patients were blinded to the needle size used. All specimens were assessed via the Bethesda System for Reporting Thyroid Cytopathology and assigned a morphologic quantitative score based on number of thyroid cells and lymphocytes, amount of colloid, and degree of blood/fibrin artifact in each sample. Patient pain experience was scored. A chi-square test was used to compare nondiagnostic rates, and differences in cytologic morphology and pain scores were compared with 2-sample Student t tests. Results Of the 148 nodules, 77 were biopsied with 25G needles and 71 with 27G needles. Twenty-five percent (19/77) of the samples obtained with 25G needles yielded a nondiagnostic cytology result (Bethesda category 1) as compared with 11% (8/70) in the 27G group (P = .0282; 95% CI, 1.47%-25.97%). On average, samples from 25G needles had a higher blood/fibrin quantitative score (P = .043; 95% CI, −0.64 to −0.010). There were no differences in pain between groups. Conclusion Use of a 27G needle for fine-needle biopsies is not only safe and feasible but desirable and highly recommended, as it yields better diagnostic information.
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Affiliation(s)
- Christopher M Shumrick
- Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts, USA
| | - Jonathan C Simmonds
- Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts, USA
| | | | | | - Jagdish K Dhingra
- Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts, USA.,ENT Specialists Inc, Brockton, Massachusetts, USA
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14
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Xia S, Chen Y, Zhan W, Zhou W. Ultrasound-Guided Fine-Needle Aspiration Versus Fine-Needle Capillary Sampling in Evaluation of Lymph Node Metastasis of Thyroid Cancer. Front Oncol 2021; 11:642142. [PMID: 33937044 PMCID: PMC8079778 DOI: 10.3389/fonc.2021.642142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background To compare the sampling adequacy and diagnostic efficiency of ultrasound-guided fine-needle aspiration with 22-, 25-gauge needles and capillary sampling with 22-gauge needle in the biopsy of cervical lymph node. Methods A total of 130 cervical lymph nodes from 103 patients were consecutively included in the prospective study. Each suspected lymph node was aspirated with a 22-gauge needle, capillary sampled with a 22-gauge needle and aspirated with a 25-gauge needle. The adequacy rates and nondiagnostic rates of obtained specimen were calculated. Results Of the 130 suspected lymph nodes, there were 77 lymph nodes<6.0 mm and 53 lymph nodes≥6.0mm in the smallest dimension. Both FNA22G and FNC22G got significantly higher sampling adequacy than FNA25G for the total lymph nodes. For lymph nodes<6.0 mm, the sampling adequacy was significantly higher with FNA22G than with FNA25G for each parameter and the cumulative score (all P<0.05), while no difference were seen between FNA22G and FNC22G, and between FNC22G and FNA25G. There were higher nondiagnostic rates for FNA25G compared with FNA22G and FNC22G in all lymph nodes and in each size subgroups. FNA25G yielded more diagnostically inadequate specimens than FNA22G and FNC22G did in the total lymph nodes (P=0.002), in lymph nodes<6.0 mm (P=0.014), and in those ≥ 6.0 mm (P=0.000). Conclusions FNA22G and FNC22G obtained more diagnostically adequate specimens than FNA25G in cervical lymph nodes. FNA22G and FNC22G may be more suitable than FNA25G in diagnosing cervical lymph nodes. FNA22G and FNC22G may yield specimens with similar quality.
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Affiliation(s)
- Shujun Xia
- Department of Ultrasound, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yilai Chen
- Department of Ultrasound, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiwei Zhan
- Department of Ultrasound, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Zhou
- Department of Ultrasound, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Ultrasound, Ruijin Hospital/Lu Wan Branch, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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The Effect of Needle Sizes for Sample Adequacy in Thyroid Nodule Fine-Needle Biopsies. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.803436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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