Ultrasound-guided fine-needle aspiration of thyroid nodules: assessment of the ideal number of punctures

Correlation between thyroid fine needle aspiration and pathological examination: a 10 year retrospective study

OBJECTIVE

To establish the diagnostic performance of fine-needle aspiration in detecting benign and malignant neoplasm in comparison with post-thyroidectomy histopathological findings among patients who received a thyroidectomy.

METHODS

Retrospective observational data collected between 2011-2021 were included from patients who received partial or total thyroidectomy. The Bethesda system was used to classify neoplasms from fine-needle aspiration procedures as benign or malignant. Sample characteristics, diagnostic accuracy, sensitivity, specificity, and predictive values were evaluated.

RESULTS

Patients (n=360) who underwent thyroidectomy were analyzed, of whom 142 (39.4%) and 218 (60.6%) had benign and malignant neoplasms, respectively. Using the Bethesda system, 23 (6.4%) were classified as unsatisfactory result (BI), 83 (23.1%) as benign (BII), 50 (13.9%) as atypia of undetermined significance (BIII), 23 (6.4%) as suspected follicular or Hürthle cell neoplasia (BIV), 102 (28.3%) as suspected malignancy (BV) and 79 (21.9%) as malignant (BVI). The fine-needle aspiration diagnostic accuracy for carcinomas was 92%, while the sensitivity and specificity were 94.4% and 86.9%, respectively. The negative and positive predictive values were 87.9% and 93.9%, respectively.

CONCLUSION

Fine-needle aspiration has high diagnostic accuracy, sensitivity and specificity, and is a reliable test for distinguishing between benign and malignant thyroid pathologies.

Computed tomography-guided percutaneous biopsy of bone lesions: rate of diagnostic success and complications

OBJECTIVE

To determine the rates of diagnostic success and complications of computed tomography (CT)-guided percutaneous biopsy of bone lesions suspected for malignancy.

MATERIALS AND METHODS

Retrospective study including 186 cases of CT-guided percutaneous biopsies of bone lesions in the period from January, 2010 to December, 2012. All the specimens were obtained with 8-10 gauge needles. The following data were collected: demographics, previous history of malignancy, data related to the lesion, to the procedure, and to histological results.

RESULTS

Most patients were women (57%), and the mean age was 53.0 ± 16.4 years. In 139 cases (74.6%), there was diagnostic suspicion of metastasis and the most common primary tumors were breast (32.1%) and prostate (11.8%). The bones most commonly involved were spine (36.0%), hip (32.8%) and long bones (18.3%). Complications occurred in only three cases (1.6%) including bone fracture, paresthesia with functional impairment, and needle breakage requiring surgical removal. The specimens collected from 183 lesions (98.4%) were considered appropriate for diagnosis. Malignant results were more frequently found in patients who had a suspected secondary lesion and history of known malignancy (p < 0.001), and in patients who underwent PET/CT-guided procedures (p = 0.011).

CONCLUSION

CT-guided percutaneous biopsy is a safe and effective procedure for the diagnosis of suspicious bone lesions.

Computed tomography-guided percutaneous biopsy of pancreatic masses using pneumodissection

Objective To describe the technique of computed tomography-guided percutaneous biopsy of pancreatic tumors with pneumodissection. Materials and Methods In the period from June 2011 to May 2012, seven computed tomography-guided percutaneous biopsies of pancreatic tumors utilizing pneumodissection were performed in the authors' institution. All the procedures were performed with an automatic biopsy gun and coaxial system with Tru-core needles. The biopsy specimens were histologically assessed. Results In all the cases the pancreatic mass could not be directly approached by computed tomography without passing through major organs and structures. The injection of air allowed the displacement of adjacent structures and creation of a safe coaxial needle pathway toward the lesion. Biopsy was successfully performed in all the cases, yielding appropriate specimens for pathological analysis. Conclusion Pneumodissection is a safe, inexpensive and technically easy approach to perform percutaneous biopsy in selected cases where direct access to the pancreatic tumor is not feasible.