Comparison of two different standards of care in detecting malignant thyroid nodules using thyroid fine-needle aspiration

Thyroid cancer diagnosis with transdermal probe 22G U/S versus EBUS-convex probe TBNA-B 22G and 19G: pros and cons

INTRODUCTION

Thyroid cancer is usually diagnosed both with imaging techniques and transdermal biopsy. Laboratory tests are also included in the initial work-up.

PATIENTS AND METHODS

One hundred and thirty patients were included in our study with pathological imaging findings in the thyroid region. Biopsies were performed with 22 G with transdermal convex probe, EBUS 22 G Mediglobe® needle and 19 G Olympus® needle. We investigated the efficiency and safety of both techniques and identified the best candidates for each method.

DISCUSSION

19 G needle identified cancer types such as; Lymphoma, Medullary thyroid cancer, and Hurthle cell cancer, which we know from previous pathology studies that a larger sample is necessary for diagnosis. No safety issues were observed for both techniques and the EBUS technique produced more cell block material when 22 G needle was compared to transdermal biopsy in peritracheal lesions.

CONCLUSION

The method of biopsy should be made based on the size and accessibility of the lesion.

High-Score US-Suspicious Subcentimeter Thyroid Nodules: What Factors Affect Adequate Sampling of US-Guided Fine-Needle Aspiration Biopsy?

BACKGROUND

Fine-needle aspiration biopsy (FNAB) is diagnostic standard for thyroid nodules. However, the influence of adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules is not known well.

OBJECTIVES

To assess the factors affecting adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules.

METHODS

Three hundred and forty-nine consecutive US-guided FNAB procedures were performed in 344 patients with subcentimeter thyroid nodules. The adequate sample rate was analyzed for all nodules on the basis of nodule-related and technical factors. The factors affecting adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules were determined by multivariate logistic regression.

RESULTS

The adequate sample rate increased with larger nodules (72.7% for 3-6 mm nodules and 84.9% for 7-10 mm nodules (P=0.007)). The adequate sample rate was 63.9%, 81.3%, and 90.6% in nodules with macrocalcifcation, microcalcification, and no calcification, respectively (P < 0.001). The adequate sample rate was 71.8% for biopsies performed with a perpendicular needle path and 85.0% with a parallel needle path (P=0.004). The significant factors affecting adequate sample rate of US-guided FNAB for subcentimeter thyroid nodules were nodule size (P < 0.001; odds ratio (OR) for 7-10 mm nodules was approximately 3.0 times higher than that for 3-6 mm nodules), calcification (P < 0.001; OR for nodules without calcification was approximately 5.3 times higher than that for the nodules with macrocalcification), and needle path (P=0.044; OR for the use of the parallel needle path was about 1.8 times higher than that for the perpendicular needle path).

CONCLUSION

Nodule size, calcification, and needle path were the determinants of sample adequacy. The adequate sample rate was higher in larger nodules, in nodules without calcification, and upon using a parallel needle path for biopsy.