A model for training ultrasound-guided fine-needle punctures

Abstract

OBJECTIVE:To evaluate the efficacy of a training program in ultrasound-guided fine needle puncture using a cost-effective model. METHODS: We evaluated the training of 20 resident radiology physicians, based on a theoretical course and a practical simulation part with models that focused on the puncture technique of thyroid nodules. The total time to perform the procedure, the number of punctures on the model surface, and the application of a questionnaire were used to assess the performance and confidence of the resident physicians in performing the procedure. RESULTS:The training model used was easy to reproduce, inexpensive, versatile, and capable of simulating the echotexture of thyroid tissue. There was a significant reduction in the total time needed to perform the procedure with a mean of 173.7 s±91.28 s from R1 and 112.8 s±17.66 s from R2 before the course vs. 19.2 s±112.8 s and 14.3 s±9.36 s, respectively, after the course (p<0.0001); as well as the number of superficial punctures, with a mean of 2.2 punctures±0.92 from R1 and 1.5 punctures±0.32 from R2 before the course vs 1.1 punctures±0.71 and 1.0 puncture±0.0, respectively, after the course (p<0.0001). There was also a subjective improvement in the performance and confidence in performing this procedure. CONCLUSIONS: An inexpensive and easy-to-reproduce gelatin-based model enabled adequate training of resident physicians and proved capable of improving their skills and confidence in simulating the procedure, even with a short period of training.

A vignette epexegesis of a model for training sonography-guided fine-needle aspirations in thyroidology and thyroidologists: think twice with needle size?

“…As a matter of fact, this issue merits further investigation. We thank Luz et al 1 for their valuable study.…”

“…We read with a great deal and respect the research article entitled “A model for training ultrasound-guided fine-needle punctures”. This beneficial research of high quality seems to demand determining in order to evaluate the efficacy of a training program in sonography-guided fine-needle aspiration (FNA) using a cost-effective model 1 . Luz et al 1 declared in their study published in the 68th volume of Rev Assoc Med Bras that no difference had been detected between the two groups of residents, resident physicians from the first year of the course (R1) vs. those from the second year of the course (R2), in the time required to perform the procedure before or after the FNA training course.…”

“…This beneficial research of high quality seems to demand determining in order to evaluate the efficacy of a training program in sonography-guided fine-needle aspiration (FNA) using a cost-effective model 1 . Luz et al 1 declared in their study published in the 68th volume of Rev Assoc Med Bras that no difference had been detected between the two groups of residents, resident physicians from the first year of the course (R1) vs. those from the second year of the course (R2), in the time required to perform the procedure before or after the FNA training course. Conversely, the authors reported that the posttraining punctures performed were significantly lower than pretraining ones numerically, regardless of the group of residents, R1 vs. R2.…”

“…Of note, the debate is still ongoing on this controversial issue utilizing a broad range, from 21 to 27 gauges, of needle sizes 2 , 3 , 4 . Luz et al 1 emphasized using a 25-gauge needle, without the puncture guide, in their good work. However, the aforementioned size has been known as not much “finer” and also a “larger” one 2 , 3 , 4 .…”

Needle visualization during ultrasound-guided puncture: image optimization

“…Due to their ease of handling and low cost, models made from gelatin are mainly used. 10,11 This study aims to verify the perceptions of medical students with little or no experience of USG guided puncture in relation to the number of pixels seen using specific software (photoshop), identifying in which situations images are better evaluated by the students, in relation to the angle between the needle and the surface to be punctured and which needle should be used for puncture, and also to evaluate whether there is a difference when needle visualization software is used.…”