Adequacy criteria for thyroid FNA evaluated by ThinPrep slides only

Vivero, Marina; Renshaw, Andrew A.; Krane, Jeffrey F.

doi:10.1002/cncy.21858

Cited by 26 publications

(15 citation statements)

References 33 publications

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“…While identifying "scant but adequate" cases may be of value as part of a quality assurance program for thyroid aspiration, at the threshold used in the Bethesda system there is no difference in clinical outcome between scant and nonscant samples. Whether this is true at the lower adequacy thresholds that have been proposed is not clear [47,48,53] . Further study appears to be warranted.…”

Section: Discussionmentioning

confidence: 87%

Characteristics of False-Negative Thyroid Fine-Needle Aspirates

Renshaw

Gould²

2017

Acta Cytologica

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Introduction: False-negative thyroid fine-needle aspirates (FNA) are not well characterized. Methods: We correlated the results of all thyroid aspirations from 1997 to 2016 with histologic follow-up. Results: There were 13,733 aspirates, 2,112 (15.3%) resections, and 678 malignancies (32.1%). Eighteen (2.7%) false-negative cases were identified (interpretation, n = 6; sampling, n = 7; and new nodules, n = 5). Interpretive false-negative cases were significantly less likely when the indeterminate rate was greater than 13% (p = 0.01). Interpretive errors involved rare cells with poorly developed features of malignancy. Sampling errors were not associated with scant cellularity in the specimen. The majority of false-negative cases were not resected because of a clinical suspicion of malignancy. The sensitivity of FNA for 9-mm papillary carcinomas was 44.3%. Conclusion: In this cohort, the false-negative rate of thyroid FNA was 2.7% and the risk of malignancy for a benign diagnosis was 3.5%. Interpretative errors involved rare cells with poorly developed features of malignancy. There is little evidence that either the false-negative rate or the risk of malignancy of a benign thyroid FNA is different in patients who do and do not undergo resection.

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Section: Discussionmentioning

confidence: 87%

Characteristics of False-Negative Thyroid Fine-Needle Aspirates

Renshaw

Gould²

2017

Acta Cytologica

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“…In such cases, a viable alternative could be the use of LBC for the repeat FNA: its diagnostic accuracy is similar to the conventional preparations and additional studies such as immunocytochemistry and molecular analysis can be easily performed . A recent paper has also shown that lowering the adequacy threshold in liquid‐based preparations does not affect test performance . In our samples, if molecular analysis was used in lieu of repeat aspiration, it would be unnecessarily used in 75% of the samples that were reclassified as benign after the second assessment.…”

Section: Discussionmentioning

confidence: 92%

“…16,17 A recent paper has also shown that lowering the adequacy threshold in liquid-based preparations does not affect test performance. 18 In our samples, if molecular analysis was used in lieu of repeat aspiration, it would be unnecessarily used in 75% of the samples that were reclassified as benign after the second assessment. In addition, repeat FNA is a cheaper alternative, which can be an important issue in developing countries or in remote centres with no direct access to modern technologies.…”

Section: Discussionmentioning

confidence: 95%

The impact of repeat FNA in non‐diagnostic and indeterminate thyroid nodules: A 5‐year single‐centre experience

Saieg

Barbosa²,

Nishi

et al. 2017

Cytopathology

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“…Quantitatively, predominantly cystic thyroid nodules have a low cellularity compared to solid thyroid nodules; qualitatively, large and predominantly cystic thyroid nodules tend to accompany intranodular changes such as cystic degeneration and/or hemorrhage, which may have poor colloid accumulation [14]. Furthermore, the amount of colloid can be diminished and appear dense, fragmented, and in droplet form during LBC preparations [20]. In our study, slides with frequent and easily identifiable colloids were classified as cytological adequacy even if they lacked the threshold of 6 groups of follicular cells; however, all of these cases exhibited low cellularity.…”

Section: Discussionmentioning

confidence: 99%

Factors that Influence Sample Adequacy in Liquid-Based Cytology after Ultrasonography-Guided Fine-Needle Aspiration of Thyroid Nodules: A Single-Center Study

et al. 2018

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Objective: The factors that influence the acquisition of adequate samples during liquid-based cytology (LBC) remain unclear. This study aimed to identify factors that affect cytological adequacy in LBC after ultrasonography (US)-guided fine-needle aspiration (US-FNA) of thyroid nodules. Study Design: From January 2017 to May 2017, a single radiologist performed US-FNA to diagnose 112 thyroid nodules in 112 consecutive patients. Based on US findings after US-FNA, the size, location, position, composition, calcification, and vascularity of each nodule, as well as the US-based diagnosis, were investigated by the same radiologist. Blinded to US information, a single cytopathologist investigated cytological adequacy, cytological cellularity, and Bethesda category. Results: Of the 112 thyroid nodules, cytological adequacy was achieved in 91.1% (102/112). Thyroid nodules with sizes ≥20 mm or those that were predominantly cystic showed a higher rate of cytological inadequacy (p < 0.05). Thyroid nodule location, position, calcification status, and vascularity did not influence cytological adequacy, nor did US-based diagnosis (p > 0.05). Nodule composition or calcification significantly influenced cytological cellularity (p < 0.05), whereas nodule size, location, position, vascularity, and US-based diagnosis did not (p > 0.05). Conclusions: Most investigated factors did not influence cytological adequacy or cellularity.

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Adequacy criteria for thyroid FNA evaluated by ThinPrep slides only

Cited by 26 publications

References 33 publications

Characteristics of False-Negative Thyroid Fine-Needle Aspirates

Characteristics of False-Negative Thyroid Fine-Needle Aspirates

The impact of repeat FNA in non‐diagnostic and indeterminate thyroid nodules: A 5‐year single‐centre experience

Factors that Influence Sample Adequacy in Liquid-Based Cytology after Ultrasonography-Guided Fine-Needle Aspiration of Thyroid Nodules: A Single-Center Study

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