Adequacy of surgeon‐performed ultrasound‐guided thyroid fine‐needle aspiration biopsy

Abstract

Prior publications recommend that obtaining adequate thyroid cytology specimens requires use of US-guided FNAB and on-site evaluation of cytology adequacy. This study demonstrates that a combination of experienced US guidance, both capillary and aspiration sampling, and three to four needle passes produce comparable results while conserving costs and resources.

Role of operator experience in ultrasound-guided fine-needle aspiration biopsy of the thyroid

“…As reported by Ljung et al [13], the nondiagnostic rate in 314 breast FNAB performed by physicians without specific training was 36.9% compared with 2.2% in 729 FNAB performed by adequately trained physicians. Bhatki et al [14] also reported an 8.2% rate of nondiagnostic thyroid US-FNAB performed by an inexperienced radiologist compared with 5.4% performed by an expert radiologist. Because the training of young radiologists is key to the success of the procedure, the biopsy should be done under the supervision of an expert radiologist.…”

“…Come riportato infatti da Ljung et al [13], la percentuale non-diagnostica in 314 FNAB mammarie eseguite da medici senza uno specifico training era del 36,9% rispetto al 2,2% in 729 FNAB dei medici formati con adeguato training. Anche Bhatki et al [14] hanno riportato una percentuale di FNAB-ecoguidate tiroidee non diagnostiche dell'8,2% del radiologo inesperto rispetto al 5,4% del radiologo esperto. Costituendo pertanto il training del giovane radiologo un aspetto fondamentale della procedura, esso deve essere condotto sotto la supervisione di un radiologo esperto e dovrebbe constare inizialmente di un periodo di esclusiva osservazione per valutare l'importanza dell'indicazione e della fattibilità dell'esame e non ultimo per affinare la capacità nella gestione e nella comunicazione con il paziente.…”

Surgeon-performed Ultrasound-guided Needle Biopsy of the Thyroid: A Safe and Effective Diagnostic Procedure

“…9,[11][12][13][14][15][16][17][18][19] It has been recommended that in order to maintain satisfactory standards, US-FNABs should be carried out by dedicated groups of clinicians. 20,21 Our series demonstrated that with appropriate training, thyroid surgeons are well placed to perform such procedures in the office setting due to their sound understanding of the anatomy and pathology of thyroid gland, and their considerable experience gained from large caseload numbers of patients with thyroid nodules.…”

American Thyroid Association Statement on Preoperative Imaging for Thyroid Cancer Surgery

“…Also, the number of separate passes used should be based on whether on-site assessment of cytology is available, and whether additional studies are planned. In the absence of on-site adequacy assessment, the preferred number is three to four passes (27).…”

“…We recommend attempts to focus preoperative evaluation at high volume centers for radiological evaluation, as the diagnostic performance of staging ultrasound for thyroid malignancy varies according to experience (27,39).…”