Immediate on-site interpretation of fine-needle aspiration smears

Layfield, Lester J.; Bentz, Joel S.; Gopez, Evelyn V.

doi:10.1002/cncr.9046

Cited by 190 publications

(162 citation statements)

References 22 publications

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“…Only when the cytopathologist personally performs the aspirate and immediately interprets it is adequate compensation for these professional services rendered. 17 Therefore, it is unlikely that this service will be maintained at all institutions. In cases in which USgFNA has to be performed without a cytologist present, it may be useful to emphasize that 5 passes will be diagnostic in 81% of patients.…”

Section: Discussionmentioning

confidence: 99%

Utility and Safety of Ultrasound‐Guided Fine‐Needle Aspiration of Salivary Gland Masses Including a Cytologist's Review

Siewert

Kruskal

Kelly

et al. 2004

J of Ultrasound Medicine

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Objective. To evaluate the utility and safety of ultrasound-guided fine-needle aspiration of the salivary glands for diagnosis of focal masses in the salivary glands, including the prevalence of nondiagnostic sampling, the impact of the presence of a cytologist during the procedure, and the usefulness of flow cytometry. Methods. A retrospective analysis of 43 ultrasound-guided fine-needle aspirations of the salivary glands from 36 lesions in 33 patients was performed. Fine-needle aspirations were obtained under sonographic guidance, and 1 to 6 punctures were made with 20-to 25-gauge needles. Ultrasound-guided fine-needle aspirations obtained in the presence of a cytologist were compared with those performed without a cytologist regarding the adequacy of the specimen and the number of punctures performed. Postprocedural complications and the frequency with which flow cytometry was performed were noted. Cytopathologic diagnosis was correlated with clinical follow-up (n = 33) and surgical pathologic findings (n = 10). Results. Cytologic diagnosis was made in 31 (94%) of 33 patients, confirming a neoplastic process in 18 (50%) of 36 and a non-neoplastic process in 16 (44%) of 36. Although the presence of a cytologist at the bedside resulted in a higher prevalence of diagnostic sampling (P < .05), it did not alter the number of punctures performed (mean, 3 punctures). No complications were encountered except for pain in 2 patients. Flow cytometry was helpful in 8 (22%) of 36 patients. Conclusions. Ultrasound-guided fine-needle aspiration of the salivary glands is a safe procedure with a low prevalence of nondiagnostic sampling. Approximately 44% of patients can be spared surgical intervention through diagnosis of a non-neoplastic process. The presence of a cytologist increases the likelihood of obtaining a diagnostic sample. Flow cytometry was helpful in 22% of patients.

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Section: Discussionmentioning

confidence: 99%

Utility and Safety of Ultrasound‐Guided Fine‐Needle Aspiration of Salivary Gland Masses Including a Cytologist's Review

Siewert

Kruskal

Kelly

et al. 2004

J of Ultrasound Medicine

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“…[144][145][146] The presence of a cytopathologist in the examination room is also debated, although most published studies showed an increased accuracy when a cytopathologist is available during the procedure. [147][148][149][150] An experienced cytopathologist, as well as the direct communication with the endoscopists, are essential for the success of the procedure. 151 Several large reports reported a complication rate of 1-2% for EUS-FNA.…”

Section: Eus-fnamentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

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Early diagnosis of pancreatic cancer remains a difficult task, and multiple imaging tests have been proposed over the years. The aim of this review is to describe the current role of endoscopic ultrasound (EUS) for the diagnosis and staging of patients with pancreatic cancer. A detailed search of MEDLINE between 1980 and 2007 was performed using the following keywords: pancreatic cancer, endoscopic ultrasound, diagnosis, and staging. References of the selected articles were also browsed and consulted. Despite progress made with other imaging methods, EUS is still considered to be superior for the detection of clinically suspected lesions, especially if the results of other cross-sectional imaging modalities are equivocal. The major advantage of EUS is the high negative predictive value that approaches 100%, indicating that the absence of a focal mass reliably excludes pancreatic cancer. The introduction of EUS-guided fine needle aspiration allows a preoperative diagnosis in patients with resectable cancer, as well as a confirmation of diagnosis before chemoradiotherapy for those that are not. This comprehensive review highlighted the diagnostic capabilities of EUS including the newest refinements such as contrast-enhanced EUS, EUS elastography, and 3-dimensional EUS. The place of EUSguided biopsy is also emphasized, including the addition of molecular marker techniques.

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“…With better training and experience, cytotechnologists can also assess the diagnostic accuracy of FNACs. Many studies have used ROSE to provide cytodiagnosis and have compared the results with those of histopathological diagnosis (4,5,9,10). However, we used ROSE only to check adequacy of the aspirated material.…”

Section: Discussionmentioning

confidence: 99%