Neck lump clinics: is on-site assessment of fine needle aspirate diagnostic adequacy cost-effective?

Burgess, Christopher; Dias, Laura; Moorthy, Ram

doi:10.1017/s0022215113002272

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…This literature review relied on the authors’ methodology as published in the relevant articles. Of the 25 studies, 22 indicated whether or not ROSE was undertaken. If ROSE was not specifically mentioned in the methods section or elsewhere in the article it was assumed that ROSE was not undertaken.…”

Section: Resultsmentioning

confidence: 99%

Rates of Thy 1‐non‐diagnostic thyroid fine needle aspiration using the UK Royal College of Pathologists Thy Terminology. A systematic review of the literature comparing patients who undergo rapid on‐site evaluation and those who do not

et al. 2020

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Introduction: The UK Royal College of Pathologists (RCPath) Thy terminology is an internationally recognised system for reporting thyroid fine needle aspiration. The terminology has been used throughout the UK and Ireland, in some parts of Italy and Switzerland, and elsewhere in the world. There is no systematic review of the literature specifically addressing the use of the non-diagnostic for cytological diagnosis-Thy1/Thy 1c category in the UK RCPath terminology. Methods: A comprehensive literature search of online databases was conducted in October 2019 specifically examining overall reported rates of Thy1 and Thy1c in aspirates classified according to the UK Thy terminology. Results: Twenty-five articles were identified showing a Thy1 rate of 13.4% (2540/18 920). The studies were then stratified according to whether or not the patients underwent rapid on-site evaluation (ROSE): 6.0% (353/5841; range 3.0%-10.9%) of ROSE aspirates were Thy1 whereas 18.5% (2072/11 204; range 7.9%-43.3%) of non-ROSE patients were Thy1; (P < .05). Three studies from 2016 reported Thy1c rates of 5.4%, 6.5% and 10.6%, respectively, implying Thy1 rates excluding Thy1c aspirates of 20.9%, 8.7% and 12.7%, respectively. Conclusion: This systematic review of the literature shows relatively high rates of aspirates non-diagnostic for cytological diagnosis-Thy1 in the peer-reviewed published literature using the UK terminology. Utilisation of ROSE appears to produce lower rates of Thy1 aspirates and ROSE should be considered if rates of non-diagnostic for cytological diagnosis-Thy1/Thy 1c are high.

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Section: Resultsmentioning

confidence: 99%

Rates of Thy 1‐non‐diagnostic thyroid fine needle aspiration using the UK Royal College of Pathologists Thy Terminology. A systematic review of the literature comparing patients who undergo rapid on‐site evaluation and those who do not

et al. 2020

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“…Thus, technically inadequate smears might, in some instances, contribute to significant diagnostic errors. In some countries, it is normal for pathologists to perform FNA, and this is suggested to provide optimal material 7 . However, this does not usually occur in the UK and FNA does not form part of the Pathology curriculum.…”

Section: Discussionmentioning

confidence: 99%

Routine non-thyroid head and neck cytology in a large UK centre: clinical utility and pitfalls

et al. 2015

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“…One of the strategies used to improve the diagnostic performance of US‐guided FNA has been a real‐time evaluation of specimen adequacy by a cytopathologist . The benefits and cost‐effectiveness of a real‐time adequacy evaluation continue to be investigated . Another strategy used to improve the diagnostic performance of US‐guided needle biopsy is substitution of FNA with core needle biopsy (CNB).…”

mentioning

confidence: 99%

Ultrasound‐Guided Fine‐Needle Aspiration With Optional Core Needle Biopsy of Head and Neck Lymph Nodes and Masses: Comparison of Diagnostic Performance in Treated Squamous Cell Cancer Versus All Other Lesions

Wagner

Monfore

McCullough

et al. 2018

J of Ultrasound Medicine

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Objectives-To evaluate the diagnostic performance of ultrasound (US)-guided fine-needle aspiration with optional core needle biopsy of head and neck lymph nodes and masses, with attention to differences between biopsy of treated squamous cell carcinoma (SCC) and biopsy of other lesions.Methods-Institutional Review Board approval was obtained, and the need for consent was waived for this retrospective study. All 861 US-guided biopsies of head and neck lymph nodes and masses performed between March 1, 2012, and May 16, 2016, were reviewed.Results-Of the 861 biopsies, 53 targeted SCC with residual masses after treatment. The biopsy procedures yielded benign or malignant pathologic results in 71.7% (38 of 53) of treated SCC and 90.7% (733 of 808) of all other lesions (P < .001). A reference standard based on subsequent pathologic results or clinical and imaging follow-up was established in 68.4% of procedures. In cases with benign or malignant biopsy results and a subsequent reference standard, the sensitivity values for malignancy were 87.5% (95% confidence interval, 64.0%-96.5%) in treated SCC and 98.3% (95% confidence interval, 96.0%-99.3%) in all other cases (P = .047), and the specificity values were 63.6% (95% confidence interval, 35.4%-84.8%) in treated SCC and 99.5% (95% confidence interval, 97.3%-99.9%) in all other cases (P < .001). There were no major complications related to the biopsy procedures.Conclusions-Excluding treated SCC, US-guided fine-needle aspiration with optional core needle biopsy of head and neck lymph nodes and masses has excellent diagnostic performance. Needle biopsy of head and neck SCC with a residual mass after therapy has a high rate of nondiagnostic samples, suboptimal sensitivity, and poor specificity.

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Neck lump clinics: is on-site assessment of fine needle aspirate diagnostic adequacy cost-effective?

Abstract: In this series, the experience of individuals performing fine needle aspirations was the most important factor related to adequacy.

Cited by 6 publications

References 12 publications

Rates of Thy 1‐non‐diagnostic thyroid fine needle aspiration using the UK Royal College of Pathologists Thy Terminology. A systematic review of the literature comparing patients who undergo rapid on‐site evaluation and those who do not

Rates of Thy 1‐non‐diagnostic thyroid fine needle aspiration using the UK Royal College of Pathologists Thy Terminology. A systematic review of the literature comparing patients who undergo rapid on‐site evaluation and those who do not

Routine non-thyroid head and neck cytology in a large UK centre: clinical utility and pitfalls

Ultrasound‐Guided Fine‐Needle Aspiration With Optional Core Needle Biopsy of Head and Neck Lymph Nodes and Masses: Comparison of Diagnostic Performance in Treated Squamous Cell Cancer Versus All Other Lesions

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