Value of ultrasound guidance in cytopathologist-performed fine-needle aspirations of palpable lesions

Dueber, Julie C.; Pang, Judy; Lew, Madelyn; Jing, Xin; Heider, Amer; Davenport, Robertson D.; Bernacki, Kurt D.; Kantola, Scott; Roh, Michael H.

doi:10.1016/j.jasc.2014.12.002

Cited by 9 publications

(23 citation statements)

References 9 publications

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“…This pattern was also seen in a similar pathologist study, where the nondiagnostic rate was 12.7% (17 of 134 cases) for the PGFNA cohort and 2.5% (3 of 118 cases) for the UGFNA cohort (P ¼ .004). 13 The reduced nondiagnostic rate in our study with ultrasound-guided cases was also observed across all nodule sizes. As was expected, the nondiagnostic rate was highest (38.6% [17 of 44]) for lesions measuring less than 1 cm in size when only palpation guidance was performed.…”

Section: Resultssupporting

confidence: 61%

“…One study of 118 UGFNAs and 134 PGFNAs found that 22 (18.6%) of the UGFNAs were completed-in other words, achieved adequacy-after one pass, as opposed to 6 (4.5%) of the PGFNAs (P , .001). 13 Another study also showed favorable UGFNA pass number results, with the mean and median number of passes required to reach adequacy being 1.43 and 1.0, respectively. 16 This illustrates that with UGFNA one can achieve specimen adequacy with just a few passes.…”

Section: Resultsmentioning

confidence: 93%

“…4,7,15 Moreover, the burgeoning interest in UGFNA has led to reports by some pathology training programs and individual pathologists on their experiences with the technique in pathologist-led clinics. [12][13][14]16 Although there are studies comparing UGFNA and PGFNA by nonpathologists showing a decrease in specimen inadequacy rates 2,[8][9][10][11] and increased accuracy rates 9,11 with UGFNA relative to PGFNA, there currently exist only a few such comparison studies for procedures done by cytopathologists. 12,13 The current study aims to further address this latter topic.…”

Section: Resultsmentioning

confidence: 99%

“…4,7 Although there have been several reports comparing the performance characteristics of FNAs performed by clinicians with versus without ultrasound guidance, 2,[8][9][10][11] to date only a few studies have directly compared the performance of UGFNA and PGFNA in a setting where both techniques are done by cytopathologists. 12,13 We report a single-institutional experience of cytopathologist-performed UGFNA and compare that to cytopathologist-performed PGFNA in a variety of anatomic sites. Features such as adequacy rates and discordance rates using primarily corresponding surgical pathology follow-up as the gold standard are evaluated.…”

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confidence: 99%

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Comparison of Cytopathologist-Performed Ultrasound-Guided Fine-Needle Aspiration With Cytopathologist-Performed Palpation-Guided Fine-Needle Aspiration: A Single Institutional Experience

Conrad¹,

Yang²,

Chang³

et al. 2018

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Although fine-needle aspiration (FNA) practice by pathologists is now well established, it has been primarily performed by manual palpation. In recent years, pathologists have begun to venture into ultrasound-guided FNAs (UGFNAs). Reports on experiences with this relatively new technique for pathologists have shown promising results. However to date, there have been few studies in the literature comparing pathologist-performed UGFNA with the more traditional pathologist-performed palpation-guided FNA (PGFNA).Objective.-To compare UGFNA to PGFNA by cytopathologists at an academic medical center.Design.-A retrospective study of FNAs performed by cytopathologists within the University of California, Los Angeles (UCLA) pathology departmental FNA clinic was performed. Data collected included performance technique (UGFNA versus PGFNA), lesion site and size, adequacy status (nondiagnostic rate), and number of passes per procedure. Corresponding surgical pathology/ flow cytometric/cytogenetic result follow-up was compared to FNA results. Findings between UGFNA and PGFNA cases were compared.Results.-Of 1029 FNA cases during the study period, there were 449 UGFNA cases (43.6%) and 580 PGFNA cases (56.4%). Nondiagnostic rates with UGFNA and PGFNA were 6.7% (30 of 449 cases) and 20.7% (120 of 580 cases), respectively. Nondiagnostic rate was also significantly lower with UGFNA than with PGFNA for lesions within the thyroid (6.0% versus 33.3%), head and neck (6.6% versus 21.2%), and salivary gland (6.2% versus 17.1%), and across all nodule sizes. A total of 495 of 1029 FNA cases (48.1%) had follow-up. Discordance rate was significantly lower with UGFNA than with PGFNA (5.4% versus 12.8%).Conclusions.-This study shows improved performance characteristics of cytopathologist-performed UGFNA versus PGFNA.

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Section: Resultssupporting

confidence: 61%

Section: Resultsmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Cytopathologist-Performed Ultrasound-Guided Fine-Needle Aspiration With Cytopathologist-Performed Palpation-Guided Fine-Needle Aspiration: A Single Institutional Experience

Conrad¹,

Yang²,

Chang³

et al. 2018

Archives of Pathology &Amp; Laboratory Medicine

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show abstract

“…[ 1 2 3 ] In the world of cytology there is growing interest in “cytopathologist-performed ultrasound-guided FNA” (CP US-FNA), which has been reported to yield accurate results. [ 4 5 6 7 8 9 10 11 12 13 14 15 ] The first author has been applying FNA in his own private cytopathology practice with a radiologist and under the guidance of US for more than 20 years. This study retrospectively reviews the first author's personal experience.…”

Section: Introductionmentioning

confidence: 99%

Cytopathologist-performed and ultrasound-guided fine needle aspiration cytology enhances diagnostic accuracy and avoids pitfalls: An overview of 20 years of personal experience with a selection of didactic cases

Paksoy

Ozbek

2018

CytoJournal

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Over the last few decades, fine needle aspiration cytology (FNA) has emerged as a SAFE (Simple, Accurate, Fast, Economical) diagnostic tool based on the morphologic evaluation of cells. The first and most important step in obtaining accurate results from FNA is to procure sufficient and representative material from the lesion and to appropriately transfer this material to the laboratory. Unfortunately, the most important aspect of this task occurs beyond the control of the cytopathologist, a key reason for obtaining unsatisfactory results with FNA. There is growing interest in the field of cytology in “cytopathologist-performed ultrasound (US)-guided FNA,” which has been reported to yield accurate results. The first author has been applying FNA in his own private cytopathology practice with a radiologist and under the guidance of US for more than 20 years. This study retrospectively reviews the utility of this practice. We present a selection of didactic examples under different headings that highlight the application of FNA by a cytopathologist, accompanied by US, under the guidance of a radiologist, in the form of an “outpatient FNA clinic.” The use of this technique enhances diagnostic accuracy and prevents pitfalls. The highlights of each case are also outlined as “take-home messages.”

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Pathologist‐performed ultrasound‐guided fine needle aspiration biopsies of extrathyroidal sites: An observational study

Kliassov

McKenzie

Dash

et al. 2022

Diagnostic Cytopathology

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Background Pathologist‐performed ultrasound‐guided fine needle aspiration (USFNA) biopsies have become an increasingly important component of the interventional cytopathologist's toolbox. However, its application varies between institutions, and there is limited literature describing its performance characteristics when utilized in extrathyroidal sites. Here we review our institutional experience within our pathologist‐run FNA clinic. Methods A retrospective review was conducted of pathologist‐performed USFNAs of extrathyroidal sites over a 9‐year period. Data collected included lesion site, size, patient age, patient gender, diagnostic category, and corresponding results from surgical resection when available. The diagnosis on surgical resection was considered the gold standard for determining discordance rates. Results A total of 143 pathologist‐performed USFNAs of extrathyroidal lesions were performed from October 2011 to October 2020. These encompassed a wide range of sites, with most biopsies from the head and neck. The mean recorded size was 2.2 cm, with a range of 0.6–6 cm. Larger lesions (over 2 cm) were more likely to be noted in challenging locations, demonstrate difficult features, or be cystic. Most (n = 133) biopsies were sufficient for diagnosis, with a non‐diagnostic rate of 7% (n = 10). Accuracy when compared to subsequent surgical resection was high, with sensitivity of 89%, specificity of 93%, positive predictive value of 94%, and negative predictive value of 87%. Conclusion Our experience supports that pathologist‐performed USFNA of extrathyroidal lesions—even those with challenging features—can result in excellent diagnostic yield and accuracy. The addition of USFNA to the interventional cytopathologists' repertoire can be a valuable tool to enhance patient care.

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Value of ultrasound guidance in cytopathologist-performed fine-needle aspirations of palpable lesions

Cited by 9 publications

References 9 publications

Comparison of Cytopathologist-Performed Ultrasound-Guided Fine-Needle Aspiration With Cytopathologist-Performed Palpation-Guided Fine-Needle Aspiration: A Single Institutional Experience

Comparison of Cytopathologist-Performed Ultrasound-Guided Fine-Needle Aspiration With Cytopathologist-Performed Palpation-Guided Fine-Needle Aspiration: A Single Institutional Experience

Cytopathologist-performed and ultrasound-guided fine needle aspiration cytology enhances diagnostic accuracy and avoids pitfalls: An overview of 20 years of personal experience with a selection of didactic cases

Pathologist‐performed ultrasound‐guided fine needle aspiration biopsies of extrathyroidal sites: An observational study

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