Value of rapid on-site evaluation for ultrasound-guided thyroid fine needle aspiration

Objective Application of rapid on-site evaluation (ROSE) for thyroid fine needle aspiration (FNA) is controversial. Therefore, ROSE has not been universally applied. This study aimed to evaluate the value of ROSE for ultrasound-guided thyroid FNA. Methods A total of 997 patients with 1103 suspicious thyroid nodules had ultrasound-guided FNA performed from January 2016 to February 2018. There were 513 nodules with ROSE and 590 nodules without ROSE. The cytological nondiagnostic rate, needle passes, and procedural times of thyroid FNA with or without ROSE were compared. The nondiagnostic rates of subsets of suspicious thyroid nodules were further compared. Results There was no significant effect of ROSE on the nondiagnostic rate of FNA. However, FNA with ROSE significantly reduced the numbers of sub-centimeter, mixed solid-cystic, macrocalcified, and hypervascular nodules. There was a significantly smaller number of needle passes and less procedural times with ROSE than without ROSE. There was no significant difference in the complication rate of FNA with and without ROSE. Conclusion ROSE for thyroid FNA reduces the number of needle passes and procedural times. ROSE has a higher clinical application value in subsets of thyroid nodules, which tend to be difficult to diagnose with FNA.

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Rapid On-Site Evaluation With Telecytology Significantly Reduced Unsatisfactory Rates of Thyroid Fine-Needle Aspiration

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz164 ◽

2019 ◽

Author(s):

Diana M Lin ◽

Jessica Tracht ◽

Frida Rosenblum ◽

Erik Kouba ◽

Deepti Bahl ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Control Clinical Trial ◽

Needle Aspiration ◽

Control Group ◽

Ultrasound Guided ◽

Fine Needle ◽

First Case ◽

Significant Difference ◽

Thyroid Fine Needle Aspiration ◽

Site Evaluation

Abstract Objectives We evaluated telecytology rapid on-site evaluation (ROSE) for thyroid ultrasound-guided fine-needle aspiration. To the best of our knowledge, this study is the first case-control clinical trial of thyroid telecytology. Methods We introduced on-site ROSE in our institution’s thyroid clinic for 6 months, followed by telecytology for 12 months. Our institution’s ultrasound clinic, where ROSE is not provided, was used as a control group for each period. Results Both groups had similar initial unsatisfactory rates (thyroid clinic: 8.8%; ultrasound clinic: 8.0%) before the study began. The thyroid clinic’s unsatisfactory rate was significantly reduced to 1.6% after on-site ROSE (P = .001) and to 3.8% after telecytology ROSE (P = .010), with no significant difference between on-site and telecytology ROSE periods (P > .05). The ultrasound clinic’s unsatisfactory rate was unchanged for both periods. Concordance between telecytology ROSE and final adequacy was 97% (κ = 0.699). Conclusions Telecytology ROSE reduces unsatisfactory rates for ultrasound-guided fine-needle aspiration without compromising patient care.

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Rapid On-site Evaluation (ROSE) for Fine Needle Aspiration of Thyroid: Is It Helpful?

SciMedicine Journal ◽

10.28991/scimedj-2021-0301-1 ◽

2021 ◽

Vol 3 (1) ◽

pp. 1-7

Author(s):

Ahmed K. Aly ◽

Mahmoud A. Ali ◽

Apoorva Sharma ◽

Michael A. Gubbels ◽

Xing Zhao ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Fine Needle ◽

Significant Difference ◽

Site Evaluation ◽

Bethesda System ◽

The Difference ◽

Thyroid Cytopathology ◽

The Bethesda System

Introduction: Thyroid nodules are very common. Many are detected incidentally due to increased head and neck imaging. The majority are benign; however, malignancy can’t be excluded in many cases and tissue sampling is needed. Ultrasound guided fine needle aspiration is an easy and effective way to sample g thyroid nodules. Inadequate sampling was reported in 10-40% of the cases. Rapid On-site Evaluation (ROSE) was proposed to assess obtained sample for adequacy. The aim of this study is to identify the benefit of applying ROSE with US-FNA of thyroid nodules within our institution. Materials and methods: Patients who underwent FNA for thyroid nodules with ROSE availability documented in their procedure note between January 2017 to December 2018 were retrospectively included. All procedures were done by experienced radiologists. Aspirated material was Diff Quik stained for immediate evaluation. The final cytological diagnosis and specimen adequacy was based on The Bethesda system for reporting thyroid cytopathology. Specimen adequacy was compared between ROSE and non-ROSE groups. Results: 442 thyroid nodules were biopsied. ROSE was available for 65 nodules. Non-diagnostic rate with ROSE was 10.8% compared to 13.8% without ROSE with the difference being statistically insignificant. ROSE availability improved sample adequacy of nodules less than 3 cm with statistically significant difference of 100.0% with ROSE vs. 87% without ROSE. Conclusion: The current study does not justify the routine use of ROSE. However, ROSE availability is beneficial with smaller sized thyroid nodules and less experienced radiologists performing the procedure. Doi: 10.28991/SciMedJ-2021-0301-1 Full Text: PDF

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Experience of the Implementation of Rapid On-Site Evaluation in Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules

Current Problems in Diagnostic Radiology ◽

10.1067/j.cpradiol.2017.06.009 ◽

2018 ◽

Vol 47 (4) ◽

pp. 220-224 ◽

Cited By ~ 2

Author(s):

Flor Marina Medina Chamorro ◽

José Abella Calle ◽

Juliana Escobar Stein ◽

Lina Merchancano ◽

Andrés Mauricio Mendoza Briñez ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Fine Needle Aspiration Biopsy ◽

Needle Aspiration ◽

Aspiration Biopsy ◽

Ultrasound Guided ◽

Fine Needle ◽

Site Evaluation ◽

Needle Aspiration Biopsy

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Ultrasound-guided fine needle aspiration of thyroid nodules: factors affecting diagnostic outcomes and confounding variables

Acta Radiologica ◽

10.1177/0284185116654331 ◽

2016 ◽

Vol 58 (3) ◽

pp. 301-306 ◽

Cited By ~ 7

Author(s):

John Kavanagh ◽

Niall McVeigh ◽

Eoghan McCarthy ◽

Kathleen Bennett ◽

Peter Beddy

Keyword(s):

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Multivariable Analysis ◽

Needle Aspiration ◽

High Rate ◽

Ultrasound Guided ◽

Factors Affecting ◽

Fine Needle ◽

Factors Associated ◽

Thyroid Fna

Background The incidence of thyroid cancer is increasing in men and women. Fine needle aspiration (FNA) is an accepted technique to assess thyroid nodules but is associated with a high rate of non-diagnostic sampling. Purpose To assess the diagnostic performance of ultrasound-guided FNA of thyroid nodules and identify factors associated with non-diagnostic sampling. Material and Methods A retrospective review of thyroid FNAs was performed between 2006 and 2013. Patient demographics, nodule characteristics, procedural technique, cytology, and complications were recorded. Cytology was categorized THY1-5 based on the British Thyroid Association guidelines. Descriptive and multivariable analysis were conducted to identify factors associated with non-diagnostic sampling. Results A total of 724 procedures were identified with 597 (82.5%) in women, and an overall mean age of 40 years (age range, 17–87 years). Factors associated with a non-diagnostic outcome in the multivariable regression analysis included increasing lesion depth (OR, 1.05 per mm; 95% confidence interval [CI], 1.007–1.10), age (OR, 1.012 per year; 95% CI, 1.0–1.025) and number of FNA passes (1 vs. 4+; OR, 6.07; 95% CI, 2.27–16.21). The complication rate was 1.1% related to perilesional hematomas and vaso-vagal episodes. Conclusion Thyroid FNA is a safe and reliable procedure for cytological assessment of thyroid nodules. Deeper nodules and older patients are more likely to have non-diagnostic samples.

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Routine On-Site Evaluation of Specimen Adequacy During Initial Ultrasound-Guided Fine Needle Aspiration of Thyroid Nodules: A Cost-Effectiveness Analysis

Annals of Surgical Oncology ◽

10.1245/s10434-013-2954-1 ◽

2013 ◽

Vol 20 (8) ◽

pp. 2462-2467 ◽

Cited By ~ 15

Author(s):

Kyle Zanocco ◽

Lisa Pitelka-Zengou ◽

Sharvari Dalal ◽

Dina Elaraj ◽

Ritu Nayar ◽

...

Keyword(s):

Cost Effectiveness ◽

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Cost Effectiveness Analysis ◽

Ultrasound Guided ◽

Fine Needle ◽

Effectiveness Analysis ◽

Site Evaluation

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Ultrasound-guided thyroid fine needle aspiration with rapid on-site evaluation of adequacy: data from the clinic of endocrinology of a Greek tertiary general hospital in 2013

Endocrine Abstracts ◽

10.1530/endoabs.35.p979 ◽

2014 ◽

Author(s):

Stelios Fountoulakis ◽

Labrini Papanastasiou ◽

Spiros Koutmos ◽

Pinelopi Charalambous ◽

Aimilia Stratigaki ◽

...

Keyword(s):

General Hospital ◽

Fine Needle Aspiration ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Fine Needle ◽

Thyroid Fine Needle Aspiration ◽

Site Evaluation

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Comparison of Diagnostic Rates and Concordance with Subsequent Surgical Resections between Conventional Smear and ThinPrep Preparations versus ThinPrep Only in Thyroid Fine Needle Aspiration (T-FNA) Specimens

Acta Cytologica ◽

10.1159/000519489 ◽

2021 ◽

pp. 1-10

Author(s):

Miguel Rufail ◽

Xin Jing ◽

Brian Smola ◽

Amer Heider ◽

Richard Cantley ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Diagnostic Category ◽

Needle Aspiration ◽

Follicular Neoplasm ◽

Fine Needle ◽

Advantages And Disadvantages ◽

Thyroid Fine Needle Aspiration ◽

Thyroid Fna ◽

Thyroid Cytopathology

Background: Thyroid fine needle aspiration (T-FNA) is a mainstay in management of thyroid nodules. However, the preparation of T-FNA specimens varies across institutions. Prior studies have compared diagnostic rates between different specimen preparations of T-FNA specimens and their associated advantages and disadvantages. However, few have compared the rates of all diagnostic categories of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) between liquid-based preparations (LBPs) and a combination of LBP and conventional smear (CS) preparations. Our study compares TBSRTC diagnostic rates between these 2 cohorts and correlates cytologic diagnoses with subsequent thyroid resections to evaluate rates of neoplasia (RON) and malignancy (ROM). Methods: 584 consecutive thyroid FNA specimens were collected and stratified by preparation type (ThinPrep [TP] vs. CS & TP). Diagnostic rates for each TBSRTC diagnostic category were calculated. The institution’s electronic medical records database was searched for histologic diagnoses of previously sampled thyroid nodules to evaluate the RON and ROM. Results: Of 584 thyroid FNA specimens, 73 (12.5%) and 511 (87.5%) were evaluated by TP only and CS & TP, respectively, reflecting the predominance of rapid on-site evaluation (ROSE) with CS for T-FNAs at our institution. Of the TP only and CS & TP cohorts, 29 (39.7%) and 98 (19.2%) had subsequent resections, respectively. The frequency of non-diagnostic cases was lower in the CS & TP cohort (12.7% vs. 26%). While the diagnostic rate of follicular lesion of undetermined significance was similar for both cohorts, SFN categorization was only utilized in the CS & TP cohort (1.5% vs. 0%). Although RON and ROM were similar between cohorts in many of the TBSRTC categories, there was a higher RON associated with non-diagnostic specimens in the TP only cohort when the denominator included all non-diagnostic cases. Conclusion: The combination of CS and LBP may potentially decrease the non-diagnostic rate of T-FNA specimens as well as the number of passes required for diagnosis, particularly with ROSE. Evaluation of morphologic features highlighted in conventional smears may facilitate diagnostic categorization in the “suspicious for follicular neoplasm” category.

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Factors Influencing the Reliability of Thyroid Fine-Needle Aspiration: Analysis of Thyroid Nodule Size, Guidance Mode for Aspiration and Preparation Method

Acta Cytologica ◽

10.1159/000381412 ◽

2015 ◽

Vol 59 (2) ◽

pp. 169-174 ◽

Cited By ~ 7

Author(s):

Hui-qin Guo ◽

Zhi-hui Zhang ◽

Huan Zhao ◽

Li-juan Niu ◽

Qing Chang ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Rate Sensitivity ◽

Needle Aspiration ◽

Fine Needle ◽

Nodule Size ◽

Study Results ◽

Thyroid Fine Needle Aspiration ◽

Thyroid Fna ◽

Thinprep Technique

Objective: We aimed to clarify the influence of ThinPrep preparation, nodule size and guidance mode on the accuracy of thyroid fine-needle aspiration (FNA). Methods: A total of 1,240 thyroid FNAs were reviewed and 489 cases with histological correlations were enrolled in this study. Results: Of the 489 total cases examined, 101 were processed with both ThinPrep and conventional preparation and 388 entirely with ThinPrep. The overall nondiagnostic rate, sensitivity and accuracy of FNA were 2.0, 91.0 and 89.4%, respectively. The cases with a preoperative ultrasound (n = 469) were grouped according to nodule size. The nondiagnostic rate, sensitivity and accuracy of FNA did not differ significantly with nodule size (p1 = 0.339, p2 = 0.179, p3 = 0.119). A total of 101 resections were performed with palpation-guided FNA and 388 were performed with ultrasound-guided FNA. The nondiagnostic rates, sensitivity and accuracy of FNA were similar in these two groups. Conclusions: The ThinPrep technique is a valid method for thyroid FNA and is effective for thyroid nodules ≥0.5 cm. The reliability of FNA results is not reduced with larger nodules. The use of palpation-guided FNA for palpable solid nodules is also effective.

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