scholarly journals The benefits of on-site cytology with ultrasound-guided fine needle aspiration in a one-stop neck lump clinic

2010 ◽  
Vol 92 (8) ◽  
pp. 660-664 ◽  
Author(s):  
A Ganguly ◽  
TE Giles ◽  
PA Smith ◽  
FE White ◽  
PP Nixon
Keyword(s):  
Fine Needle Aspiration ◽  
Ultrasound Guidance ◽  
Clinical Excellence ◽  
Needle Aspiration ◽  
University Hospital ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
One Stop ◽  
Neck Lump ◽  
Set Up

INTRODUCTION In the National Institute for Health and Clinical Excellence (NICE) guidance on cancer services published in 2004, it was recommended that specialist clinics should be set up for the assessment of patients with neck lumps, structured in a similar way to one-stop breast lump clinics with a cytopathologist present and preferably ultrasound guidance. The aim of this study was to audit the performance of ultrasound-guided fine needle aspiration (FNA) with on-site cytology in a one-stop neck lump clinic at The Royal Liverpool University Hospital. PATIENTS AND METHODS Data were collected between November 2008 and May 2009 (7 months). Details of the adequacy rate for the FNA were recorded and whether multiple passes were required. The likely adequacy rate if ultrasound guidance was not available was also calculated. RESULTS A total of 274 patients were included in the audit. Of these, 227 (83%) patients required a single pass for adequate diagnostic material. Of the remaining, 45 (16%) required two passes and 2 (1%) required three passes. The overall sample inadequacy rate was 11 of 274 (4%). From these results, it could be predicted that, if immediate cytological evaluation was unavailable, the inadequacy rate would have been 41 of 274 (15%). CONCLUSIONS This audit has illustrated the benefits of a one-stop clinic with on-site cytology in providing a rapid diagnostic head and neck cancer service.

scholarly journals ENDOSCOPIC ULTRASOUND GUIDED FINE NEEDLE ASPIRATION OF SOLID PANCREATIC LESIONS: EXPERIENCE AT GEORGETOWN UNIVERSITY HOSPITAL

2003 ◽  
Vol 98 ◽  
pp. S66-S67
Author(s):  
Nabil A. Toubia ◽  
Christian E. Noguera ◽  
Jennifer S.C. Sartorelli ◽  
Firas A. Al-Kawas ◽  
Stanley B. Benjamin ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
University Hospital ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Georgetown University

scholarly journals Fine needle aspiration adequacy in a one-stop neck lump clinic: 2nd cycle improvement

2020 ◽  
Author(s):  
George McNally ◽  
Usama Fawzy Kamel ◽  
Sucha Hampal
Keyword(s):  
Head And Neck ◽  
Fine Needle Aspiration ◽  
Diagnostic Delay ◽  
Needle Aspiration ◽  
Specimen Preparation ◽  
Fine Needle ◽  
One Stop ◽  
Neck Lump ◽  
Cancer Guidelines ◽  
The One

The one-stop neck lump clinic at Warrington Hospital was established in 2011 in line with NICE head and neck cancer guidelines.1 They recommend that fine needle aspiration (FNA) is performed under ultrasound guidance in the presence of an onsite cytopathologist. This enables an immediate assessment of adequacy and repeat sampling as required on the same day to prevent diagnostic delay.2 The Royal College of Radiologists recommend a minimum adequacy rate of 70% for thyroid lesions. In 2014, a systematic review of 78 papers found an average FNA adequacy rate for all head and neck lesions of 90.7%.3 Methods: This re-audit aimed to evaluate whether local recommendations for improving the performance of ultrasound. Data collected retrospectively between August 2017 and January 2018 were compared to the first cycle audit (December 2015 May 2016). The adequacy of initial FNA samples were recorded and whether repeat aspirations were required. Samples were considered inadequate if the cytology report stated insufficient material for adequate diagnosis.4 The reasons for diagnostically inconclusive reports were documented. Results: FNA cytology reports for 62 patients (53% female) in the second cycle were compared to 56 patients (64% female) in the first cycle. All pathologies were included, except for patients with suspected lymphoma.The adequacy rate for initial FNA reports increased from 76% to 89%. The specific adequacy rates for thyroids, salivary glands and lymph nodes improved by 18%, 18% and 4% respectively Conclusion: Discussion with the local pathology and radiology departments after the initial audit generated recommendations to improve adequacy rates. The introduction of CytoRich fluid for thyroid specimen preparation significantly increased adequacy. Narrower bore needles reduce the risk of haemorrhagic samples and were used for repeat FNA sampling to successfully decrease inadequate reports.

Endoscopic Ultrasound Guided Pancreatic Fine Needle Aspiration at a Newly Established Northwest Ohio University Hospital

2012 ◽  
Vol 107 ◽  
pp. S111-S112
Author(s):  
Raja Thotakura ◽  
Muhammad Bawany ◽  
Luis De Las Casas ◽  
Ehsan Rafiq ◽  
Michael McPhee ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
University Hospital ◽  
Ohio University ◽  
Ultrasound Guided ◽  
Fine Needle

How good are we at fine needle aspiration cytology?

2010 ◽  
Vol 124 (7) ◽  
pp. 765-766 ◽  
Author(s):  
S Carr ◽  
V Visvanathan ◽  
T Hossain ◽  
S Uppal ◽  
P Chengot ◽  
...  
Keyword(s):  
Lymph Node ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Ultrasound Guidance ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Study Results ◽  
Neck Lump ◽  
Needle Aspiration Cytology

AbstractObjectives:To determine the accuracy of fine needle aspiration cytology conducted within a standard ENT out-patients service (rather than a one-stop neck lump clinic), and also to assess the value of ultrasound guidance during fine needle aspiration cytology.Design:Retrospective study of all patients undergoing fine needle aspiration cytology of a neck lump, from 2005 to 2008 in Leeds teaching hospitals.Main outcome measures:Accuracy of fine needle aspiration cytology, compared with the corresponding histology report of the original surgical specimen, and non-diagnostic fine needle aspiration cytology rates with and without ultrasound.Results:Fine needle aspiration cytology yielded the following respective sensitivity, specificity and accuracy rates: 85, 91 and 87 per cent for lymph nodes; 80, 93 and 89 for salivary glands; and 52, 80 and 69 for thyroid. The proportion of non-diagnostic procedures was 28 per cent, both with and without ultrasound guidance.Conclusion:Cytologist-led fine needle aspiration cytology would have reduced the time to diagnosis and the number of clinic visits per patient. Fine needle aspiration cytology was accurate for predicting malignancy in salivary gland and lymph node lesions, and for diagnosing lymph node pathology. Study results did not support the use of ultrasound guidance during fine needle aspiration cytology.

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

2013 ◽  
Vol 127 (11) ◽  
pp. 1122-1126 ◽  
Author(s):  
C Burgess ◽  
L Dias ◽  
E Maughan ◽  
R Moorthy
Keyword(s):  
Fine Needle Aspiration ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Needle Aspiration ◽  
Benefit Analysis ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Neck Lump ◽  
Needle Aspiration Cytology

AbstractObjectives:To establish the diagnostic adequacy of ultrasound-guided fine needle aspiration cytology samples at the East Berkshire neck lump clinic, and to perform a cost-benefit analysis related to the hypothetical addition of an on-site cytology technician (required to review fine needle aspiration specimen adequacy).Method:The adequacy of all ultrasound-guided fine needle aspiration procedures was reviewed from 1 January to 30 June 2011. These results were used in the cost-benefit analysis related to on-site cytology assessment.Results:Of the 307 ultrasound-guided fine needle aspiration cytology procedures performed over 6 months, 67 (22 per cent) were reported to be non-diagnostic. Operator experience was found to correlate significantly with diagnostic adequacy (p < 0.001). Only 5 per cent of all fine needle aspirations were initially non-diagnostic but diagnostic on repeat sampling. This suggests that the financial and time costs of on-site fine needle aspirate adequacy assessment would outweigh any benefit.Conclusion:In this series, the experience of individuals performing fine needle aspirations was the most important factor related to adequacy.

scholarly journals Significance of ultrasound and ultrasound-guided fine-needle aspiration for the detection of laryngeal occult metastases

2005 ◽  
Vol 62 (12) ◽  
pp. 901-907
Author(s):  
Ljiljana Cvorovic ◽  
Zoran Milutinovic ◽  
Mile Strbac ◽  
Ljubomir Pavicevic ◽  
Alek Racic
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Fine Needle Aspiration ◽  
Preoperative Staging ◽  
Needle Aspiration ◽  
University Hospital ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
The Status ◽  
Neck Lymph Nodes

Background/Aim. To evaluate ultrasound criteria based on a node size, shape, vascularity and cytology findings with respect to their value for the comparative determination of metastatic lymph nodes in laryngeal carcinoma. Methods. A prospective study included 30 patients with laryngeal squamous cell carcinoma without node enlargement on computerized tomography, at the Department of Otorhinolaryngology, the University Hospital, Zemun. Thirty-six neck lymph nodes were evaluated sonographically and aspirated with an ultrasound-guided fine-needle. They were examined cytologically and/or histopathologically and compared to the sonographic assessment of their malignancy. Results. Of the 36 neck lymph nodes evaluated cytologically, the 13 were found to be with a metastatic deposit. The assessment of a lymph node malignancy using the parameter of size had the sensitivity of 84%, the specificity of 70%, and the reliability of 75%. Using the criteria of a lymph node shape for the assessment of malignancy, the sensitivity of 61%, specificity of 65%, and the reliability of 64% were achieved. The evaluation of a lymph node vascularity by the use of the effect of Doppler showed the sensitivity of 69%, the specificity of 95%, and the reliability of 86%. Concluson. Ultrasound and ultrasound-guided fine-needle aspiration cytology should be always used for the preoperative staging and for the postoperative follow-up of the status of the neck with cancer of the larynx becouse of their high accuracy, availability and semiinvasivity, and in order to enhance the reliability of the evaluation of the malignant disease progression.

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