Optimierung der Schilddrüsen- Feinnadelpunktion

SummaryObjective: Optimization of a specially developed automatic microaspirator for fine-needle aspiration of suspicious thyroid nodules. Patients, method: In a preliminary test biopsy effectiveness was evaluated in 20 native resected thyroid glands in vitro with both a Cameco® gun and a specially designed microaspirator respectively. In addition in both techniques two different needles (21-G and 27-G) were used to evaluate the influence of these two cannula. Subsequently, 103 thyroid nodules were biopsied in vivo and compared the results with a preliminary series of the same physician. In the workup and evaluation of the cytology the ThinPrep® technology was used. Results: In vitro the automatic microaspirator was superior to Cameco gun in both when using the 21-Gauge and the 27-Gauge needle. In terms of needle sizes a statistically significant difference at the 95% confidence level was evident for both comparisons in favor of 21-gauge needle. In vivo, 91% of punctures with the microaspirator were usable, while in the pre-series only 84% were usable (p > 0.05). Conclusion: The automatic microaspirator is superior to the manual aspiration. Moreover, under sonographic control it is more convenient, to biopsy even very small nodules and lesiosn (down to 4 mm in diameter)

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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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Comparison of Fine Needle Aspiration and Fine Needle Nonaspiration Cytology of Thyroid Nodules: A Meta-Analysis

BioMed Research International ◽

10.1155/2015/796120 ◽

2015 ◽

Vol 2015 ◽

pp. 1-13 ◽

Cited By ~ 6

Author(s):

Hongming Song ◽

Chuankui Wei ◽

Dengfeng Li ◽

Kaiyao Hua ◽

Jialu Song ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Predictive Value ◽

Thyroid Nodules ◽

Meta Analysis ◽

Needle Aspiration ◽

Cochrane Library ◽

Average Score ◽

Fine Needle ◽

Advantages And Disadvantages ◽

Significant Difference

Background. Fine needle aspiration cytology (FNAC) and fine needle nonaspiration cytology (FNNAC) are useful cost-effective techniques for preoperatively assessing thyroid lesions. Both techniques have advantages and disadvantages, and there is controversy over which method is superior. This meta-analysis was performed to evaluate the differences between FNAC and FNNAC for diagnosis of thyroid nodules.Methods. Primary publications were independently collected by two reviewers from PubMed, Web of Science, Google Scholar, EBSCO, OALib, and the Cochrane Library databases. The following search terms were used: fine needle, aspiration, capillary, nonaspiration, sampling without aspiration, thyroid, and cytology. The last search was performed on February 1, 2015.Results. Sixteen studies comprising 1,842 patients and 2,221 samples were included in this study. No statistically significant difference was observed between FNAC and FNNAC groups with respect to diagnostically inadequate smears, diagnostically superior smears, diagnostic performance (accuracy, sensitivity, specificity, negative predictive value, and positive predictive value), area under the summary receiver operating characteristic curve, average score of each parameter (background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma, and retention of appropriate architecture), and total score of five parameters.Conclusion. FNAC and FNNAC are equally useful in assessing thyroid nodules.

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Evaluation of Fine Needle Aspiration Biopsy (FNAB) Results in Macrocalcified Thyroid Nodules

The Journal of Tepecik Education and Research Hospital ◽

10.5222/terh.2021.75317 ◽

2021 ◽

Author(s):

Ali Murat Koç ◽

Zehra Hilal Adıbelli ◽

Zehra Erkul ◽

Yasemin Şahin

Keyword(s):

Thyroid Nodule ◽

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Fine Needle Aspiration Biopsy ◽

Needle Aspiration ◽

Aspiration Biopsy ◽

Gold Standard Method ◽

Fine Needle ◽

Significant Difference ◽

Needle Aspiration Biopsy

Objective: Thyroid nodule is the most common disease of the thyroid gland and is closely associated with thyroid cancer. The gold standard method in diagnosis is Fine Needle Aspiration Biopsy (FNAB). Although the relationship between nodules containing microcalcification and malignancy is well known, there is no consensus on the relation of nodules with macrocalcification to malignancy and the adequacy of FNAB. In this study, it was aimed to compare the results of FNAB of nodules with and without macrocalcification in US examination. Methods: In this retrospective study, 466 nodules undergoing FNAB of 450 patients who applied for biopsy were included in the study. The demographic characteristics of the patients, US features of the nodules and cytopathology results of FNAB in the Bethesda classification were recorded. Nodules were divided into two main groups as calcified and non-calcified. US features and cytopathology results of the groups were compared. Results: Transverse sizes of calcified nodules were found to be larger than non-calcified ones (p = 0.003). In addition, solid composition, hypoechoic and prominent hypoechoic echogenicity, and irregular border feature were found with a higher rate in the calcified group (p <0.001). No significant difference was found between insufficient sample/non-diagnostic cytology (Bethesda-1) ratios in both groups (19.2% and 14.7%). Cytopathologically, number of malignant and suspected malignant nodules (Bethesda 5 and 6) were found to be higher in the calcified group (p=0.05). Conclusion: According to the results of this study, detection of macrocalcification in thyroid nodules in US examination does not cause a significant increase in insufficient FNAB results. However, the presence of macrocalcification increases the risk of malignancy of the thyroid nodule.

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

Journal of International Medical Research ◽

10.1177/0300060518807060 ◽

2018 ◽

Vol 47 (2) ◽

pp. 626-634 ◽

Cited By ~ 5

Author(s):

Danni Jiang ◽

Yichen Zang ◽

Dandan Jiang ◽

Xiaojuan Zhang ◽

Cheng Zhao

Keyword(s):

Fine Needle Aspiration ◽

Complication Rate ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Fine Needle ◽

Significant Difference ◽

Thyroid Fine Needle Aspiration ◽

Site Evaluation ◽

Thyroid Fna

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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Rates of Malignancy in Incidentally Discovered Thyroid Nodules Evaluated With Sonography and Fine-Needle Aspiration

Yearbook of Endocrinology ◽

10.1016/s0084-3741(08)70367-6 ◽

2006 ◽

Vol 2006 ◽

pp. 235-238

Author(s):

E.L. Mazzaferri

Keyword(s):

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Needle Aspiration ◽

Fine Needle

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The incidentaloma of the thyroid

Nuklearmedizin ◽

10.1055/s-0038-1625208 ◽

2005 ◽

Vol 44 (05) ◽

pp. 213-224

Author(s):

C. Kobe ◽

M. Schmidt ◽

H. Schicha ◽

M. Dietlein

Keyword(s):

Risk Stratification ◽

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Outcome Measurement ◽

Needle Aspiration ◽

Epidemiological Studies ◽

Fine Needle ◽

Small Cancer ◽

The Family ◽

Wait And See

Summary:The incidentally detected thyroid nodule using sonography is described as incidentaloma; the most nodules have a diameter up to 1.5 cm. Sonography will detect thyroid nodules in more than 20% of the population in Germany. Epidemiological studies investigating the prevalence of malignancy in such incidentalomas are missing. The incidence of differentiated thyroid cancer is about 3 per 100,000 people and year. However, several monocentric studies have shown a prevalence of malignancy of up to 10% of the thyroid nodules in selected patients’ group. The histology did not found microcarcinomas only, but also small cancer with infiltration of the thyroid capsule, lymph node metastasis or multifocal spread. The studies were not designed for outcome measurement after early and incidental detection of small thyroid cancers. Hypoechogenity, ill defined borders, central hypervascularization or microcalcifications were used as combined criteria for risk stratification. The second method for risk stratification is scintigraphy and further tests are warranted for hypofunctioning nodule ≥1 cm. Additionally, the family history, patient’s age <20 years, former radiation of the neck, and measurement of calcitonin should be regarded. Without such a risk stratification selection for fine needle aspiration is impossible. Fine needle aspiration of non-palpable incidentalomas led to non-representative or unequivocal cytological findings in up to 40%. Because better outcome of incidentally detected small thyroid carcinomas is not proved and because sonography, scintigraphy and fine needle aspiration remain imprecise regarding dignity of incidentalomas, fine needle aspiration is not the standard for small, non-palpable thyroid nodules. Conclusion: For management of incidentaloma, sonographically unsuspicious, scintigraphically indifferent (nodules ≥1 cm) and without any risk factors in patients’ history, wait and see is justified when patient is informed about the problem.

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