Effect of Puncture Methods on Ultrasound-guided Fine-needle Aspiration Biopsy of Thyroid Nodules_West China Medical Journal

Authors：

 ZHANGQiong ,  PENGYu-lan , MABu-yun , ZHOUXiang , YUBo-yang , LIANGLi

Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

PENGYu-lan, Email: yulanpeng@163.com

Keywords：

Thyroid nodules; Fine-needle aspiration biopsy; Ultrasonography; Technique

DOI：

10.7507/1002-0179.20150592

Video：

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Objective To assess the effect of short-axis and long-axis punctures of thyroid nodules on the diagnostic rate of ultrasound guided aspiration biopsy (US-FNAB). Methods We retrospectively analyzed the clinical data of 2 686 thyroid nodule patients who underwent US-FNAB between March 2011 and November 2014. The US-FNAB was performed by 5 beginners (571 each for Dr1-Dr4 and 402 for Dr5). Yields of US-FNAB were divided into two levels according to the classification standard of the Bethesda system:adequacy and inadequacy. Short-axis puncture technique was used by Dr2 and long-axis puncture was performed by the others. According to chronological sequence of thyroid nodules examined, we compared the inadequate diagnostic rate between Dr2 and the others for the first 200 cases and the last 200 cases, respectively. The inadequate diagnostic rate was compared among the 4 doctors who used long-axis punctures for the first 200 cases and the last 200 cases, respectively. Results The inadequacy rate of US-FNAB for Dr2 was higher than that for Dr1, Dr3, Dr4 and Dr5 in the first 200 cases, with statistical significance (P=0.036,<0.001,=0.007 and <0.001, respectively). There was no significant difference in inadequate diagnostic rate among the 4 doctors who used long-axis punctures for the first 200 cases (P=0.033, 0.551, 0.011, 0.122, 0.672 and 0.050). The inadequacy rate of US-FNAB for Dr2 was higher than that for Dr5 and lower than that for Dr4 in the last 200 cases with statistical significance (P=0.027 and 0.003, respectively). The inadequacy rate of US-FNAB for Dr5 was lower than that for Dr3 (P=0.005) and Dr4 (P<0.001) among the 4 doctors who used long-axis punctures for the last 200 cases. Conclusion For beginners, the inadequacy rate of short-axis puncture is higher than long-axis puncture. We suggest beginners learn long-axis puncture method. There is no significant difference in inadequate diagnostic rate among short-axis and long-axis punctures, when the number of operated cases reaches 200. At this point, the operator can choose either way to puncture according to the disease condition or personal interests.

Citation： ZHANGQiong, PENGYu-lan, MABu-yun, ZHOUXiang, YUBo-yang, LIANGLi. Effect of Puncture Methods on Ultrasound-guided Fine-needle Aspiration Biopsy of Thyroid Nodules. West China Medical Journal, 2015, 30(11): 2094-2097. doi: 10.7507/1002-0179.20150592 Copy

1.	Goldfarb M, Gondek S, Solorzano C, et al. Surgeon-performed ultrasound can predict benignity in thyroid nodules[J]. Surgery, 2011, 150(3):436-441.
2.	Ko HM, Jhu IK, Yang SH, et al. Clinicopathologic analysis of fine needle aspiration cytology of the thyroid. A review of 1,613 cases and correlation with histopathologic diagnoses[J]. Acta Cytol, 2003, 47(5):727-732.
3.	Carmeci C, Jeffrey RB, Mcdougall IR, et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses[J]. Thyroid, 1998, 8(4):283-289.
4.	Danese D, Sciacchitano S, Farsetti A, et al. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules[J]. Thyroid, 1998, 8(1):15-21.
5.	Hatada T, Okada K, Ishii H, et al. Evaluation of ultrasound-guided fine-needle aspiration biopsy for thyroid nodules[J]. Am J Surg, 1998, 175(2):133-136.
6.	Tabaqchali MA, Hanson JM, Johnson SJ, et al. Thyroid aspiration cytology in Newcastle:a six year cytology/histology correlation study[J]. Ann R Coll Surg Engl, 2000, 82(3):149-155.
7.	Morgan JL, Serpell JW, Cheng MS. Fine-needle aspiration cytology of thyroid nodules:how useful is it?[J]. ANZ J Surg, 2003, 73(7):480-483.
8.	Houlton JJ, Sun GH, Fernandez N, et al. Thyroid fine-needle aspiration:does case volume affect diagnostic yield and interpretation?[J]. Arch Otolaryngol Head Neck Surg, 2011, 137(11):1136-1139.
9.	卢斌, 游向东, 黄品同, 等. 甲状腺结节大小对细针穿刺细胞学诊断结果的影响[J]. 中华超声影像学杂志, 2014(9):778-781.
10.	王菁, 蒋天安, 厉竟, 等. 超声引导下甲状腺钙化结节细针穿刺细胞学无法诊断率的分析[J]. 中华医学杂志, 2014(37):2948-2950.
11.	周伟, 倪晓枫, 叶廷军, 等. 超声引导下小于5 mm甲状腺结节细针穿刺细胞学检查与超声评估的应用价值[J]. 中国超声医学杂志, 2014(1):7-10.
12.	Cibas ES, Ali SZ. The bethesda system for reporting thyroid cytopathology[J]. Thyroid, 2009, 19(11):1159-1165.
13.	Kim DW, Choo HJ, Park JS, et al. Ultrasonography-guided fine-needle aspiration cytology for thyroid nodules:an emphasis on one-sampling and biopsy techniques[J]. Diagn Cytopathol, 2012, 40(Suppl 1):E48-E54.
14.	Yokozawa T, Miyauchi A, Kuma K, et al. Accurate and simple method of diagnosing thyroid nodules the modified technique of ultrasound-guided fine needle aspiration biopsy[J]. Thyroid, 1995, 5(2):141-145.
15.	Rausch P, Nowels K, Jeffrey RB. Ultrasonographically guided thyroid biopsy:a review with emphasis on technique[J]. J Ultrasound Med, 2001, 20(1):79-85.
16.	Lee YH, Lee NJ, Kim JH, et al. Sonographically guided fine needle aspiration of thyroid nodule:discrepancies between cytologic and histopathologic findings[J]. J Clin Ultrasound, 2008, 36(1):6-11.
17.	Kim DW, Lee EJ, Kim SH, et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules:comparison in efficacy according to nodule size[J]. Thyroid, 2009, 19(1):27-31.
18.	De Fiori E, Rampinelli C, Turco F, et al. Role of operator experience in ultrasound-guided fine-needle aspiration biopsy of the thyroid[J]. Radiol Med, 2010, 115(4):612-618.
19.	吴亮, 杨顺实, 余芬, 等. 操作经验对超声引导下甲状腺结节细针穿刺活检的影响[J]. 中华内分泌外科杂志, 2012, 6(6):404-408.

1. Goldfarb M, Gondek S, Solorzano C, et al. Surgeon-performed ultrasound can predict benignity in thyroid nodules[J]. Surgery, 2011, 150(3):436-441.
2. Ko HM, Jhu IK, Yang SH, et al. Clinicopathologic analysis of fine needle aspiration cytology of the thyroid. A review of 1,613 cases and correlation with histopathologic diagnoses[J]. Acta Cytol, 2003, 47(5):727-732.
3. Carmeci C, Jeffrey RB, Mcdougall IR, et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses[J]. Thyroid, 1998, 8(4):283-289.
4. Danese D, Sciacchitano S, Farsetti A, et al. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules[J]. Thyroid, 1998, 8(1):15-21.
5. Hatada T, Okada K, Ishii H, et al. Evaluation of ultrasound-guided fine-needle aspiration biopsy for thyroid nodules[J]. Am J Surg, 1998, 175(2):133-136.
6. Tabaqchali MA, Hanson JM, Johnson SJ, et al. Thyroid aspiration cytology in Newcastle:a six year cytology/histology correlation study[J]. Ann R Coll Surg Engl, 2000, 82(3):149-155.
7. Morgan JL, Serpell JW, Cheng MS. Fine-needle aspiration cytology of thyroid nodules:how useful is it?[J]. ANZ J Surg, 2003, 73(7):480-483.
8. Houlton JJ, Sun GH, Fernandez N, et al. Thyroid fine-needle aspiration:does case volume affect diagnostic yield and interpretation?[J]. Arch Otolaryngol Head Neck Surg, 2011, 137(11):1136-1139.
9. 卢斌, 游向东, 黄品同, 等. 甲状腺结节大小对细针穿刺细胞学诊断结果的影响[J]. 中华超声影像学杂志, 2014(9):778-781.
10. 王菁, 蒋天安, 厉竟, 等. 超声引导下甲状腺钙化结节细针穿刺细胞学无法诊断率的分析[J]. 中华医学杂志, 2014(37):2948-2950.
11. 周伟, 倪晓枫, 叶廷军, 等. 超声引导下小于5 mm甲状腺结节细针穿刺细胞学检查与超声评估的应用价值[J]. 中国超声医学杂志, 2014(1):7-10.
12. Cibas ES, Ali SZ. The bethesda system for reporting thyroid cytopathology[J]. Thyroid, 2009, 19(11):1159-1165.
13. Kim DW, Choo HJ, Park JS, et al. Ultrasonography-guided fine-needle aspiration cytology for thyroid nodules:an emphasis on one-sampling and biopsy techniques[J]. Diagn Cytopathol, 2012, 40(Suppl 1):E48-E54.
14. Yokozawa T, Miyauchi A, Kuma K, et al. Accurate and simple method of diagnosing thyroid nodules the modified technique of ultrasound-guided fine needle aspiration biopsy[J]. Thyroid, 1995, 5(2):141-145.
15. Rausch P, Nowels K, Jeffrey RB. Ultrasonographically guided thyroid biopsy:a review with emphasis on technique[J]. J Ultrasound Med, 2001, 20(1):79-85.
16. Lee YH, Lee NJ, Kim JH, et al. Sonographically guided fine needle aspiration of thyroid nodule:discrepancies between cytologic and histopathologic findings[J]. J Clin Ultrasound, 2008, 36(1):6-11.
17. Kim DW, Lee EJ, Kim SH, et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules:comparison in efficacy according to nodule size[J]. Thyroid, 2009, 19(1):27-31.
18. De Fiori E, Rampinelli C, Turco F, et al. Role of operator experience in ultrasound-guided fine-needle aspiration biopsy of the thyroid[J]. Radiol Med, 2010, 115(4):612-618.
19. 吴亮, 杨顺实, 余芬, 等. 操作经验对超声引导下甲状腺结节细针穿刺活检的影响[J]. 中华内分泌外科杂志, 2012, 6(6):404-408.

West China Medical Journal

Effect of Puncture Methods on Ultrasound-guided Fine-needle Aspiration Biopsy of Thyroid Nodules

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