Comparison of palpation-guided fine-needle aspiration biopsy to ultrasound-guided fine-needle aspiration biopsy in the evaluation of thyroid nodules.
Author(s): Cesur M, Corapcioglu D, Bulut S, Gursoy A, Yilmaz AE, Erdogan N, Kamel N
Publication: Thyroid, 2006, Vol. 16, Page 555-61
PubMed ID: 16839257 PubMed Review Paper? No
Purpose of Paper
This paper compared palpation-guided (PG) and ultrasound-guided (UG) fine needle aspiration biopsies (FNAB) on the recovery of sufficient material for accurate diagnosis and also investigated the effects of nodule size on specimen adequacy.
Conclusion of Paper
UG-FNAB was more likely to yield adequate material for diagnosis and resulted in higher sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy than PG-FNAB. Specimen adequacy was also affected by nodule size, with larger nodules (16-25 mm) more likely to yield adequate material than small nodules (10-15 mm).
Studies
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Study Purpose
This study compared the accuracy of PG- and UG-FNAB and investigated the effects of nodule size on obtaining sufficient material for diagnosis. A total of 285 palpable nodules of 1-2.5 cm from 215 patients were first biopsied under PG and then under UG by the same operator. Subsequent surgical resection was performed for 15 patients. All specimens underwent cytological and histological analysis (using an unspecified preservation and visualization method) by a single cytologist that was blind to the guidance method used during biopsy.
Summary of Findings:
Inadequate material for diagnosis was obtained in more PG-FNAB than UG-FNAB specimens (32.3% versus 21.4%, p=0.004) and occurred more frequently for small nodules (10-15 mm) than large nodules (16-25 mm) both when PG (37.6% and 25.8%, p=0.03) and UG (34.2% and 18%, p=0.02) were used, but otherwise cytological findings occurred with similar frequency. UG-FNAB resulted in higher sensitivity (85.7% versus 57.1%), specificity (89.5% versus 84.2%), PPV (75% versus 57.1%), NPV (94.4% versus 84.2%), and accuracy (88.5% versus 76.9%) compared to PG-FNAB.
Biospecimens
Preservative Types
- Ethanol
- None (Fresh)
- Formalin
Diagnoses:
- Neoplastic - Carcinoma
- Neoplastic - Benign
Platform:
Analyte Technology Platform Morphology H-and-E microscopy Morphology Light microscopy Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Method of tissue acquisition Palpation-guided aspiration
Ultrasound-guided biopsy
Preaquisition Prognostic factor 10-15 mm nodule
16-25 mm nodule