World Journal of Endocrine Surgery

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VOLUME 3 , ISSUE 3 ( September-December, 2011 ) > List of Articles

RESEARCH ARTICLE

Surgeon-performed Ultrasound-guided Needle Biopsy of the Thyroid: A Safe and Effective Diagnostic Procedure

Michael T Law, Martyn Taylor, Ian C Bennett

Citation Information : Law MT, Taylor M, Bennett IC. Surgeon-performed Ultrasound-guided Needle Biopsy of the Thyroid: A Safe and Effective Diagnostic Procedure. World J Endoc Surg 2011; 3 (3):116-121.

DOI: 10.5005/jp-journals-10002-1072

Published Online: 01-12-2014

Copyright Statement:  Copyright © 2011; The Author(s).


Abstract

With the ready availability of good quality portable units, office-based ultrasound (US) is increasingly being utilized by endocrine surgeons in their daily practices, particularly in the management of thyroid patients. Ultrasound-guided fine needle aspiration biopsy (US-FNAB) of thyroid lesions is a useful interventional diagnostic technique which can be readily performed by endocrine surgeons as an office-based procedure offering significant convenience for the patient. A retrospective review of US-FNAB's performed in a single surgeon practice between 2006 and 2008 was undertaken particularly assessing the diagnostic outcomes and complication rates. Factors affecting FNAB outcome were tested using Chi-square test and significance defined as p < 0.05. A total of 128 FNABs were performed on 100 patients in the time period under review. Mean lesion size was 22 mm, and the majority were solid on US. US-FNAB had sensitivity of 85%, accuracy 75%. No complications were reported. A total of 14.8% of samples were reported as either malignant, atypical or with Hurthle cell findings. In this series of patients, 22% of cases proceeded to thyroidectomy, 46% of which yielded malignancy. The nondiagnostic rate was only 5.5%. Solid lesions < 2 cm were associated with higher nondiagnostic rate (p = 0.04). Surgeon-performed thyroid US-FNAB is a safe and effective procedure which compares favorably to radiologist-performed series and offers a convenient ‘one-stop’ process for patients. In this series, it was associated with a low nondiagnostic rate and a low complication rate. Surgeon-performed US-FNAB techniques can be easily acquired; however, structured training and appropriate credentialing are important for the maintenance of quality assurance standards.


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  1. Fine needle aspiration biopsy of benign thyroid nodules: An evidence-based review. World J Surg 2008;32:1247-52.
  2. Comparison of palpationguided fine needle aspiration biopsy to US-guided fine needle aspiration biopsy of the evaluation of thyroid nodules. Thyroid 2006;16:555-61.
  3. Evidence-based assessment of the role of ultrasonography in the management of benign thyroid nodules. World J Surg 2008;32:1253-63.
  4. Surgeon-performed ultrasound in patients referred for thyroid disease improves patient care by minimizing performance of unnecessary procedures and optimizing surgical treatment. World J Surg June 2010;34(6): 1164-70.
  5. asum.com.au/site/index.php Qualifications; CCPU Certificate in Clinician Performed Ultrasound 2010.
  6. The national cancer institute thyroid fine needle aspiration state of the science conference: A summation. Cyto Journal 2008;5(6):1-17.
  7. Thyroid gland: US screening in a random adult population. Radiology 1991;181: 683-87.
  8. Sonographically guided percutaneous biopsy of small masses. AJR 1988;151:189-92.
  9. Use of ultrasoundguided fine needle aspiration biopsy in the management of thyroid disease. The American Surgeon 1998;64:738-42.
  10. An overview of office-based ultrasonography: New versions of an old technology. Otolaryngology—Head and Neck Surgery 2004;131:1001-03.
  11. The role of ultrasonography-guided fine needle aspiration guided biopsy in the management of nonpalpable and palpable thyroid nodules. Thyroid 1998;8:511-15.
  12. Ultrasound-guided fine needle aspiration biopsy of the thyroid. Cancer 1999;87(5):299-305.
  13. The results of ultrasound-guided fine needle aspiration biopsy for evaluation of nodular thyroid disease. Surgery 2002;132(4):648-53; discussion 653-54.
  14. Ultrasound guidance improves the accuracy of our preoperative thyroid cytology but not its accuracy. Cytopathology 2006;17: 137-44.
  15. Cost-effectiveness of immediate specimen adequacy assessment of thyroid fine needle aspirations. Am J Clin Pathol 2004;121:64-69.
  16. Ultrasound-guided fine needle aspiration biopsy of thyroid nodules performed in the office. The Laryngoscope 2008;118:228-31.
  17. Adequacy of surgeon-performed ultrasound-guided thyroid fine needle aspiration biopsy. Otolaryngology—Head and Neck Surgery 2008;139:27-31.
  18. Thyroid nodules: Clinical effect of ultrasound-guided fine-needle aspiration biopsy. J Clin Ultrasound 1994;22:535-42.
  19. Ultrasound-guided fine needle aspiration biopsy of thyroid masses. Thyroid 1998;8:283-89.
  20. Training, credentialing and re-credentialing for the performance of a thyroid FNA. Diagnostic Cytopathology 2008;36:400-06.
  21. Fine-needle aspiration biopsy of the thyroid. CMAJ 2002;167:491-95.
  22. Ultrasonography for the endocrine surgeon: A valuable clinical tool that enhances diagnostic and therapeutic outcomes. J Surg 2005;138:1193-201.
  23. Evaluation of ultrasound-guided fine needle aspiration biopsy for thyroid nodules. Am J Surg 1998;175:133-36.
  24. Ultrasonographically guided thyroid biopsy: A review with emphasis on technique. J Ultrasound Med 20:79-85.
  25. Ultrasound-guided fine needle aspiration biopsy of the thyroid: Role of on-site assessment and multiple cytologic preparations. Diagn Cytopathol 2000;23:425-29.
  26. Diagnostic value and costeffectiveness of on-site evaluation of fine needle aspiration specimens: Review of 5,688 cases. Diagn Cytopathol July 2002; 27(1):1-4.
  27. US-guided fine needle aspiration biopsy of thyroid nodules: Adequacy of cytologic material and procedure time with and without immediate cytologic analysis. Radiology 2002;222:383-87.
  28. Ultrasound-guided fine needle aspiration and thyroid disease. Otolaryngol Head Neck Surg 2000;123:700-05.
  29. Unsatisfactory consequences from fine needle aspiration biopsy of thyroid nodules. Thyroid 2008;18(5): 491-92.
  30. Structured ultrasonography workshop for breast surgeons: Is it an effective training tool? World Journal of Surgery 2010;34(3):549-54.
  31. Surgical Innovation 2008;15(1):52-58.
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