Does the site of aspiration affect the efficacy of ultrasound-guided fine needle aspiration biopsy of thyroid nodules?

Abstract

Objective: To investigate whether the choice of a hypovascular or a hypervascular site of a thyroid nodule affects the efficacy of the ultrasound-guided fine needle aspiration procedure or not. Methods: Sixty solid thyroid nodules in 60 patients with hypo- and hypervascular parts were included in this prospective clinical study. Under color Doppler sonographic guidance, the fine needle aspiration was made with 22-gauge needle. Radiological and cytological features as well as the adequacy of samples were noted and compared. Results: Sonographically, 25 nodules (41.7%) were hetereogenous and calcified, 21 were hypoechoic (35%), 10 were isoechoic (16.7%) and 4 were hyperechoic (6.6%). Rate of adequate sampling when only hypervascular was used or hypovascular sites were evaluated were 81.7% and 83.3%, respectively. When both sites were evaluated together, rate of adequate sampling was found to be 91.7% in total. Presence and distribution of endothelial cells in the sample seems not to influence the diagnostic value of the procedure. Conclusion: Our results indicate that vascularity of a thyroid nodule outlined by color Doppler sonography can aid in optimizing the efficiency of fine-needle aspiration biopsy. The samples obtained from aspirates of hypo- and hypervascular sites are both complementary and assessment of these sites together yields better results in terms of diagnostic accuracy.

Keywords

• Thyroid, nodule, diagnosis, ultrasonography, fine-needle aspiration, color Doppler

Aspirasyon yerinin tiroid nodüllerinin ultrason destekli jet iğne biyopsisi verimliliği üzerindeki etkileri

Öz

Amaç: Çalışmanın amacı ultrason destekli jet iğne biyopsisinde hipovasküler ya da hipervasküler tiroid nodül tercihinin prosedür verimliliğine etkisinin incelenmesidir. Yöntem: Bu prospektif çalışmada hipovasküler ve hipervasküler tiroid nodülleri olan 60 hasta değerlendirilmiştir. Renkli Doppler sonografik yönlendirme altında 22 numara iğne ile jet iğne biyopsisi gerçekleştirmiştir. Radyolojik ve sitolojik faktörler ve numunelerin yeterliliği değerlendirilmiş ve karşılaştırılmıştır. Bulgular: Sonografik olarak 25 nodül (%41.7) heterojen ve kalsifiye, 21 nodül hipoekoik (%35), 10 nodül izoekoik (%16.7) ve 4 nodül (%6.6) hiperekoik olarak tanımlanmıştır. Yalnızca hipervasküler ve hipovasküler nodüller değerlendirildiğinde yeterli örneklem oranı %81.7 ve %83.3 olarak ölçülmüştür. Her iki grup beraber değerlendirildiğinde toplam yeterli örneklem oranı %91.7 olarak bulunmuştur. Örneklerde endotelyal hücrelerin bulunmasının ya da bu hücrelerin dağılımının prosedürün teşhis değerini etkilemediği görülmüştür. Sonuç: Elde ettiğimiz sonuçlara göre renkli Doppler sonografisi ile tiroid nodüllerinin vaskülaritesinin incelenmesinin jet iğne biyopsisinin etkinliğini optimize edebileceği görülmüştür. Hipovasküler ve hipervasküler bölgelerde yapılan biyopsiler birbirini tamamlayıcıdır ve bu verilerin birlikte kullanılması teşhis doğruluğunu arttırmaktadır.

Anahtar Kelimeler

• Tiroid, nodül, tanı, ultrason, ince iğne aspirasyonu, renkli Doppler

Kaynakça

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28. Please cite this article as: Çakmakcı E, Tokgöz Özal S, Kolçak Türko¤lu Ö, Uçan B, Kaygusuz U, Dinç T, Ece D. Does the site of aspiration affect
29. the efficacy of ultrasound-guided fine needle aspiration biopsy of thyroid nodules? ENT Updates 2015;5(1):13–18.