Araştırma Makalesi
BibTex RIS Kaynak Göster

Tiroid ince iğne aspirasyon biyopsisi: Nodüllerin radyolojik özelliklerinin sitolojik yeterlilik oranına etkisi

Yıl 2020, Cilt: 4 Sayı: 9, 790 - 793, 01.09.2020
https://doi.org/10.28982/josam.792221

Öz

Amaç: Tiroid ince iğne aspirasyon biyopsisi (İİAB), tiroid nodüllerinin tanısında kullanılan ucuz ve mikroinvaziv bir işlemdir. Bununla birlikte, biyopsilerin % 40'ına kadarında sitoloji yetersiz gelebilir. Bu çalışma, tiroid nodüllerinin radyolojik özelliklerinin sitolojik yeterlilik oranına etkisini değerlendirmeyi amaçlamıştır.
Yöntemler: Kliniğimizde, 2016-2019 yılları arasında tiroid nodul İİAB'si yapılan hastalar bu retrospektif kohort çalışmada incelendi. Nodüllerin tanısal yeterlilik oranı ve radyolojik özellikleri (boyut, kistik komponent, kalsifikasyon içeriği, ekojenite, sınır özelliği) not edildi ve aralarındaki ilişki araştırıldı.
Bulgular: Toplam 525 hastada (%77 kadın, %23 erkek; ortalama yaş 53.3; yaş aralığı 14-87) 595 nodüle İİAB yapıldı. Nodüllerin ortalama çapı 20.1 mm (min: 4 mm; maks: 60 mm) idi. Biyopsilerin %25'inde tanısal yetersizlik saptandı. Makrokalsifikasyon içeren nodüllerde yeterlilik anlamlı olarak düşüktü (P=0.036). Nodüllerin yeterlilik oranları ile ekojenite, sınır özelliği, solid yapısı veya boyutu arasında anlamlı bir ilişki yoktu (her biri için P>0.05).
Sonuç: Bazı radyolojik özellikler, yetersiz örneklemenin habercisi olabilir. Bununla birlikte, radyolojik özelliklerin yanı sıra çeşitli dış faktörler de sitopatolojik yeterliliği etkiler. Bu nodüllerde ek teknikler gerekebilir.

Kaynakça

  • 1. Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009;19(11):1159–65.
  • 2. Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytologica. 2012;56(4):333–9.
  • 3. Lee YH, Baek JH, Jung SL, Kwak JY, Kim JH, Shin JH. Ultrasound-guided fine needle aspiration of thyroid nodules: a consensus statement by the korean society of thyroid radiology. Korean J Radiol. 2015;16(2):391-401. doi: 10.3348/kjr.2015.16.2.391.
  • 4. Kim MJ, Kim EK, Park SI, Kim BM, Kwak JK, Kim SJ, et al. US-guided fine-needle aspiration of thyroid nodules: indications, techniques, results. Radiographics. 2008;28(7):1869-87. doi: 10.1148/rg.287085033.
  • 5. de Koster EJ, Kist JW, Vriens MR, Borel Rinkes IH, Valk GD, de Keizer B. Thyroid Ultrasound-Guided Fine-Needle Aspiration: The Positive Influence of On-Site Adequacy Assessment and Number of Needle Passes on Diagnostic Cytology Rate. Acta Cytol. 2016;60(1):39-45. doi: 10.1159/000444917.
  • 6. Veltri A, Bargellini I, Giorgi L, Almeida PAMS, Akhan O. CIRSE Guidelines on Percutaneous Needle Biopsy (PNB). Cardiovasc Intervent Radiol. 2017;40(10):1501-13. doi: 10.1007/s00270-017-1658-5.
  • 7. Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedüs L et al. American Association of Clinical Endocrinologists, American College of endocrinology and Associazione Medici Endocrinologi. Medical Guidelines for clinical practice for the diagnosis and management of thyroid nodules. 2016;22(5):622-39. doi: 10.4158/EP161208.G.L.
  • 8. Çayır D, Kulah B. Effects of preoperative fine needle aspiration biopsy on surgical strategy in patients with papillary thyroid carcinomas. J Surg Med. 2019;3(9):655-658.
  • 9. Baloch ZW, Cibas ES, Clark DP, Layfield LJ, Ljung BM, Pitman MB, et al. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. Cytojournal. 2008;5:6.
  • 10. Pitman MB, Abele J, Ali SZ, Duick D, Elsheikh TM, Jeffrey RB, et al. Techniques for thyroid FNA: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 2008;36:407-24.
  • 11. Fadda G, Basolo F, Bondi A, Bussolati G, Crescenzi A, Nappi O. Cytological classifi- cation of thyroid nodules. Proposal of the SIAPEC-IAP Italian Consensus Working Group. Pathologica. 2010;102,:405–8.
  • 12. Richards, ML, Bohnenblust E., Sirinek K. Bingener J. Nondiagnostic thyroid fine-needle aspiration biopsies are no longer a dilemma. American Journal of Surgery. 2008;196:398–402.
  • 13. Moon HJ, Kwak JY, Kim EK, Kim MJ. Ultrasonographic characteristics predictive of nondiagnostic results for fine-needle aspiration biopsies of thyroid nodules. Ultrasound in Medicine and Biology. 2011;37:549–55.
  • 14. Alexander EK, Heering JP, Benson CB, Frates MC, Doubilet PM, Cibas ES, et al: Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. J Clin Endocrinol Metab. 2002;87:4924–7.
  • 15. Degirmenci B, Haktanir A, Albayrak R, Acar M, Sahin DA, Sahin O et al. Sonographically guided fine-needle biopsy of thyroid nodules: the effects of nodule characteristics, sampling technique, and needle size on the adequacy of cytological material. Clin Radiol. 2007;62(8):798-803. doi: 10.1016/j.crad.2007.01.024.
  • 16. Grani G, Calvanese A, Carbotta G, D’Alessandri M, Nesca A, Bianchini M et al. Intrinsic factors affecting adequacy of thyroid nodule fine-needle aspiration cytology. Clin Endocrinol (Oxf). 2013;78(1):141-4. doi: 10.1111/j.1365-2265.2012.04507.x.
  • 17. Yi KS, Kim JH, Na DG, Seo H, Min HS, Won JK et al. Usefulness of core needle biopsy for thyroid nodules with macrocalcifications: comparison with fine-needle aspiration. Thyroid. 2015;25(6):657-64. doi: 10.1089/thy.2014.0596.
  • 18. Choi SH, Han KH, Yoon JH, Moon HJ, Son EJ, Youk JH, et al. Factors affecting inadequate sampling of ultrasound-guided fine-needle aspiration biopsy of thyroid nodules. Clin Endocrinol (Oxf). 2011;74:776–82.
  • 19. Belfiore A, La Rosa GL. Fine-needle aspiration biopsy of the thyroid. Endocrinol Metab Clin North Am. 2001;30:361–400.
  • 20. Nasuti JF, Gupta PK, Baloch ZW. Diagnostic value and cost-effectiveness of on-site evaluation of fine-needle aspiration specimens: review of 5,688 cases. Diagn Cytopathol. 2002;27:1–4.
  • 21. O’Malley ME, Weir MM, Hahn PF, Misdraji J, Wood BJ, Mueller PR. US-guided fine-needle aspiration biopsy of thyroid nodules: adequacy of cytologic material and procedure time with and without immediate cytologic analysis. Radiology. 2002;222:383–7.
  • 22. Eedes CR, Wang HH. Cost-effectiveness of immediate specimen adequacy assessment of thyroid fine-needle aspirations. Am J Clin Pathol. 2004;121:64–9.
  • 23. Ghofrani M, Beckman D, Rimm DL. The value of onsite adequacy assessment of thyroid fine-needle aspirations is a function of operator experience. Cancer. 2006;108:110–3.
  • 24. Gümüş M, Cay N, Algin O, Ipek A, Ersoy RÜ, Belenli O, et al. Comparison of 21 and 27 gauge needles for determining sample adequacy in the aspiration biopsy of thyroid nodules. Diagn Interv Radiol. 2012;18(1):102-5. doi: 10.4261/1305-3825.DIR.4340-11.1.
  • 25. Rausch P, Nowels K, Jeffrey Jr RB. Ultrasonographically guided thyroid biopsy: a review with emphasis on technique. J Ultrasound Med. 2001;20:79e85.

Thyroid fine needle aspiration biopsy: The effect of radiological features of nodules on cytological adequacy

Yıl 2020, Cilt: 4 Sayı: 9, 790 - 793, 01.09.2020
https://doi.org/10.28982/josam.792221

Öz

Aim: Thyroid fine needle aspiration biopsy (FNAB) is an inexpensive and microinvasive procedure used in the diagnosis of thyroid nodules. However, cytology may be insufficient in up to 40% of biopsies. This study aimed to assess the effect of radiological features of thyroid nodules on cytological adequacy.
Methods: The patients who underwent thyroid FNAB between 2016 and 2019 in our clinic were reviewed in this retrospective cohort study. Diagnostic adequacy rate and radiological features of nodules (size, cystic component, calcification content, echogenicity, margin feature) were noted and their relationship was investigated.
Results: A total of 525 patients (77% female, 23% male; mean age 53.3 years; age range 14-87) had FNAB for 595 nodules. Mean diameter of the nodules was 20.1 mm (min: 4mm; max: 60 mm). Of the all biopsies, 25% were inadequate for diagnosis. Adequacy was significantly low in nodules containing macrocalcification (P=0.036). There was no significant relationship between adequacy and echogenicity, margin feature, solid structure or size of the nodules (P>0.05 for each).
Conclusion: Some radiological features may be predictive of inadequate sampling. Nevertheless, varied extrinsic factors affect cytopathological adequacy besides radiological features. Additional techniques may be required in these nodules.

Kaynakça

  • 1. Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009;19(11):1159–65.
  • 2. Bongiovanni M, Spitale A, Faquin WC, Mazzucchelli L, Baloch ZW. The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytologica. 2012;56(4):333–9.
  • 3. Lee YH, Baek JH, Jung SL, Kwak JY, Kim JH, Shin JH. Ultrasound-guided fine needle aspiration of thyroid nodules: a consensus statement by the korean society of thyroid radiology. Korean J Radiol. 2015;16(2):391-401. doi: 10.3348/kjr.2015.16.2.391.
  • 4. Kim MJ, Kim EK, Park SI, Kim BM, Kwak JK, Kim SJ, et al. US-guided fine-needle aspiration of thyroid nodules: indications, techniques, results. Radiographics. 2008;28(7):1869-87. doi: 10.1148/rg.287085033.
  • 5. de Koster EJ, Kist JW, Vriens MR, Borel Rinkes IH, Valk GD, de Keizer B. Thyroid Ultrasound-Guided Fine-Needle Aspiration: The Positive Influence of On-Site Adequacy Assessment and Number of Needle Passes on Diagnostic Cytology Rate. Acta Cytol. 2016;60(1):39-45. doi: 10.1159/000444917.
  • 6. Veltri A, Bargellini I, Giorgi L, Almeida PAMS, Akhan O. CIRSE Guidelines on Percutaneous Needle Biopsy (PNB). Cardiovasc Intervent Radiol. 2017;40(10):1501-13. doi: 10.1007/s00270-017-1658-5.
  • 7. Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedüs L et al. American Association of Clinical Endocrinologists, American College of endocrinology and Associazione Medici Endocrinologi. Medical Guidelines for clinical practice for the diagnosis and management of thyroid nodules. 2016;22(5):622-39. doi: 10.4158/EP161208.G.L.
  • 8. Çayır D, Kulah B. Effects of preoperative fine needle aspiration biopsy on surgical strategy in patients with papillary thyroid carcinomas. J Surg Med. 2019;3(9):655-658.
  • 9. Baloch ZW, Cibas ES, Clark DP, Layfield LJ, Ljung BM, Pitman MB, et al. The National Cancer Institute Thyroid fine needle aspiration state of the science conference: a summation. Cytojournal. 2008;5:6.
  • 10. Pitman MB, Abele J, Ali SZ, Duick D, Elsheikh TM, Jeffrey RB, et al. Techniques for thyroid FNA: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 2008;36:407-24.
  • 11. Fadda G, Basolo F, Bondi A, Bussolati G, Crescenzi A, Nappi O. Cytological classifi- cation of thyroid nodules. Proposal of the SIAPEC-IAP Italian Consensus Working Group. Pathologica. 2010;102,:405–8.
  • 12. Richards, ML, Bohnenblust E., Sirinek K. Bingener J. Nondiagnostic thyroid fine-needle aspiration biopsies are no longer a dilemma. American Journal of Surgery. 2008;196:398–402.
  • 13. Moon HJ, Kwak JY, Kim EK, Kim MJ. Ultrasonographic characteristics predictive of nondiagnostic results for fine-needle aspiration biopsies of thyroid nodules. Ultrasound in Medicine and Biology. 2011;37:549–55.
  • 14. Alexander EK, Heering JP, Benson CB, Frates MC, Doubilet PM, Cibas ES, et al: Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. J Clin Endocrinol Metab. 2002;87:4924–7.
  • 15. Degirmenci B, Haktanir A, Albayrak R, Acar M, Sahin DA, Sahin O et al. Sonographically guided fine-needle biopsy of thyroid nodules: the effects of nodule characteristics, sampling technique, and needle size on the adequacy of cytological material. Clin Radiol. 2007;62(8):798-803. doi: 10.1016/j.crad.2007.01.024.
  • 16. Grani G, Calvanese A, Carbotta G, D’Alessandri M, Nesca A, Bianchini M et al. Intrinsic factors affecting adequacy of thyroid nodule fine-needle aspiration cytology. Clin Endocrinol (Oxf). 2013;78(1):141-4. doi: 10.1111/j.1365-2265.2012.04507.x.
  • 17. Yi KS, Kim JH, Na DG, Seo H, Min HS, Won JK et al. Usefulness of core needle biopsy for thyroid nodules with macrocalcifications: comparison with fine-needle aspiration. Thyroid. 2015;25(6):657-64. doi: 10.1089/thy.2014.0596.
  • 18. Choi SH, Han KH, Yoon JH, Moon HJ, Son EJ, Youk JH, et al. Factors affecting inadequate sampling of ultrasound-guided fine-needle aspiration biopsy of thyroid nodules. Clin Endocrinol (Oxf). 2011;74:776–82.
  • 19. Belfiore A, La Rosa GL. Fine-needle aspiration biopsy of the thyroid. Endocrinol Metab Clin North Am. 2001;30:361–400.
  • 20. Nasuti JF, Gupta PK, Baloch ZW. Diagnostic value and cost-effectiveness of on-site evaluation of fine-needle aspiration specimens: review of 5,688 cases. Diagn Cytopathol. 2002;27:1–4.
  • 21. O’Malley ME, Weir MM, Hahn PF, Misdraji J, Wood BJ, Mueller PR. US-guided fine-needle aspiration biopsy of thyroid nodules: adequacy of cytologic material and procedure time with and without immediate cytologic analysis. Radiology. 2002;222:383–7.
  • 22. Eedes CR, Wang HH. Cost-effectiveness of immediate specimen adequacy assessment of thyroid fine-needle aspirations. Am J Clin Pathol. 2004;121:64–9.
  • 23. Ghofrani M, Beckman D, Rimm DL. The value of onsite adequacy assessment of thyroid fine-needle aspirations is a function of operator experience. Cancer. 2006;108:110–3.
  • 24. Gümüş M, Cay N, Algin O, Ipek A, Ersoy RÜ, Belenli O, et al. Comparison of 21 and 27 gauge needles for determining sample adequacy in the aspiration biopsy of thyroid nodules. Diagn Interv Radiol. 2012;18(1):102-5. doi: 10.4261/1305-3825.DIR.4340-11.1.
  • 25. Rausch P, Nowels K, Jeffrey Jr RB. Ultrasonographically guided thyroid biopsy: a review with emphasis on technique. J Ultrasound Med. 2001;20:79e85.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Radyoloji ve Organ Görüntüleme
Bölüm Araştırma makalesi
Yazarlar

Cennet Şahin 0000-0002-8695-327X

Bade Von Bodelschwingh Bu kişi benim 0000-0002-4049-0222

Yayımlanma Tarihi 1 Eylül 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 4 Sayı: 9

Kaynak Göster

APA Şahin, C., & Von Bodelschwingh, B. (2020). Thyroid fine needle aspiration biopsy: The effect of radiological features of nodules on cytological adequacy. Journal of Surgery and Medicine, 4(9), 790-793. https://doi.org/10.28982/josam.792221
AMA Şahin C, Von Bodelschwingh B. Thyroid fine needle aspiration biopsy: The effect of radiological features of nodules on cytological adequacy. J Surg Med. Eylül 2020;4(9):790-793. doi:10.28982/josam.792221
Chicago Şahin, Cennet, ve Bade Von Bodelschwingh. “Thyroid Fine Needle Aspiration Biopsy: The Effect of Radiological Features of Nodules on Cytological Adequacy”. Journal of Surgery and Medicine 4, sy. 9 (Eylül 2020): 790-93. https://doi.org/10.28982/josam.792221.
EndNote Şahin C, Von Bodelschwingh B (01 Eylül 2020) Thyroid fine needle aspiration biopsy: The effect of radiological features of nodules on cytological adequacy. Journal of Surgery and Medicine 4 9 790–793.
IEEE C. Şahin ve B. Von Bodelschwingh, “Thyroid fine needle aspiration biopsy: The effect of radiological features of nodules on cytological adequacy”, J Surg Med, c. 4, sy. 9, ss. 790–793, 2020, doi: 10.28982/josam.792221.
ISNAD Şahin, Cennet - Von Bodelschwingh, Bade. “Thyroid Fine Needle Aspiration Biopsy: The Effect of Radiological Features of Nodules on Cytological Adequacy”. Journal of Surgery and Medicine 4/9 (Eylül 2020), 790-793. https://doi.org/10.28982/josam.792221.
JAMA Şahin C, Von Bodelschwingh B. Thyroid fine needle aspiration biopsy: The effect of radiological features of nodules on cytological adequacy. J Surg Med. 2020;4:790–793.
MLA Şahin, Cennet ve Bade Von Bodelschwingh. “Thyroid Fine Needle Aspiration Biopsy: The Effect of Radiological Features of Nodules on Cytological Adequacy”. Journal of Surgery and Medicine, c. 4, sy. 9, 2020, ss. 790-3, doi:10.28982/josam.792221.
Vancouver Şahin C, Von Bodelschwingh B. Thyroid fine needle aspiration biopsy: The effect of radiological features of nodules on cytological adequacy. J Surg Med. 2020;4(9):790-3.