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27G İğne ve Aspirasyon Kullanılarak Yapılan İnce İğne Aspirasyon Biyopsisinin Etkinliği

Yıl 2025, Cilt: 51 Sayı: 3, 483 - 487, 08.12.2025
https://doi.org/10.32708/uutfd.1777070

Öz

Tiroid nodüllerinin tanı ve takibinde ultrasonografi (US) değerlendirmesi, hızlı, güvenilir, non-invaziv ve tekrarlanabilir bir görüntüleme yöntemi olarak diğer radyolojik tekniklerden üstündür. Literatürde birçok farklı tiroid nodülü biyopsi tekniği bildirilmiştir. Amacımız, 27G iğne ucu ve aspirasyon kanülü kullandığımız bir tekniğin sitopatolojik yeterliliğini değerlendirmektir. Ocak 2016-Aralık 2018 tarihleri arasında ince iğne aspirasyon biyopsisi (İİAB) yapılan toplam 116 hasta çalışmaya dahil edildi. Tüm biyopsileri 10 yıllık deneyime sahip aynı radyolog gerçekleştirdi. Biyopsi için steril cerrahi örtü, 27 gauge (G) iğne, 20 cc enjektör ve aspirasyon kanülü kullanıldı. Yaşları 14 ile 80 (ortalama 45,3, SD 15,8) arasında değişen toplam 116 hastanın (84 kadın, 32 erkek) İİAB sonuçları değerlendirildi. Nodüllerin boyutları 5-40 mm arasında, ortalama boyut 18±1,3 mm idi. Nodüllerin yaklaşık %53,4'ü sağ lobda, %44'ü sol lobda ve %2,6'sı istmustaydı. Toplam 54 olguya malignite, 19'una malignite şüphesi, 43'üne ise benign patoloji tanısı konuldu. Negatif basınçla birlikte 27G iğne ve aspirasyon kanülünü kullandığımız teknikte başarı oranımız %100'dü ve bu yaklaşımın hasta yönetimine önemli katkı sağladığını düşünüyoruz.

Kaynakça

  • 1. Periakaruppan G, Seshadri KG, Vignesh Krishna GM et al. Correlation between Ultrasound-based TIRADS and Bethesda System for Reporting Thyroid-cytopathology: 2-year Experience at a Tertiary Care Center in India. Indian J Endocrinol Metab. 2018;22(5):651-655.
  • 2. Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med. 1993;328(8):553-559.
  • 3. De Bernardi I.C, Floridi C, Muollo A. et al. Vascular and interventional radiology radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: literature review. Radiol med 2014; 119:512–520.
  • 4. Barile A, Quarchioni S., Bruno F et al. Interventional radiology of the thyroid gland: critical review and state of the art. Gland surgery 2018; 7:132–146.
  • 5. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009; 19:1167-214.
  • 6. Ogilvie JB, Piatigorsky EJ, Clark OH. Current status of fine needle aspiration for thyroid nodules. Adv Surg. 2006; 40:223-238.
  • 7. Robitschek J, Straub M, Wirtz E et al. Diagnostic efficacy of surgeon-performed ultrasound-guided fine needle aspiration: a randomized controlled trial. Otolaryngol Head Neck Surg. 2010; 142:306-309.
  • 8. Carmeci C, Jeffrey RB, McDougall IR et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses. Thyroid. 1998; 8:283-289.
  • 9. Cesur M, Corapcioglu D, Bulut S, et al. Comparison of palpation-guided fine-needle aspiration biopsy to ultrasound-guided fine-needle aspiration biopsy in the evaluation of thyroid nodules. Thyroid. 2006; 16:555-561.
  • 10. Bongiovanni M, Spitale A, Faquin WC et al. The Bethesda System for Reporting Thyroid Cytopathology: a meta-analysis. Acta Cytol. 2012; 56:333-339.
  • 11. Williams BA, Bullock MJ, Trites JR et al. Rates of thyroid malignancy by FNA diagnostic category. J Otolaryngol Head Neck Surg. 2013; 20:61.
  • 12. Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2009; 19:1159-1165.
  • 13. Paschke R, Hegedus L, Alexander E et al. Thyroid nodule guidelines: agreement, disagreement and need for future research. Nat Rev Endocrinol. 2011; 7:354-361.
  • 14. Pitman MB, Abele J, Ali SZ 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; 36:407-424.
  • 15. Tessler FN, Middleton WD, Grant EG et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol. 2017; 14:587-595.
  • 16. Ucak R, Eryilmaz OT, Ozguven BY, Uludag M, Kabukcuoğlu F. Evaluation of Thyroid Fine-Needle Aspiration Biopsies according to Cytological Methods and Comparison with Histopathological Diagnosis. Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):93-100.
  • 17.Wong LQ, Baloch ZW. Analysis of the bethesda system forreporting thyroid cytopathology and similar precursor thyroidcytopathology reporting schemes. Adv Anat Pathol. 2012;19:313-319.
  • 18.Braga M, Cavalcanti TC, Collaço LM et al. Efficacy ofultrasound-guided fine-needle aspiration biopsy in the diagnosis of complex thyroid nodules. J Clin Endocrinol Metab. 2001;86:4089-4091.
  • 19.Alexander EK, Heering JP, Benson CB et al. Assessment ofnondiagnostic ultrasound-guided fine needle aspirations ofthyroid nodules. J Clin Endocrinol Metab. 2002; 87:4924-4927.
  • 20.Arıbaş BK, Ünlü DN, Dingil G et al. The comparison Between21 G and 22 G Injector Needles in the Fine-Needle AspirationBiopsy of Thyroid Nodules AOT 2006; 39:85-89.
  • 21.Aslaner R, Şahin H, Şahin M et al. Effect of needle size on thediagnostic adequacy in fine needle aspiration of thyroidnodules. The Journal of TERH 2015; 25:13-18.
  • 22.Tangpricha V, Chen BJ, Swan NC et al. Twenty-one-gauge needles provide more cellular samples than twenty-five-gaugeneedles in fine-needle aspiration biopsy of the thyroid but maynot provide increased diagnostic accuracy. Thyroid. 2001;11:973-976.
  • 23.Hanbidge AE, Arenson AM, Shaw PA et al. Needle size andsample adequacy in ultrasound-guided biopsy of thyroidnodules. Can Assoc Radiol J. 1995; 46:199-201.
  • 24.Zhang L, Liu Y, Tan X et al. Comparison of Different-GaugeNeedles for Fine-Needle Aspiration Biopsy of ThyroidNodules. J Ultrasound Med. 2018; 37:1713-1716.
  • 25.Lee J, Kim BK, Sul HJ et al. Negative pressure is not necessaryfor using fine-needle aspiration biopsy to diagnose suspectedthyroid nodules: a prospective randomized study. Ann SurgTreat Res. 2019; 96:216-222.
  • 26.Khorsandi N, Balassanian R, Vohra P. Fine needle aspirationbiopsy in low- and middle-income countries. Diagn Cytopathol.2024 Aug;52(8):426-432.

Efficacy of Fine-Needle Aspiration Biopsy Using 27G Needle and Aspiration Cannula in Suspected Malignant Thyroid Nodules

Yıl 2025, Cilt: 51 Sayı: 3, 483 - 487, 08.12.2025
https://doi.org/10.32708/uutfd.1777070

Öz

Ultrasound (US) assessment for the diagnosis and follow-up of thyroid nodules is superior to other radiological techniques as being a fast, reliable, non-invasive, and repeatable imaging method. Many different thyroid nodule biopsy techniques have been reported in the literature. Our aim is to evaluate the cytopathological adequacy of a technique, in which we use a 27 gauge (G) needle and aspiration cannula. A total of 116 patients who underwent fine-needle aspiration biopsy (FNAB) between January 2016-December 2018 were included in the study. The same radiologist who has 10 years of experience performed all biopsies. A sterile surgical drape, 27 G needle, 20 cc syringe, and aspiration cannula were used for biopsy. The FNAB results of a total of 116 patients (84 females, 32 males) with an age range between 14 to 80 (mean 45.3, SD 15.8) years were evaluated. The sizes of the nodules were between 5-40 mm, and the mean size was 18±1.3 mm. About 53.4% of the nodules were on the right lobe, 44% on the left lobe, and 2.6% on the isthmus. A total of 54 cases were diagnosed with malignancy, 19 with a suspicion of malignancy, and 43 with benign pathologies. Our success rate was 100% in the technique, in which we use a 27G needle and aspiration cannula along with negative pressure, and we think that this approach significantly contributes to patient management.

Kaynakça

  • 1. Periakaruppan G, Seshadri KG, Vignesh Krishna GM et al. Correlation between Ultrasound-based TIRADS and Bethesda System for Reporting Thyroid-cytopathology: 2-year Experience at a Tertiary Care Center in India. Indian J Endocrinol Metab. 2018;22(5):651-655.
  • 2. Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med. 1993;328(8):553-559.
  • 3. De Bernardi I.C, Floridi C, Muollo A. et al. Vascular and interventional radiology radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: literature review. Radiol med 2014; 119:512–520.
  • 4. Barile A, Quarchioni S., Bruno F et al. Interventional radiology of the thyroid gland: critical review and state of the art. Gland surgery 2018; 7:132–146.
  • 5. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009; 19:1167-214.
  • 6. Ogilvie JB, Piatigorsky EJ, Clark OH. Current status of fine needle aspiration for thyroid nodules. Adv Surg. 2006; 40:223-238.
  • 7. Robitschek J, Straub M, Wirtz E et al. Diagnostic efficacy of surgeon-performed ultrasound-guided fine needle aspiration: a randomized controlled trial. Otolaryngol Head Neck Surg. 2010; 142:306-309.
  • 8. Carmeci C, Jeffrey RB, McDougall IR et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses. Thyroid. 1998; 8:283-289.
  • 9. Cesur M, Corapcioglu D, Bulut S, et al. Comparison of palpation-guided fine-needle aspiration biopsy to ultrasound-guided fine-needle aspiration biopsy in the evaluation of thyroid nodules. Thyroid. 2006; 16:555-561.
  • 10. Bongiovanni M, Spitale A, Faquin WC et al. The Bethesda System for Reporting Thyroid Cytopathology: a meta-analysis. Acta Cytol. 2012; 56:333-339.
  • 11. Williams BA, Bullock MJ, Trites JR et al. Rates of thyroid malignancy by FNA diagnostic category. J Otolaryngol Head Neck Surg. 2013; 20:61.
  • 12. Cibas ES, Ali SZ. The Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2009; 19:1159-1165.
  • 13. Paschke R, Hegedus L, Alexander E et al. Thyroid nodule guidelines: agreement, disagreement and need for future research. Nat Rev Endocrinol. 2011; 7:354-361.
  • 14. Pitman MB, Abele J, Ali SZ 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; 36:407-424.
  • 15. Tessler FN, Middleton WD, Grant EG et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol. 2017; 14:587-595.
  • 16. Ucak R, Eryilmaz OT, Ozguven BY, Uludag M, Kabukcuoğlu F. Evaluation of Thyroid Fine-Needle Aspiration Biopsies according to Cytological Methods and Comparison with Histopathological Diagnosis. Sisli Etfal Hastan Tip Bul. 2021 Mar 17;55(1):93-100.
  • 17.Wong LQ, Baloch ZW. Analysis of the bethesda system forreporting thyroid cytopathology and similar precursor thyroidcytopathology reporting schemes. Adv Anat Pathol. 2012;19:313-319.
  • 18.Braga M, Cavalcanti TC, Collaço LM et al. Efficacy ofultrasound-guided fine-needle aspiration biopsy in the diagnosis of complex thyroid nodules. J Clin Endocrinol Metab. 2001;86:4089-4091.
  • 19.Alexander EK, Heering JP, Benson CB et al. Assessment ofnondiagnostic ultrasound-guided fine needle aspirations ofthyroid nodules. J Clin Endocrinol Metab. 2002; 87:4924-4927.
  • 20.Arıbaş BK, Ünlü DN, Dingil G et al. The comparison Between21 G and 22 G Injector Needles in the Fine-Needle AspirationBiopsy of Thyroid Nodules AOT 2006; 39:85-89.
  • 21.Aslaner R, Şahin H, Şahin M et al. Effect of needle size on thediagnostic adequacy in fine needle aspiration of thyroidnodules. The Journal of TERH 2015; 25:13-18.
  • 22.Tangpricha V, Chen BJ, Swan NC et al. Twenty-one-gauge needles provide more cellular samples than twenty-five-gaugeneedles in fine-needle aspiration biopsy of the thyroid but maynot provide increased diagnostic accuracy. Thyroid. 2001;11:973-976.
  • 23.Hanbidge AE, Arenson AM, Shaw PA et al. Needle size andsample adequacy in ultrasound-guided biopsy of thyroidnodules. Can Assoc Radiol J. 1995; 46:199-201.
  • 24.Zhang L, Liu Y, Tan X et al. Comparison of Different-GaugeNeedles for Fine-Needle Aspiration Biopsy of ThyroidNodules. J Ultrasound Med. 2018; 37:1713-1716.
  • 25.Lee J, Kim BK, Sul HJ et al. Negative pressure is not necessaryfor using fine-needle aspiration biopsy to diagnose suspectedthyroid nodules: a prospective randomized study. Ann SurgTreat Res. 2019; 96:216-222.
  • 26.Khorsandi N, Balassanian R, Vohra P. Fine needle aspirationbiopsy in low- and middle-income countries. Diagn Cytopathol.2024 Aug;52(8):426-432.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

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

Gökhan Öngen 0000-0002-7348-0813

Gökhan Gökalp 0000-0002-3682-2474

Ömer Fatih Nas 0000-0001-6211-4191

Gönderilme Tarihi 2 Eylül 2025
Kabul Tarihi 15 Ekim 2025
Yayımlanma Tarihi 8 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 51 Sayı: 3

Kaynak Göster

AMA Öngen G, Gökalp G, Nas ÖF. Efficacy of Fine-Needle Aspiration Biopsy Using 27G Needle and Aspiration Cannula in Suspected Malignant Thyroid Nodules. Uludağ Tıp Derg. Aralık 2025;51(3):483-487. doi:10.32708/uutfd.1777070

ISSN: 1300-414X, e-ISSN: 2645-9027

Uludağ Üniversitesi Tıp Fakültesi Dergisi "Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License" ile lisanslanmaktadır.


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Journal of Uludag University Medical Faculty is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

2023