Comparison of Aspiration versus Non-Aspiration Techniques in Fine-Needle Cytology of Thyroid Lesions

Abstract

Abstract Background Thyroid nodules are frequent among the general population. Ultrasound is the most commonly used imaging technique in the evaluation of thyroid nodules, Fine needle cytology (FNC) has been routinely used as the baseline investigation for diagnosis of nodular thyroid disease. Its advantages include minimal invasion and high sensitivity, specificity, and accuracy. Objective To compare the diagnostic quality of FNC sample obtained by aspiration versus non- aspiration techniques, aiming to improve the overall quality of FNC and hence better evaluation of thyroid nodules avoiding repeating FNC and unnecessary thyroidectomies. Patients and Methods Our study was conducted on 40 adult patients with thyroid nodules, whose ages range between 25 and 70 years old and were referred to undergo FNA procedures. Results 40 patients with thyroid nodules were included in this study, our results showed statistically significant improvement in overall quality of the samples obtained by the non-aspiration (FNNAC) technique with less cellular trauma, less background blood, better preservation of cellular architecture and less cellular degeneration, however, there was no significant difference in the amount of the cellular material obtained and shows statistically significant difference regarding the diagnostic quality of the samples with more diagnostically superior samples were acquired by the FNNAC than by FNAC (50% and 5% respectively), while FNAC acquired more diagnostically adequate samples than FNNAC (75% and 50% respectively), non-diagnostic samples were only 20% with FNAC and 0% with FNNAC. Conclusion Both aspiration and non-aspiration techniques can be implemented and used for acquiring cytology samples, however, non-aspiration technique (FNNAC) was associated with overall better-quality samples with statistically significant better performance compared to FNAC. Non-aspiration technique is more convenient for both the patient and for the operator.