Abstract
Objective To compare the cytology quality of ultrasound-guided fine-needle biopsy in thyroid nodules with 22-, 23-, and 25-gauge (G) needles prospectively. Methods A total of 240 consecutive nodules underwent ultrasound-guided fine-needle aspiration (USG-FNA) and 240 nodules underwent ultrasound-guided fine-needle capillary (USG-FNC) were included in this prospective study from October 2014 to February 2016. Each nodule was sampled using 22 G, 23 G, and 25 G needle according to designed orders, and 1240 smears were finally obtained. Cytology quality was scored by a cytologist blinded to needle selection. Results In USG-FNA, the average scores and standard deviations were 5.50 ± 2.87 for 25 G needles, 4.82 ± 2.95 for 23 G needles, and 5.19 ± 2.81 for 22 G needles. In USG-FNC, the average scores and standard deviations of each group were 5.12 ± 2.69 for 25 G, 4.60 ± 2.90 for 23 G, and 4.90 ± 2.90 for 22 G needles. The specimen quality scores of 25 G group were significantly higher than that of 23 G group (P < 0.017) in both USG-FNA and USG-FNC. However, the differences were not statistically significant in nondiagnostic rate using different gauge of needles (P > 0.017 for all). Conclusions 25 G needles obtained the highest scores of sample quality in thyroid FNA and FNC comparing with 22 G and 23 G needles. 25 G needle should be first choice of thyroid FNA and FNC in routine work.
Highlights
There is an increasing population of thyroid nodule patients in the world
Cytology results of Ultrasound-guided fine needle biopsy (USG-FNB) in thyroid nodules can be affected by many factors including punctuation method, needle gauges and types, passes of punctuation, and sample preparation [2, 5, 6]
Target nodules were selected according to the guidelines of the European Thyroid Association (ETA) and the American Thyroid Association for the management of thyroid nodules and differentiated thyroid cancer [1, 11]
Summary
There is an increasing population of thyroid nodule patients in the world. About 30%~60% of the adult harbors at least one thyroid nodule. Cytology results of USG-FNB in thyroid nodules can be affected by many factors including punctuation method (ultrasound-guided fine needle aspiration and ultrasound-guided fine needle capillary, USG-FNA and USG-FNC), needle gauges and types, passes of punctuation, and sample preparation [2, 5, 6]. 22-25-gauge needles were most commonly used in the majority of reported studies [1, 2, 10]. It had not been evaluated how needle gauge affected cytology specimen quality in routine work of USGFNA and USG-FNC.
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