Young Investigator Challenge: Building an ultrasound‐guided FNA clinic—our 5‐year experience: From project to practice

Abstract

The authors' fine-needle aspiration (FNA) clinic opened in 2010, allowing cytopathologists to increase their proficiency and experience in FNA performance. Here, they report their 5-year experience. The FNA clinic log book and the institution's database were retrospectively reviewed to record patients' demographics, the number of FNAs performed per year by each cytopathologist, the number of passes, rapid on-site evaluation (ROSE) and diagnosis, adequacy-diagnosis concordance, and follow-up histology when available. The numbers and types of cases per year and variations among cytopathologists were compared. In total, 474 cases were identified within a 5-year time-frame. The discrepancy rate between the on-site and final diagnoses decreased progressively, from 4.4% to 2.4%. The nondiagnostic rate decreased from 2011 to 2015, with the exception of 2014, when an increase was noted, possibly because of a lower number of cases. Cytopathologists' performance was assessed over a 3-year period. The number of passes for each FNA decreased over time. The cytology-histology concordance was 100% over time for all cytopathologists. There was a diagnostic discrepancy between the ROSE and final diagnoses for 3 of 104 cases in 2013 and for 3 of 124 cases in 2015. The total number of passes was not consistently recorded until 2014, when a final report template was instituted. The technique improved over time because of accumulated experience, constant practice with phantoms, and attending the College of American Pathologists' training in ultrasound-guided FNA. FNAs performed by cytopathologists have a high-rate of ROSE/adequacy and a low diagnostic discrepancy rate. Cytopathologists as interventionalists provide optimal care and excellent patient satisfaction. Cancer Cytopathol 2017;125:161-168. © 2016 American Cancer Society.