Diagnostic efficacy of ultrasound-guided fine needle aspiration performed by head and neck surgeon: the first year experience in single institute
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Background and Objectives: To investigate the effectiveness of fine needle aspiration (FNA) and core needle biopsy (CNB) performed by a head and neck surgeon for head and neck mass lesion.
Subjects and Method: The study included 322 cases of US-FNA & US-NBC performed by a single surgeon between 2017and 2018. Their medical histories and ultrasound (US) findings were retrospectively reviewed. Sample adequacy was analyzed according to the surgeon’s experience, anatomic tumor location, and US tumor characteristics. The sensitivity, specificity, positive predictive value (PPV), negative pre- dictive value (NPV), and diagnostic accuracy of FNAC were calculated after correlation with the surgical histopathologic results.
Results: The overall adequacy rate for surgeon-performed US-FNAC was 91.9 % (295/322). Inadequate specimens were obtained from 9.7 % (16/168). The effect of the surgeon’s experience plateaued (inadequate sampling rate, 6–8 %) after 100 US- FNAC procedures. Inadequate sampling was associated with tumor characteristics such as cystic change and rim calcification. Overall, US-FNAC showed a sensitivity of 88.2 %, a specificity of 98.2 %, a PPV of 98.5 %, an NPV of 85.7 %, and a diagnostic accuracy of 91.6 %.
Conclusion: With proper training and experience managing at least 100 US-FNAC cases, surgeons can ensure a low inadequate sampling rate and good diagnostic accuracy for a range of head and neck mass lesions.
Two Approaches to Level 5 Neck Dissection
- Jeff Blumberg