EP48 – Capillary versus Aspiration Techniques in Fine Needle Biopsies of Thyroid Nodules in a Community Setting

      Strand, Mark1,3; Fornelli, Rick1, 2,3 1 Department of Otolaryngology, University of Pittsburgh Medical Center- Hamot, Erie, PA, USA 2 Department of Otolaryngology, West Virginia University School of Medicine, Morgantown, West Virginia, USA 3 Ear Nose & Throat Specialists of Northwestern Pennsylvania, Erie, PA, USA Background/Purpose: This study provides clinicians with relevant information regarding the variety of techniques used when performing thyroid needle biopsies and their diagnostic rates. Objectives: To compare the adequacy rates of obtaining a diagnostic specimen in thyroid nodules by comparing ultrasound-guided fine-needle aspiration (FNA), fine-needle capillary (FNC), and a combination of both (FNAC) techniques. Methods: A retrospective cohort study was performed of consecutive needle thyroid biopsies over a 13 month period by radiologists at two area referral centers. The sonographic, pathologic, and biopsy procedure reports were reviewed to determine nodule size, adequacy of specimen, pathologic diagnosis, number of needle passes, slides prepared and technique used. The differences between variables were determined using descriptive statistics. Results: A total of 259 fine needle thyroid biopsies were performed with an overall non-diagnostic rate of 19%. FNA, FNC, and FNAC biopsies were performed on 68, 155, 36 nodules respectively. The nondiagnostic rate in FNA sampling was 51%, 6% in FNC, and 19% in FNAC sampling. Discussion: This study gives a unique perspective on the challenges of thyroid needle biopsies in a community setting with a variety of specialists performing and interpreting thyroid needle biopsies.  Future studies are needed to evaluate the impact of nondiagnostic specimens on patient discomfort and health care costs. Conclusion: Our results indicate that FNC resulted in lower nondiagnostic rates than FNA and FNAC. Incorporation of capillary techniques into a clinician’s armamentarium may help limit the number of nondiagnostic specimens.   References:
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