Francisco Jose Campoy-Balbontin MD, Presenter: Nothing to Disclose

Carmen Jurado-Gomez MD, Abstract Co-Author: Nothing to Disclose

To determine the best way of obtaining sufficient cytological material (SCM) when performing thyroid nodule FNB.

From January to November 2011, 335 patients (312 women, 23 men; aged from 19 to 87 years, mean age 54.7) were evaluated by US by a senior radiologist, who performed FNNAB to 335 nodules (6.4-82 mm; mean 25.8 mm), according the guideline of the Society of Radiologist in Ultrasound. During 2008, 335 patients (302 women, 33 men; aged 15-89 years, mean 55.6) with 335 thyroid nodules (5-70 mm; mean 24.5 mm) were studied by US. FNAB were performed by different attending Pathologists, guided by palpation or a skin mark done by a Radiologist according to nodule size criteria. The procedures were carried out in the same hospital, covering the same area population disease. Both groups were retrospectively compared taken into consideration their cytological results, adapted from the Bethesda Classification System. The cytological results from Radiologist and Pathologists were Statistically confronted by Χ2 (Significance p<0.005).

The cytological results obtained by the Radiologist were: T1, 17.9%; T2, 65.4%; T3, 8.1%; T4, 3%; T5, 3.6%, and T6, 2.1% (T=Thyroid). The cytological results obtained by the Pathologists were T1, 18.5%; T2, 78.2%; T3, 0,6%; T4, 0.9%; T5, 1.8% and T6, 0%. There is no significance difference among the cytological results obtained by the Radiologist and Pathologists (FNNAB versus FNAB). The SCM rate is similar between both groups. According to cytological results three groups are created: A surgical group (T4, T5, T6); a non-surgical group (T2); and a third group formed by T1 and T3, where FNB is going to be repeated. FNNAB detected more nodules in the surgical group (p<0.005).

There is no difference between the SCM obtained by FNNAB and FNAB; as FNNAB is easier to perform, we suggest it should be considered as the first step, considering FNAB an alternative when scarce specimen is obtained in the first needle pass. FNNAB is associated in our work to an increase rate in the diagnosis of surgical nodules, probably this is a consequence of using a well established guideline for choosing the nodule, and that FNNAB had always been performed US-Guided.

FNB should be done following a well established guideline, to find out the most suspicious nodule; and must always be US-guided, to target in the periphery and solid part of the nodule.

Campoy-Balbontin, F, Jurado-Gomez, C, Fine Needle Aspiration Biopsy (FNAB) versus US-Guided Fine Needle Non-Aspiration Biopsy (FNNAB) in Fine Needle Biopsy (FNB) of the Thyroid Nodule.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12023624.html