Endocrine Abstracts

FNA of the thyroid is used for fast and early assessment of thyroid nodules, however it is sensitivity as a useful diagnostic test depends largely on the technique, experience of the aspirator and expertise of the cytologist. We undertook a retrospective audit of FNA to evaluate our results and compliance with the national guidelines.

We examined 121 patients had FNAs at Pinderfields Hospital from October 2000 to June 2007. The cohort was comprised of 106 females. Mean age 53±16 years. One hundred and ninety-six FNA were recorded, 63 patients had one FNA, while the rest had more than once, we recorded the quality of documentation including technique, consent, and site of the aspiration, aspirator, size of needle, number of passes, transport medium and thyroid function status as well as cytology report of each FNA and the outcome.

One hundred and twenty-three FNA cytologies yielded a diagnostic result (66.6%), 66 patients had surgery, and cancer was confirmed in 9 patients (7.4%). We examined the diagnostic yield of each FNA for each aspirator, and results were as follow; aspirator A (62% n=74), B (81% n=26), C (63% n=27), D (69% n=13), E (62.5% n=8), F (33% n=3), G (33% n=3), H (43% n=3). Diagnostic results per each cytologist was as follow; A (53% n=64), B (76% n=54), C (63% n=9), D (91% n=11), E (65% n=40). Overall the percentage of diagnostic FNAs was 56±17.4%. THY classification of FNA cytologies led to more FNAs being repeated to comply with the national guidelines, 77 FNAs were repeated based on this classification. About 12±16 weeks was the average time lapse between GP referral and clinic review and 18±18 weeks to FNA. Cytology reports were available in 6.6±9 days following FNA.

Our results were comparable with the national standards. Our practice of FNA has changed since the publication of thyroid cancer guidelines which led to more structured approach to the management of patients with thyroid nodules.