ECE2022 Oral Communications Oral Communications 14: Late Breaking (6 abstracts)
The effect of multiple passes to the same thyroid nodule in the fine needle aspiration biopsy session on obtaining adequate and/or the AUS/FLUS cytological result
Fatma Dilek Dellal Kahramanca 1 , Fatma Neslihan Cuhaci Seyrek 2 , Afra Alkan 3 , Oya Topaloglu 2 , Reyhan Ersoy 2 & Bekir Cakir 2
1Ankara City Hospital, Endocrinology and Metabolism, Ankara, Turkey; 2Ankara Yildirim Beyazit University, Faculty of Medicine, Endocrinology and Metabolism, Ankara, Turkey; 3Ankara Yildirim Beyazit University, Faculty of Medicine, Biostatistics, Ankara, Turkey
Aim: To determine whether multiple fine needle passes to the same thyroid nodule in the fine needle aspiration biopsy (FNA) session affect sufficient and/or atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) cytological result.
Materials and Methods: Ultrasonography (US) and cyto-histopathology results of the nodules of patients who were diagnosed with thyroid nodules and underwent FNA between May-August 2021 were retrospectively analyzed. The nodules were divided into two groups according to the number of needle passes performed in the same FNA session as those with one pass (one-pass group) and those with two or three passes (multiple-passes group). The two groups were compared in terms of cytological adequacy and the rate of AUS/FLUS diagnosis as well as US features and TIRADS scores.
Results: A total of 1500 thyroid nodules of 708 patients (575 female and 133 male) were included in the study. The mean age of the patients was 51.57±12.51 years. 1409 (93.9%) nodules were performed one pass, and 91 (6.1%) were performed two (n=85) or three passes (n=6). While the cystic/mixed nodule ratio and macrocalcification rate were higher in the multiple-passes group, the rates of coalescent nodules and presence of halo were higher in the one-pass group (P=0.001, P=0.039, P=0.006, and P=0.040, respectively). TIRADS 3 score was higher in multiple-passes group (P=0.001). The adequacy and AUS/FLUS ratios were similar in the two groups.When nodules with macrocalcifications and cystic/mixed structures were evaluated as two separate subgroups, the adequacy and AUS/FLUS ratios were similar in one-pass and multiple-passes groups.
| Features | One-pass (n=1409) | Multiple-passes (n=91) | P |
| Cystic/mixed structure [n (%)] | 87 (6.2) | 14 (15.4) | 0.001 |
| Presence of macrocalcification [n (%)] | 119 (8.4) | 14 (15.4) | 0.039 |
| Presence of peripheral halo [n (%)] | 250 (17.7) | 8 (8.8) | 0.040 |
| Coalescence [n (%)] | 149 (10.6) | 1 (1.1) | 0.006 |
| TIRADS Category | 0.003 | ||
| 3 | 73 (5.2) | 12 (13.2) | 0.001 |
| 4a | 702 (49.8) | 40 (44.0) | 0.278 |
| 4b | 579 (41.1) | 32 (35.2) | 0.265 |
| 4c | 55 (3.9) | 7 (7.7) | 0.078 |
| 5 | 0 (0.0) | 0 (0.0) | |
| Cytological sufficiency [n (%)] | 1033 (73.3) | 65 (71.4) | 0.694 |
| AUS/FLUS cytology [n (%)] | 240 (17.0) | 9 (9.9) | 0.103 |
Conclusion: Two or three passes to thyroid nodules have similar cytological adequacy and AUS/FLUS ratios compared to one pass.Although more passes are performed in cystic/mixed and macrocalcified nodules estimating that the material would be insufficient with macroscopic on-site evaluation, needle insertion of two or three times does not contribute to the adequacy and also the AUS/FLUS ratio compared to one pass.
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