ULTRASOUND GUIDED FINE NEEDLE ASPIRATION VERSUS NON-ASPIRATION TECHNIQUES IN THE EVALUATION OF SOLID THYROID NODULES AND THEIR DIAGNOSTIC EFFICACY COMPARED TO TISSUE HISTOPATHOLOGY

Abstract

Abstract Aim of study: Comparison between the Fine needle Non-Aspiration Cytology (FNNAC) and Fine Needle Aspiration Cytology (FNAC) in acquiring ultrasound guided fine needle cytology (FNC) samples from solid thyroid nodules to determine the better technique, hence improving the sample quality aiming to decrease the number of unnecessary thyroidectomies. Patients & methods: 48 patients with solid thyroid nodules included in this study according to TIRADS guidelines, 4 samples were obtained for each nodule, 2 samples were obtained using FNNAC while the other 2 obtained using FNAC, samples were obtained by the same operator and evaluated blindly by the same pathologist according to the following criteria: Background blood, cellular yield, degree of cellular trauma, and cellular architecture, each criterion is evaluated by score from 1 to 3 where score 3 is the best and worst is 1, the total score is calculated for each sample and used for comparison of the sample quality. Results: Prospective study showed statistically significant increase in cellular yield, preservation of cellular architecture and decrease in cellular trauma along with statistically significant increase in total sample quality with FNNAC (p value = 0.32, 0.004, 0.011, 0.21 respectively), and statistically insignificant difference in background blood in the sample (P value = 0.8). Regarding sample convenience, FNNAC was found to be more convenient for both the patient (syringe is not seen by the patient reducing discomfort) and for the operator (better handling of the needle and less maneuvers).