Ultrasound-guided needle aspiration: impact of immediate cytologic review.
OBJECTIVE
To compare the diagnostic adequacy of ultrasound-guided fine-needle aspiration biopsy (USFNA) of the head and neck with immediate on-site microscopic evaluation and feedback by a cytopathologist (IMMEDIATE) versus delayed examination without immediate feedback (DELAYED).


METHODS
Retrospective chart review of office-based USFNA performed in both IMMEDIATE and DELAYED settings by the same otolaryngologist.


METHODS
A total of 199 USFNA procedures in the head and neck were performed by one practitioner. Of these procedures, 137 biopsies were performed in the DELAYED setting, whereas 62 biopsies were performed in the IMMEDIATE setting. Cytopathology reports were reviewed for diagnostic conclusions as well as adequacy of biopsies. The results from both settings were compared using Pearson χ2 test.


RESULTS
The ability to obtain a diagnosis from USFNA was 73.0% in the DELAYED group as compared with 90.3% in the IMMEDIATE group. The rate of adequate cells on biopsy was 89.1% in the DELAYED group as compared with 96.8% in the IMMEDIATE group. There was a statistically significant difference between observed and expected diagnostic rates (χ(2)[1] = 7.568, P = .006) and a trend toward a significant difference between the observed and expected adequacy rates (χ(2)[1] = 3.259, P = .071) when IMMEDIATE evaluation by a cytopathologist was performed.


CONCLUSIONS
An immediate microscopic evaluation of USFNA specimens to confirm adequacy of sampling is strongly recommended. Diagnostic conclusions were increased when an evaluation of the specimen was performed at the time of biopsy. The specimen adequacy rate tended to increase with an immediate cytopathologic assessment. Laryngoscope, 2010.
Moberly
Aaron C
AC
Richard L Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
Vural
Emre
E
Nahas
Bari
B
Bergeson
Tonya R
TR
Kokoska
Mimi S
MS
D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D018084:Ultrasonography, Interventional