title: Do immediate cytology and specialist radiologists improve the adequacy of ultrasound-guided fine-needle aspiration cytology?
abstract: OBJECTIVE
  To assess whether a dedicated "1-stop" neck lump clinic has improved the percentage of adequate fine-needle aspiration cytology (FNAC) samples and reduced the need for repeat FNAC.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  District General Hospital in the United Kingdom.
  
  
  METHODS
  Patients attending for ultrasound-guided FNAC over a 6-month period from August 2012 to February 2013. Patients were placed in 4 groups: group 1, FNAC performed by any of the subspecialist radiologists with cytology support (n = 100); group 2, FNAC performed by general radiologists without cytology support (n = 112); group 3, FNAC performed by a particular subspecialist radiologist with cytology support (n = 61); and group 4, FNAC performed by the same subspecialist radiologist without cytology support (n = 125).
  
  
  RESULTS
  There was a significantly higher rate of adequacy of FNAC in the presence of a subspecialist radiologist with immediate cytology (group 1) versus a general radiologist without cytology support (group 2; 87/100 vs 63/112, P = .0001), a significantly higher rate of adequacy of FNAC in the presence of cytology support with the same radiologist (group 3 vs group 4, 55/61 vs 97/125, P = .04), and a significantly higher rate of adequacy of FNAC in the presence of a subspecialist radiologist versus a general radiologist without cytology support (group 4 vs group 2, 97/125 vs 63/112, P = .0005).
  
  
  CONCLUSIONS
  Immediate cytology and the presence of a subspecialist radiologist increase the adequacy of FNAC. The adequacy rate of non-cytology-supported FNAC or nonsubspecialist FNAC is below the adequate rate expected from the literature or as recommended in national guidelines.
authors.affiliation: Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom sunilsharma@doctors.org.uk.
authors.forename: Sunil Dutt
authors.initials: SD
authors.lastname: Sharma
authors.affiliation: Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Kumar
authors.affiliation: Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom.
authors.forename: Avril
authors.initials: A
authors.lastname: Horsburgh
authors.affiliation: Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom.
authors.forename: Mahmuda
authors.initials: M
authors.lastname: Huq
authors.affiliation: Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom.
authors.forename: Raed
authors.initials: R
authors.lastname: Alkilani
authors.affiliation: Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Chawda
authors.affiliation: Department of Otorhinolaryngology, Queens Hospital, Rom Valley Way, Romford, Essex, United Kingdom.
authors.forename: Hesham
authors.initials: H
authors.lastname: Kaddour
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000592:standards*; D002983:Clinical Competence; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D061705:Image-Guided Biopsy / Q000592:standards*; D008297:Male; D008511:Medicine; D008875:Middle Aged; D011871:Radiology / Q000592:standards*; D012189:Retrospective Studies; D013997:Time Factors; D018084:Ultrasonography, Interventional; D006113:United Kingdom
keywords: audit; biopsy–fine needle; head and neck neoplasms