title: How can we reduce the pain associated with FNA biopsy? Comparison of parallel and perpendicular method.
abstract: OBJECTIVE
  To assess the tolerability of two different biopsy methods for thyroid nodules in a patient with nodular thyroid disease (NTD).
  
  
  METHODS
  The study included 58 consecutive patients who had NTD from June 2014 to October 2015. Each patient had, at least, two thyroid nodules were located in two lobes. Parallel and perpendicular fine-needle aspirations (FNAs) were performed.
  
  
  RESULTS
  The mean maximum diameters of the assessed thyroid nodules using ultrasound (US) in parallel and perpendicular techniques were 23 ± 7 and 22 ± 6 mm, respectively. Nodule sizes were not significantly different (p > 0.05). For the parallel and perpendicular techniques, the mean numeric rating scale (NRS), verbal rating scale (VRS), and visual analog scale (VAS) values were 3.6 ± 1.9, 2.6 ± 1.1, and 17.2 ± 13 with 6.6 ± 1.7, 3.4 ± 0.5, and 37.8 ± 18, respectively. All these values were statistically significant (p < 0.001); there were no statistical differences between females and males in terms of three pain scales (p < 0.001).
  
  
  CONCLUSIONS
  Patients experienced significantly less pain when undergoing FNA of NTD using the parallel technique as opposed to the perpendicular technique. Therefore, we believe that FNA using parallel technique is preferable for NTD patients.
authors.affiliation: Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey. drihsany@gmail.com.
authors.forename: Ihsan
authors.initials: I
authors.lastname: Yuce
authors.affiliation: Department of Medical Oncology, School of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Turkeli
authors.affiliation: Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Eren
authors.affiliation: Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Akin
authors.initials: A
authors.lastname: Levent
authors.affiliation: Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Sade
authors.affiliation: Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Mecit
authors.initials: M
authors.lastname: Kantarci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement / Q000379:methods; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology*; D018084:Ultrasonography, Interventional; D055815:Young Adult
keywords: Biopsy; Pain; Parallel; Perpendicular; Thyroid gland