Person: TÜRELİ, DERYA
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TÜRELİ
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DERYA
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Publication Metadata only Thyroid fine needle aspiration biopsy: Do we really need an on-site cytopathologist?(ELSEVIER IRELAND LTD, 2014) TÜRELİ, DERYA; Cengic, Ismet; Tureli, Derya; Ahiskali, Rengin; Bugdayci, Onur; Aydin, Hilal; Aribal, ErkinPurpose: The aim of this single center study is to evaluate the effectiveness of performing ultrasound-guided thyroid fine-needle aspiration biopsies (FNAB) performed by the radiologist alone without an on-site cytopathologist. Materials and methods: In this prospective randomized study, 203 patients with single nodules measuring 10 mm or more underwent ultrasound-guided FNAB: 102 patients underwent FNAB performed by the radiologist accompanied by a cytopathologist (control group); 101 patients underwent FNAB by the radiologist alone (study group). In both groups biopsy time, specimen adequacy ratio, total aspiration number, cytopathologist's cytological diagnosis time (t1), cytopathologist's total time consumption (t2) were evaluated. Results: Mean total biopsy time was 8.74 +/- 2.31 min in the study group and was significantly shorter than the control group's 11.97 +/- 6.75 min (p = 0.004). The average number of aspirations per patient in the study group was 4.00 +/- 0; compared to the control group's 3.56 +/- 1.23 this was significantly higher (p = 0.001). t1 of the study group was 307.48 +/- 226.32 s; compared to 350.14 +/- 247.64 s in the control group, there was no statistically significant difference (p = 0.137). t2 of the study group was 672.93 +/- 270.45 s; compared to the control group (707.03 perpendicular to 258.78 s) there was no statistically significant difference (p = 0.360). Diagnostic adequacy of aspirated specimens was reassessed in the pathology laboratory. In the study group, 84 out of 101 aspirations and in the control group 89 out of 102 aspirations was determined as adequate with no statistically significant difference (p = 0.302). Conclusions: We believe that in centers where a cytopathologist is not available, ultrasound-guided thyroid FNAB can be adequately performed by an experienced radiologist who was effectively trained in smear preparation. (C) 2014 Elsevier Ireland Ltd. All rights reserved.Publication Metadata only Thyroid fine needle aspiration biopsy: do nodule volume and cystic degeneration ratio affect specimen adequacy and cytological diagnosis time?(SAGE PUBLICATIONS LTD, 2015) TÜRELİ, DERYA; Cengic, Ismet; Tureli, Derya; Ozden, Ferhat; Bugdayci, Onur; Aydin, Hilal; Aribal, ErkinBackground A fine needle aspiration biopsy (FNAB) of thyroid nodules - the least invasive and most accurate method used to investigate malignant lesions - may yield non-diagnostic specimens even under ultrasonographic guidance. Purpose To evaluate the effects of thyroid nodule volume and extent of cystic degeneration on both the non-diagnostic specimen ratio as well as cytopathologist's definitive cytological diagnosis time. Material and Methods In this single center study, FNAB was performed on 505 patients with single thyroid nodules greater than 10mm. Nodule volume was calculated prior to FNAB and cystic degeneration ratio was recorded. All biopsies were performed by a single radiologist who also prepared specimen slides. Specimen adequacy and final diagnosis were made in the pathology laboratory by a single-blinded cytopathologist based on the Bethesda system. Definitive cytological diagnosis time was recorded upon reaching a definitive diagnosis. Results The specimen adequacy ratio was 85.3%. The mean nodule volume of adequate specimens was larger than those of non-diagnostic samples (6.00mL vs. 3.05mL; P=0.001). There was no correlation between nodule volume and cytopathologist's definitive cytological diagnosis time (r=0.042). Biopsy of predominantly solid nodules yielded better specimen adequacy ratios compared to predominantly cystic nodules (87.8% vs. 75.3%; P=0.028). Definitive cytological diagnosis times were longer in predominantly cystic nodules compared to predominantly solid nodules (376s vs. 294s; P=0.019). Conclusion Predominantly cystic nodules are likely to benefit from repeated nodular sampling until the specimen is declared adequate by an on-site cytopathologist. If a cytopathologist is not available, obtaining more specimens per nodule may achieve desired adequacy ratios.Publication Metadata only Effects of nodule characteristics on sampling number and duration of thyroid fine-needle aspiration biopsy: size does not matter, but cystic degeneration ratio does(SAGE PUBLICATIONS LTD, 2017) TÜRELİ, DERYA; Cengic, Ismet; Tureli, Derya; Altas, Hilal; Ozden, Ferhat; Bugdayci, Onur; Aribal, ErkinBackground: Ultrasound-guided fine needle aspiration biopsy (FNAB) of thyroid nodules, though the most accurate method to rule out malignancy, still has an inherent risk of yielding non-diagnostic specimens despite immediate assessment of specimen adequacy by an on-site cytopathologist. Purpose: To evaluate the effects of nodule volume and extent of cystic degeneration on total biopsy time and number of aspirations required for obtaining an adequate specimen. Material and Methods: A total of 510 patients underwent FNAB by a single radiologist accompanied by a cytopathologist who immediately assessed each sample for specimen adequacy. All sampled nodules were single and had one maximum diameter > 10 mm. Nodule volumes and cystic degeneration ratios were calculated prior to the intervention. Aspirations were repeated until the cytological material was deemed adequate by the cytopathologist; the number of aspirations and total biopsy time were then recorded. Results: Nodule volumes did not have significant effect on neither number of aspirations necessary for achieving specimen adequacy (P > 0.05) nor total biopsy time (r = -0.148 with P = 0.001). Predominantly cystic nodules, compared to predominantly solid nodules, required more sampling per nodule (4.58 +/- 1.11 vs. 3.44 +/- 1.19 aspirations, P = 0.001) and longer total biopsy time (16.40 +/- 6.19 vs. 11.15 +/- 6.18 min, P = 0.001). Conclusion: Predominantly cystic nodules require allocation of more time for biopsy. To ensure specimen adequacy when immediate specimen evaluation by an on-site cytopathologist is not possible, four samples from predominantly solid nodules and five passes through predominantly cystic nodules are required.