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TÜRELİ, DERYA

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TÜRELİ

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2015 - 20172
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    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, Erkin
    Background 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.
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    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, Erkin
    Background: 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.