Tiroid Nodüllerinin İnce İğne Aspirasyon Biyopsisinde İkili Enjektör Modelinin Geleneksel Teknik ile Histopatolojik Sonuçlarının Karşılaştırılması

GİRİŞ ve AMAÇ: Çalışmamızda Ultrasonografi USG kılavuzluğunda geleneksel ince iğne aspirasyon biyopsisi İİAB ve yeni geliştirmiş olduğumuz ikili enjektör modeli ile İİAB işleminin başarı düzeyinin ölçülmesi çalışmamızın amacını oluşturmaktadır.YÖNTEM ve GEREÇLER: Aralık 2017-Mayıs 2018 tarihleri arasında klinisyen istemiyle tarafımıza yönlendirilen tiroid nodülü olan hasta grubunda bilgisayar ortamında tasarladığımız ve 3 boyutlu yazıcıdan çıktısını aldığımız ikili enjektör modeliyle USG klavuzluğunda aynı anda iki iğne ile 130 nodülden Grup 1 ince iğne aspirasyon biyopsisi yaptık. Alınan materyallerin histopatolojik sonuçlarını geleneksel yöntem olan tek iğne kullanılarak yine USG eşliğinde yapılan 169 Grup 2 adet İİAB sonuçları ile istatistiksel olarak karşılaştırdık. Sitolojik tanılar Bethesda sınıflaması baz alınarak yapılmış olup olguların ultrasonografi bulguları belirlenen kriterler dahilinde kaydedilmiştir.BULGULAR: Değerlendirilen olguların malign pozitif /benign negatif oranları, Grup 1 4/99 ile Grup 2 5/133 arasında farklı değildi p= 0,581 . Değerlendirmeye alınan Grup 1 olgularının %14,62 19/130 ’i yanlış, %85.38 111/130 ’u doğru, Grup 2 olgularının 12,43 21/169 ’ü yanlış, %87.57 148/169 ’si doğru, toplam %13,4 40/299 yanlış, %86,6 259/299 ’i doğru bulunmuştur.TARTIŞMA ve SONUÇ: Çalışmamızda ikili enjektör modeli kullanılarak yapılan tirod biyopsisi başarılı bir metod olarak bulunmuştur.

Anahtar Kelimeler:

Tiroid, Aspirasyon biyopsisi, Tiroid nodülü

A comparison of the histopathological results of thyroid nodule biopsy applied with ultrasound-guided traditional technique fine needle aspiration and a novel dual-injector model fine needle aspiration

INTRODUCTION: To compare the cytological aspects of traditional ultrasound guided fine needle aspiration biopsy FNAB with the newly developed dual injector model, as the measurement of successMETHODS: A total of 130 thyroid nodules Group 1 were applied with ultrasound-guided fine needle aspiration biopsy with two needles at the same time. This technique was designed in a computer environment and a 3D printed dual injector model was applied to the patient group between December 2017-May 2018. The histopathological results of the obtained materials were statistically compared with the results of 169 Group 2 thyroid nodule FNAB biopsies using a single needle, which is the ultrasound-guided traditional method. Cytological diagnoses were based on the Bethesda classification and ultrasonography findings of the cases were recorded within the specified criteria.RESULTS: No difference was determined in the malignant positive /benign negative ratios of the evaluated cases in Group 1 4/99 and Group 2 5/133 p = 0.581 . In Group 1, the diagnosis was incorrect in 14.62% 19/130 and correct in 85.38% 111/130 of cases. In Group 2, the diagnosis was incorrect in 12.43 21/169 and correct in 87.57% 148/169 of cases. For the whole sample, these rates were 13.4% 40/299 incorrect and 86.6% 259/299 correctly.DISCUSSION AND CONCLUSION: The results of this study showed succesful method in the results of thyroid biopsies made using the binary injector model that was developed in a computer.

Keywords:

Thyroid, Aspiration biopsy, Thyroid nodules,

PDF

___

Kelly NP, Um JC, DeJong S, Harmath C, Dudiak C, Wojcik EM. Specimen adequacy and diagnostic specificity of ultrasound- guided fine needle aspirations of nonpalpable thyroid nodules. Diagn Cytopathol 2006; 34:188-90
Nabriski D, Ness-Abramof R, Brosh TO, Konen O, Shapiro MS, Shenkman L. Clinical relevance of non-palpabl thyroid nodules as assessed by ultrasound-guided fine needle aspiration biopsy. J Endocrinol Invest. 2003; 26:3-4
Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg 2014;140:317-22
Cai XJ, Valiyaparambath N, Nixon P,Waghorn A, Giles T, Helliwell T. Ultrasoundguided fine needle aspiration cytology in the diagnosis and managment of thyroid nodules. Cytopathology 2006;17:251-6
Koike E, Noguchi S, Yamashita H, Murakami T, Ohshima A, Kawamoto H et al. Ultrasonographic characteristics of thyroid nodules: prediction of malignancy. Arch Surg. 2001;136:334- 7
Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG et al. Society of Radiologists in Ultrasound: Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology. 2005; 237:794-800
Chan BK, Desser TS, McDougall IR, Weigel RJ, Jeffrey RB Jr (2003) Common and uncommon sonographic features of papillary thyroid carcinoma. J Ultrasound Med 22:1083-90
Iannuccilli JD, Cronan JJ, Monchik JM. Risk for malignancy of thyroid nodules as assessed by sonographic criteria: the need for biopsy. J Ultrasound Med 2004; 23:1455-64
Papini E, Guglielmi R, Bianchini A. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 2002; 87:1941-6.
Corrias A, Einaudi S, Chiorboli E. Accuracy of fine needle aspiration biopsy of thyroid nodules in detecting malignancy in childhood: comparison with conventional clinical, laboratory, and imaging approaches. J Clin Endocrinol Metab 2001; 86:4644-8
Kwak JY, Han KH, Yoon JH, Moon HJ, Son EJ, Park SH et al. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk. Radiology 2011; 260:892–9.
Salmaslioglu A, Erbil Y, Dural C, Issever H, Kapran Y, Ozarmagan S et al. Predictive value of sonographic features in preoperative evaluation of malignant thyroid nodules in a multinodular goiter. World J Surg 2008; 32:1948–54.
Gul K, Ersoy R, Dirikoc A, Korukluoglu B, Ersoy PE, Aydin R et al. Ultrasonographic evaluation of thyroid nodules: comparison histopathological findings. Endocrine 2009; 36:464–72.
Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab 2006: 91:3411-7 cytological, and
Nam-Goong IS, Kim HY, Gong G, Lee HK, Hong SJ, Kim WB et al. Ultrasonography-guided fineneedle aspiration of thyroid incidentaloma: correlation with pathological findings. Clin Endocrinol 2004: 60:21–8
Henrichsen TL, Reading CC, Charboneau JW, Donovan DJ, Sebo TJ, Hay ID. Cystic change in thyroid carcinoma: prevalence and estimated volume in 360 carcinomas. J Clin Ultrasound 2010; 38:361–6
Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: Ann Intern Med. 1993; 118:282-9
Hamberger B, Gharib H, Melton LJ 3rd, Goellner JR, Zinsmeister AR. Fine-needle aspiration biopsy of thyroid nodules: impact on thyroid practice and cost of care. Am J Med 1982; 73:381-4
Danese D, Sciacchitano S, Farsetti A, Andreoli M, Pontecorvi A. Diagnostic accuracy of conventional versus sonography- guided fine-needle aspiration biopsy of thyroid nodules. Thyroid 1998; 8:15–21.
Carmeci C, Jeffrey RB, McDougall IR, Nowels KW, Weigel RJ. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses. Thyroid 1998; 8:283–9.
Stangierski A, Wolinski K, Martin K, Leitgeber O, RuchalaM. Core needle biopsy of thyroid nodules - evaluation of diagnostic utility and pain experience. Neuro Endocrinol Lett 2013; 34:798–801
Nasrollah N, Trimboli P, Rossi F et al. Patient’s comfort with and tolerability of thyroid core needle biopsy. Endocrine 2013; 45:79–83
Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F et al. CM. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color Doppler features. J Clin Endocrinol Metab 2002; 87:1941-6
Kuma K, Matsuzuka F, Yokozawa T, Miyauchi A, Sugawara M. Fate of untreated benign thyroid nodules: results of long- term follow-up. World J Surg. 1994; 18:495-8
Rumack CM, Wilson SR, Charboneau JW. Diagnostic Ultrasound Third edition. Mosby 2005 (1):736-43.