Landau Elliot, Del Re Danielle, Kviatkovsky Bina, Rothstein Aryeh, Scheiner Jonathan, Lin Cheryl
Department of Radiology, Staten Island University Hospital, Staten Island, New York, NY, USA.
Touro College of Osteopathic Medicine, New York, NY, USA.
J Clin Imaging Sci. 2017 Jan 27;7:4. doi: 10.4103/2156-7514.199054. eCollection 2017.
Since 2009, the rate of nondiagnostic (ND) thyroid nodule fine-needle aspiration (FNA) has ranged from 2% to 20%. A ND result can cause further patient morbidity secondary to repeated procedures and delay in diagnosis. The use of real-time strain elastography (RTE) in determining nodule malignant risk has gained considerable focus recently. A less studied area where RTE may prove beneficial is its role in targeting areas for FNA. Our hypothesis is that FNA performed in concurrence with RTE will show a decreased rate of ND results leading to fewer repeated FNA.
The Institutional Review Board approval was obtained. A retrospective review of all thyroid nodule FNA from January 1, 2011, to January 1, 2014, was performed with review of nodule size, presence of microcalcifications, vascularity, solid components, patient age, and gender. Cases were separated based if RTE was done before FNA or not. Pathology reports were reviewed to assess for specimen adequacy. Statistical comparison was performed using SAS analysis software.
A total of 221 specimens were reviewed, with RTE performed on 140 cases (63.4%). Both groups were similar in demographics and previously described nodule characteristics. The ND rate when RTE was not performed was 16% (13/68) compared to 10% when RTE was performed (14/126). The difference was not found to be statistically significant, P = 0.205.
The presence of an elastogram failed to demonstrate a significant decrease in ND FNA rates although these results may be secondary to study design. Further evaluation with prospective trials using larger sample size may ultimately detect increased accuracy of RTE-targeted FNA.
自2009年以来，甲状腺结节细针穿刺活检（FNA）的非诊断性（ND）率在2%至20%之间。非诊断性结果可能会因重复操作和诊断延迟而导致患者进一步发病。最近，实时应变弹性成像（RTE）在确定结节恶性风险方面受到了相当大的关注。RTE可能发挥有益作用的一个较少研究的领域是其在FNA靶向区域方面的作用。我们的假设是，与RTE同时进行的FNA将显示非诊断性结果的发生率降低，从而减少重复FNA的次数。
获得了机构审查委员会的批准。对2011年1月1日至2014年1月1日期间所有甲状腺结节FNA进行回顾性分析，审查结节大小、微钙化的存在、血管分布、实性成分、患者年龄和性别。根据FNA前是否进行RTE对病例进行分类。审查病理报告以评估标本是否充足。使用SAS分析软件进行统计比较。
共审查了221份标本，其中140例（63.4%）进行了RTE检查。两组在人口统计学和先前描述的结节特征方面相似。未进行RTE时的非诊断性率为16%（13/68），而进行RTE时为10%（14/126）。差异无统计学意义，P = 0.205。
弹性成像的存在未能显示非诊断性FNA率有显著降低，尽管这些结果可能归因于研究设计。使用更大样本量进行前瞻性试验的进一步评估最终可能会发现RTE靶向FNA的准确性提高。
