Thyroid fine needle aspiration specimen adequacy: a noninferiority study and cost-effectiveness comparison of puncture needles.

Needle selection plays a pivotal role in determining the success of fine needle aspiration (FNA) procedures. Two commonly utilized puncture needles for thyroid FNA are the conventional syringe needle and the stylet needle. Syringe needles are known for their cost-effectiveness in comparison to stylet needles. This study aimed to determine if FNA with syringe needles is non-inferior to FNA with stylet needles in terms of specimen adequacy while also comparing the direct costs associated with both needle types. A total of 220 thyroid nodules from 185 patients were prospectively included in this study. The same operator performed a total of four punctures on the same nodule twice using a syringe and a stylet needle. The results of this study show that the utilization of syringe needles for thyroid FNA was non-inferior to the use of stylet needles in terms of specimen adequacy. Cost analysis revealed that syringe needle FNA was not only less expensive (CNY 500.9 versus CNY 780) but also more effective (adequacy 85.91% versus 84.55%). In summary, given the global prevalence of FNA procedures, the economic considerations are paramount, and our findings support the routine use of syringe needles in thyroid FNA.