# Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

- Link: https://sifsof.com/clinical-apps/ultrasound-guided-fine-needle-aspiration-biopsy-of-the-thyroid/
- Published: 2021-09-29T14:40:06+00:00
- Author: Developer

 Ultrasound-guided fine-needle aspiration biopsy (FNAB) is a reliable, minimally
invasive diagnostic method with high sensitivity and specificity in the evaluation
of thyroid nodules or abnormality such as papillary thyroid carcinoma within the
thyroid and remove a tissue sample for examination under a microscope. The procedure
is less invasive than surgical biopsy, leaves little to no scarring and does not
involve exposure to ionizing radiation. suggestive of malignancy.

Nodule development is a commonly seen entity in the thyroid gland, and 4–7% of the
adult population has a palpable thyroid nodules. With imaging modalities, especially
the widespread use of ultrasound, nonpalpable thyroid nodules are being detected
in 19–70% of the population. While ultrasound has a high sensitivity in detecting
thyroid nodules, it is not sensitive enough in differentiating between benign and
malign nodules.  

According to the WHO classification system, papillary thyroid microcarcinomas (PTMCs)
are PTCs <10 mm in diameter. Early cancer detection and intervention has been suggested
to reduce patient’s mortality and morbidity. Given its minimal invasiveness and 
technical simplicity, ultrasound-guided fine-needle aspiration biopsy (US-FNAB) 
has been widely adopted for characterizing thyroid nodules[ cytopathologically ](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369843/#b4-cmar-11-1231)
The cytology results will help to determine whether or not subsequent thyroidectomy
is necessary. According to the American Thyroid Association (ATA) guideline, US-
FNAB is recommended for those thyroid nodules with a diameter >10 mm those with 
intermediate to[ high suspicion US pattern](https://pubmed.ncbi.nlm.nih.gov/26462967/).
On the other hand, for patients with nodules ≤10 mm of suspicious US pattern, active
sonographic surveillance is recommended instead.

The needle used is a thin, fine-gauge needle that is smaller in diameter than the
needle used in most blood draws (usually a 25 or 27 gauge 1.5 inch needle). The 
aspiration may be done with a needle or with a needle that is attached to a syringe.
The syringe may be in a plastic or metal holder to make it easier for the doctor
to aspirate the cells.

The use of US-guidance for FNAB allows real-time visualization of the needle, but
is also highly operator-dependent. Physicians from many specialties (endocrinologists,
otolaryngologists/endocrine surgeons, nuclear medicine physicians, radiologists,
and pathologists) are involved in the diagnostic workup of thyroid nodules and a
standardized and meticulous technique for US-FNAB is essential for lowering the 
yield of nondiagnostic specimens and false-negative results. A linear 7.2–14 MHz
probe and 26G fine needle are often used.

Despite the high accuracy of FNAB in the detection of malignancy, the percentage
of inadequate samples is around 10%, and in some centers this rate remains as high
as 20–34%. Repeated biopsies due to inadequacy can lead to patient anxiety, increased
costs, and unnecessary surgery. Thus biopsies should be executed under the guidance
of a reliable advanced performance ultrasound. The ultrasound system should offer
superior imaging and detail, designed to optimize viewing, and to provide an ergonomic
workplace of Physicians from many specialties.

For this delicate procedure we highly recommend the Color Doppler Laptop Multi-Head
Ultrasound Scanner [SIFULTRAS-6.6](https://sifsof.com/product/color-doppler-laptop-multi-head-ultrasound-scanner-sifultras-6-6/)
along with the **L7SVA-V Linear Probe** to minimize inadequate samples . This scanner
uses the latest advances in transducer technology, which has wider bandwidth, higher
sensitivity and better signal-noise ratio, providing superb anatomic details to 
users, delivering excellent resolution, especially during delicate-patient scanning
such as in the case of Fine Needle Aspiration Biopsy of the Thyroid.

This procedure os performed by an elligible endocrinologists*

Reference: [Comparison of Number of Passes and Cytopathological Specimen Adequacy for Thyroid Fine-Needle Aspiration Biopsy in the Absence of an On-Site Pathologist](https://www.karger.com/Article/FullText/504094)

 * ![Color Doppler Laptop Multi-Head Ultrasound Scanner SIFULTRAS-6.6 main pic](
   https://sifsof.com/wp-content/uploads/2019/11/SIFULTRAS-6.6-Main-Pic-300x300.
   jpg)
 * Color Doppler Laptop Multi-Head Ultrasound Scanner SIFULTRAS-6.6